The ministry of health and family welfare unveiled a document of a containment plan for a large outbreak that is based on the Bhilwara model. However, the commencement of the plan is yet to be clear but it is expected that it will be imposed in several hotspots of the country.
Bhilwara Model
The national containment plan proposed by the central government is based on the Bhilwara model. Bhilwara, a small district that holds a population of close to 35 lakhs reported its first case in the form of a doctor. Although there isn’t a clear origin of the doctor’s infection, the cases in the district rose to 3 very quickly as two other doctors tested positive. Within no time, it spiked to 21.
The Rajasthan government’s health secretary Rohit Kumar Singh was made in-charge of containing the outbreak in the disease. The health secretary ordered the lockdown of the district on the 20th of March, 4 days prior to the nationwide lockdown. The entire district was isolated. By April 2nd, the entire district was sealed.
The district was divided into four quadrants and each quadrant of the region was assigned to the new survey teams that were set up. The Survey teams extensively screened 30 lakh, people, by visiting each home and identified 6 hotspots in the district. Simultaneously, aggressive contact tracing also took place. During the screening, the teams looked for people with influenza-like illness symptoms and followed up with them twice every day. Close to 14,000 people were identified and followed up daily. On observation, if their symptoms worsened or they showed any suspicion, they were immediately tested and quarantined.
For quarantine facility, the government took over 4 private hospitals with a capacity of 25 beds each and 27 local hotels of combined capacity 1541. During this period, the government closed down all the shops. Groceries and other essential services were provided by the government to every door. In some cases, cooked food was also supplied.
As a result, Bhilwara has not reported a single new case for 7 days in a row. Out of the 27 people tested positive, 13 were discharged and 2 passed away. The remaining 12 have been tested negative but are not yet discharged. 950 people are still in quarantine and 7620 are in-home quarantine.
The National Containment Plan
Based on the Bhilwara model, the central government has listed steps to follow in case of larger outbreaks. First and foremost, if there are different clusters being formed in a place, that entire place needs to quarantine. Not an individual but the entire geographical area. The authorities should identify an area and need to isolate the region completely. Beyond the quarantined area, there should also be a buffer zone that needs to be isolated despite no trace of the outbreak.
As a huge country like India has different conditions at different places, a cluster containment strategy plan needs to be formed based on the infectivity, weather, humidity and other conditions of the region. Following this, the standard protocol of tracing, testing, isolating and treating should continue.
The Trigger Point for the action is also listed in the plan i.e. the symptoms of influenza-like illness or severe acute respiratory illness. If these are found in clusters, it should be reported to the central database and is an indication of a larger outbreak.
To carry out this smoothly, the center has empowered state bodies to invoke the Disaster Management act of 2005 and the Epidemic act of 1897. Several virus research and detection centers are being set up across the country. The Health Ministry also prescribes that, if there are no new cases for 4 weeks, normalcy can be declared in that region.
