Health System Response to COVID-19 Epidemic in India

Abstarct

The coronavirus disease 2019 (COVID-19) epidemic, detected first in China in December 2019, is now rapidly spreading across the world. India responded by drawing up National Containment Plan for COVID-19 that envisaged screening of people for COVID-19 for early detection of infection, providing community, primary health care-centered management for those with mild infection, tertiary care for those with severe infection, and health education to the population to reduce person-to-person transmission of infection. To minimize the spread of infection from other countries, all travelers were screened and quarantined; in the third week of March, India imposed ban on all international travel. To prevent person-to-person spread, congregation of people for commercial, educational, entertainment, sports, religious, and other social activities was banned. To minimize intracity, interstate, and urban rural spread, India imposed nationwide lockdown on 25th March 2020. The lockdown flattened the epidemic curve and provided needed time for the country to reorganize the health system, so that it can provide needed care for the increasing number of COVID-19 patients at all levels of health care. National guidelines for screening of people for severe acute respiratory syndrome-coronavirus-2 infection, quarantine, and home isolation and care of infected people were drawn up and implemented. Health education on methods by which person-to-person transmission of infection can be minimized has been provided using all media of communication. Global comparison shows that currently India has low infection rates, low fatality rates per 1,00,000, and high recovery rates. There are ongoing research studies to document the course and outcome of COVID-19 in India. Clinical trials of potential drugs for treatment of severe infections and vaccines for preventing infection in the high-risk groups are underway. A COVID-19 disease surveillance program is underway to track the infection rates and bring appropriate midcourse corrections in interventions. In the coming months, the people and health system will not only have to evolve a sustainable strategy to provide needed care for COVID-19 cases but also ensure that all other health care programs are implemented and patients with other illnesses get optimal care too.

Keywords

COVID-19 epidemic - health system response - health education - national guidelines - home care - hospital-based care

