As the third wave of COVID-19 fuelled by the Omicron virus variant spreads like wild fire across the State, and new cases and hospitalisations rise exponentially, the State’s level of preparedness to meet the exigency is in focus.
Last year, at the peak of Delta, when there were 4,45,334 active cases, with over 37,000 people hospitalised, the State had just about managed to avert the situation of a breach in the health system’s surge capacity.
“In comparison, hospitalisations are much lesser now. Of the 1.42 lakh active cases, only about 5,500 patients are in hospitals. Yet, when it comes to preparedness — ensuring adequate hospital beds and human resources — it is doubtful whether the State has done enough because this time, one cannot take all hospital beds for COVID care and allow non-COVID care to be a casualty. The focus now is indeed on treatment in periphery and field hospitals. But it would be an uphill task to revive the field hospitals and the COVID brigade, all of which had been virtually shut down by October last, “ a senior health official said.
Biggest challenges
The biggest challenges, public health experts reckon, would be that of health-care workers’ absenteeism as they themselves become COVID-positive in huge numbers and the challenge of overcoming the pandemic fatigue amongst them.
However, the State is banking on the fact that hospitalisations and serious disease will not rise as it did during the Delta wave, because of the high background vaccination rate and the immunity afforded by prior infection in the population.
“Unlike during the Delta wave, the State is no longer chasing COVID or furiously devising strategies for delaying the peak or flattening the epidemic curve. Apart from the feeling that much of the strategies adopted earlier to tackle COVID had backfired, there is also new understanding that strategies solely focussed on limiting Omicron transmission, are useless. The current strategy is to direct districts in preparedness while monitoring the situation closely, emphasising on home care and tele-consultations and not creating unnecessary panic amongst the public,” a member of the State’s COVID-19 expert committee said.
Threshold Triggers
The State has readied a new COVID-19 preparedness plan wherein it has set three indicators as “threshold triggers” for augmenting preparedness at all levels by districts -- Hospital bed occupancy, critical care occupancy and caseload.
The State has provided only a broad framework, while it will be the task of individual districts to increase the preparedness. As soon as these triggers push the set threshold, district administrations will have to initiate action plans to improve infrastructure, surveillance measures, testing strategies and stocking of liquid medical oxygen.
Accordingly, districts should set up field hospitals, prepare an human resource pool and increase oxygen beds, ICU/ ventilator beds by 20%, as soon as the first threshold -- doubling of hospital admissions due to COVID-19 or 50% increase in COVID ICU admission -- is reached.
Doubling of ICU admission due to COVID or hospital admissions reaching 10% of total hospital admissions of the district is taken as the second threshold .
Alongside, cluster identification, increased testing in clusters, stock assessment of medical oxygen, drugs and consumables in districts should also be initiated.
