India releases Covid-19 guidelines for rural areas to check its spread

The Centre on Sunday released new guidelines in the wake of the spread of coronavirus disease (Covid-19) in rural areas. The government said that a gradual ingress is now being seen in peri-urban, rural and tribal areas as well.

Releasing the guidelines, the ministry of health and family welfare said that there is a need to enable communities, strengthen primary level healthcare infrastructure at all levels to intensify Covid-19 response in these areas while continuing to provide other essential health services.

The health ministry guidelines said that in every village, active surveillance should be done for influenza-like illness/severe acute respiratory infections(ILI/SARI) periodically by ASHA with help of the Village Health Sanitation and Nutrition Committee (VHSNC).

It also asked the community health officer (CHO) the determine the seriousness of the infection by teleconsultation and recommend cases with comorbidities and low oxygen saturation to higher centres. It also said that the CHOs should be trained in performing rapid antigen testing (RAT) and the kits should be made at all public health facilities.

"These patients should be counselled to isolate themselves till test results are available. That asymptomatic but having history of high-risk exposure to COVID patients (exposure of more than 15 mins without a mask within 6 feet distance) should be advised quarantine and tested as per ICMR protocol," the ministry further said in the guidelines.

The guidelines also talk on focussing on contact tracing as per Integrated Disease Surveillance Programme's (IDSP) guidelines, adding that those testing positive should be allowed to quarantine at home by following the protocols issued by the ministry.

Stressing on the need to monitor oxygen saturation levels, the ministry directed the VHSNC to mobilise resources through local PRI to make provisions for these equipment. Theremometres and pulse oximetres can be given the families in the rural areas on loan and follow-up visits should be undertaken by frontline worker/volunteers/teacher following required infection prevention practices.

"A home isolation kit shall be provided to all such cases which should include required medicines such as Paracetamol 500 mg, Tab. Ivermectin, cough syrup, multivitamins (as prescribed by the treating doctor) besides a detailed pamphlet indicating the precautions to be taken, medication details, monitoring proforma for patient condition during the home isolation, contact details in case of any major symptoms or deterioration of health condition and the discharge criteria," the ministry said in the guidelines.

The guidelines come a day after Prime Minister Narendra Modi, chairing a high-level meeting on the Covid-19 situation, directed government officials to make a distribution plan for oxygen supply to rural areas and scale up health infrastructure to manage the disease burden in those regions.

The Prime Minister asked officials to focus on testing, including door-to-door testing and assist health care workers in rural areas, the Prime Minister's Office said in a statement.

During the first wave, urban areas contributed a majority of new infections in India every month for five months from March 2020 to July 2020, before rural areas started contributing more new cases. The second wave, which began in February this year, took just two months as rural areas began contributing more cases from April onwards.

Experts say the impact of the outbreak could be even deadlier in rural areas, where health care infrastructure is traditionally weaker and fewer medical facilities are available. About 73% of the country's population also resides in rural districts.