Publikationsverlauf

Artikel online veröffentlicht:
11. Juni 2020

• References

• 1 WHO. Coronavirus Disease (COVID-2019) Situation Reports. Available at: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/situation-reports. Accessed May 15, 2020
• 2 MoHFW. Containment Plan for Novel Coronavirus Disease 2019 (COVID 19). Available at: https://ncdc.gov.in/showfile.php?lid=528. Accessed May 15, 2020
• 3 MoHFW. COVID-19 India. Available at: https://www.mohfw.gov.in/.in/covid-19/. Accessed May 15, 2020
• 4 WHO. International Health Regulations. Available at: https://www.who.int/ihr/publications/9789241580496/en/. Accessed May 15, 2020
• 5 GOK. Official Kerala COVID-19 Statistics. Available at: https://dashboard.kerala.gov.in/. Accessed May 15, 2020
• 6 MoHFW. Guidelines for Quarantine Facilities COVID-19. Available at: https://ncdc.gov.in/showfile.php?lid=504. Accessed May 15, 2020
• 7 MoHFW. Guidelines for home quarantine. Available at: https://www.mohfw.gov.in/pdf/Guidelinesforhomequarantine.pdf. Accessed May 15, 2020
• 8 MoHFW. Revised Guidelines for Quarantine Facilities COVID-19. Available at: https://ncdc.gov.in/showfile.php?lid=552. Accessed May 15, 2020
• 9 MoHFW. Additional Guidelines for Quarantine of Returnees from Abroad/Contacts/Isolation of Suspect or Confirmed Cases in Private Facilities. Available at: https://www.mohfw.gov.in/pdf/Additionalguidelinesforquarantineofreturneesfromabroadc ontactsisolationofsuspectorconfirmedcaseinprivatefacilities.pdf. Accessed May 15, 2020
• 10 MoHFW. COVID-l9: Railway Coaches. Available at: https://www.mohfw.gov.in/pdf/GuidanceDocumentonappropriatemanagementofsuspectconfirmedcasesofCOVID19RailwayCoachesCOVIDCareCenters.pdf. Accessed May 15, 2020
• 11 MoHFW. Lockdown. Available at: https://www.mohfw.gov.in/pdf/Annexure_MHA.pdf. Accessed May 15, 2020
• 12 ICMR Revised Strategy of COVID19 Testing in India. Available at: https://www.icmr.gov.in/cteststrat.html. Accessed May 15, 2020
• 13 ICMR Guidelines for COVID19 Testing in Private Laboratories. Available at: https://www.mohfw.gov.in/pdf/NotificationofICMRguidelines for COVID 19 testinginpriva telaboratoriesi India.pdf. Accessed May 15, 2020
• 14 ICMR Sentinel Surveillance to Detect Community Transmission of COVID-19. Available at: https://www.icmr.gov.in/cteststrat.htm. Accessed May 15, 2020
• 15 MoHFW. District level Facility Based Surveillance for COVID-19 https://www.mohfw.gov.in/pdf/DistrictlevelFacilitybasedsurveillanceforCOVID19.pdf. Accessed May 15, 2020
• 16 MoHFW. Guidelines for Home Based Care of 2019-nCoV Novel Corona Virus (2019-nCoV). Available at: https://ncdc.gov.in/showfile.php?lid=462. Accessed May 15, 2020
• 17 MoHFW. Guidelines on Clinical Management of Severe Acute Respiratory Illness (SARI) in Suspect/Confirmed Novel Coronavirus (nCoV) Cases. Available at: https://ncdc.gov.in/showfile.php?lid=458. Accessed May 15, 2020
• 18 MoHFW. Guidelines for Screening Centres. Available at: https://ncdc.gov.in/showfile.php?lid=452. Accessed May 15, 2020
• 19 MoHFW. Guidelines for Elderly and High Risk Groups to Safeguard from COVID- 19 Outbreak. Available at: https://ncdc.gov.in/showfile.php?lid=526. Accessed May 15, 2020
• 20 MoHFW. COVID 19 Guidelines for Setting Up Isolation Facility/Ward. Available at: https://ncdc.gov.in/showfile.php?lid=503. Accessed May 15, 2020
• 21 MoHFW. Discharge Policy of 2019-n CoV Case. Available at: https://ncdc.gov.in/showfile.php?lid=505. Accessed May 15, 2020
• 22 Guidelines for handling, treatment and disposal of waste generated during treatment/diagnosis/quarantine of COVID-19 patients. Available at: https://ncdc.gov.in/showfile.php?lid=551. Accessed May 15, 2020
• 23 MoHFW. Enabling Delivery of Essential Health Services during the COVID 19 Outbreak: Guidance Note. Available at: https://www.mohfw.gov.in/pdf/EssentialservicesduringCOVID19. Accessed May 15, 2020
• 24 Anesi GL Coronavirus disease. (COVID-19): Critical Care and Airway Management Issues. Available at: https://www.uptodate.com/contents/coronavirus-disease-2019-covid-19-critical-care-and-airway-management-issues. Accessed May 15, 2020
• 25 MoHFW. Protective Measures against Corona Virus. Available at: https://www.mohfw.gov.in/pdf/ProtectivemeasuresEng.pdf. Accessed May 15, 2020
• 26 Office of Principal Scientific Advisor to GoI Homemade Masks to Overcome Shortage. Available at: https://pib.gov.in/newsite/PrintRelease.aspx?relid=200916. Accessed May 15, 2020
• 27 Office of Principal Scientific Advisor to GoI Masks for Curbing the Spread of SARS-CoV-2 Coronavirus. Available at: http://bit.ly/DIYMasksCorona. Accessed May 15, 2020
• 28 Cash R, Patel V. Has COVID-19 Subverted Global Health?. The Lancet 2020;
• 29 Giesecke J. The Invisible Pandemic. The Lancet 2020;
• 30 Kluge HHP, Wickramasinghe K, Rippin HL. et al. Prevention and Control of Non-communicable Diseases in the COVID-19 Response. Lancet 2020;
• 31 MoHFW. Micro Plan for Containing Local Transmission of Coronavirus Disease (COVID-19). Available at: https://ncdc.gov.in/showfile.php?lid=529. Accessed May 15, 2020
• 32 MoHFW. Revised Guidelines for Home Isolation of Very Mild/pre-symptomatic COVID-19 Cases. Available at: https://www.mohfw.gov.in/pdf/RevisedguidelinesforHomeIsolationofverymildpresympto maticCOVID19cases10May2020.pdf. Accessed May 15, 2020
• 33 MoHFW. Revised Discharge Policy for COVID-19. Available at: https://www.mohfw.gov.in/pdf/ReviseddischargePolicyforCOVID19.pdf. Accessed May 15, 2020
• 34 MoHFW. Guidance Document on Appropriate Management of Suspect/Confirmed Cases of COVID19. Available at: https://www.mohfw.gov.in/pdf/GuidanceDocumentonappropriate managementofsuspectconfirmedcases of COVID19. Accessed May 15, 2020