{"id":227923,"date":"2020-04-04T18:48:32","date_gmt":"2020-04-04T13:18:32","guid":{"rendered":"https:\/\/www.scconline.com\/blog\/?p=227923"},"modified":"2020-04-05T13:18:17","modified_gmt":"2020-04-05T07:48:17","slug":"novel-coronavirus-disease-2019-containment-plan-for-large-outbreaks-by-mohfw","status":"publish","type":"post","link":"https:\/\/www.scconline.com\/blog\/post\/2020\/04\/04\/novel-coronavirus-disease-2019-containment-plan-for-large-outbreaks-by-mohfw\/","title":{"rendered":"Novel Coronavirus Disease 2019 | Containment Plan for Large Outbreaks by MohFW"},"content":{"rendered":"<h3 style=\"text-align: justify;\"><strong><span style=\"color: #0000ff;\">Background<\/span><\/strong><\/h3>\n<div class=\"page\" title=\"Page 2\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<p style=\"text-align: justify;\">On 7-01- 2020, Chinese authorities identified a new strain of Coronavirus as the causative agent for the disease.<\/p>\n<p style=\"text-align: justify;\"><span style=\"color: #ff0000;\">The virus has been renamed by WHO as SARS-CoV-2 and the disease caused by it as COVID-19., which has now been spread to over 200 countries\/territories.<\/span><\/p>\n<p style=\"text-align: justify;\">As per WHO (as of 1-04-2020), there has been a total of <span style=\"font-family: -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen-Sans, Ubuntu, Cantarell, 'Helvetica Neue', sans-serif;\">823626 confirmed cases and 40598 deaths due to COVID-19 worldwide.<\/span><\/p>\n<div class=\"page\" title=\"Page 2\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<p style=\"text-align: justify;\">In India, as on 2-04-2020, 1965 confirmed cases (including 51 foreign nationals) and 50 deaths reported from 29 States\/UTs. Large number of cases has been reported from Delhi, Karnataka, Kerala, Maharashtra, Rajasthan, Tamil Nadu, Telangana and Uttar Pradesh.<\/p>\n<p style=\"text-align: justify;\"><span style=\"color: #0000ff;\"><strong>Risk Assessment<\/strong><\/span><\/p>\n<p style=\"text-align: justify;\">When was COVID-19 declared as a pandemic?<\/p>\n<p style=\"text-align: justify;\"><strong>WHO declared it a pandemic on 11-03-2020.<\/strong><\/p>\n<p style=\"text-align: justify;\">WHO advised countries to take a whole-of-government, whole-of-society approach to prevent infections, save lives and minimize impact.<\/p>\n<p style=\"text-align: justify;\"><span style=\"color: #0000ff;\"><strong>Epidemiology<\/strong><\/span><\/p>\n<blockquote><p>Etiological agent responsible for current outbreak <span style=\"font-family: -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen-Sans, Ubuntu, Cantarell, 'Helvetica Neue', sans-serif;\">of SARS-CoV-2 is a novel coronavirus closely related to SARS-Coronavirus.<\/span><\/p><\/blockquote>\n<div class=\"page\" title=\"Page 2\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<p style=\"text-align: justify;\">In humans, the transmission of SARS-CoV-2 can occur via respiratory secretions.<\/p>\n<div class=\"page\" title=\"Page 2\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<p style=\"text-align: justify;\">Current estimates of the incubation period of COVID range from 2-14 days, and these estimates will be refined as more data become available.<\/p>\n<h3 style=\"text-align: justify;\"><span style=\"color: #0000ff;\"><strong>Strategic Approach<\/strong><\/span><\/h3>\n<div class=\"page\" title=\"Page 3\">\n<div class=\"layoutArea\" style=\"text-align: justify;\">\n<div class=\"column\">\n<p>India would be following a scenario based approach for the following possible scenarios:<\/p>\n<\/div>\n<\/div>\n<div class=\"layoutArea\">\n<div class=\"column\">\n<ul style=\"text-align: justify;\">\n<li>Travel related case reported in India<\/li>\n<li>Local transmission of COVID-19<\/li>\n<li>Large outbreaks amenable to containment<\/li>\n<li>Wide-spread community Transmission of COVID-19 disease<\/li>\n<li>India becomes endemic for COVID-19<\/li>\n<\/ul>\n<p style=\"text-align: justify;\"><strong><span style=\"color: #008000;\">Scenario: <\/span><\/strong><\/p>\n<p style=\"text-align: justify;\"><strong><span style=\"color: #008000;\">Travel related case reported in India<\/span><\/strong><\/p>\n<div class=\"page\" title=\"Page 3\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<ul style=\"text-align: justify;\">\n<li>Inter-Ministerial coordination and <span style=\"font-family: -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen-Sans, Ubuntu, Cantarell, 'Helvetica Neue', sans-serif;\">Centre-State co-ordination been established.<\/span><\/li>\n<li><span style=\"font-family: -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen-Sans, Ubuntu, Cantarell, 'Helvetica Neue', sans-serif;\">Early detection through universal screening of all International passengers at Points of Entries.<\/span><\/li>\n<li>Surveillance and contact tracing through Integrated Disease Surveillance Programme (IDSP) for tracking travellers in the community who have travelled from affected countries.<\/li>\n<li>Early diagnosis through testing samples of suspect cases.<\/li>\n<li>Buffer stock of Personal Protective Equipment.<\/li>\n<li>Risk communication for creating awareness among public to follow preventive public <span style=\"font-family: -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen-Sans, Ubuntu, Cantarell, 'Helvetica Neue', sans-serif;\">health measures.<\/span><\/li>\n<\/ul>\n<div class=\"page\" title=\"Page 3\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<div class=\"page\" style=\"text-align: justify;\" title=\"Page 3\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<p><strong><span style=\"color: #008000;\">Local transmission of COVID-2019 disease<\/span><\/strong><\/p>\n<\/div>\n<\/div>\n<\/div>\n<div class=\"page\" title=\"Page 3\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<div class=\"page\" title=\"Page 3\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<p style=\"text-align: justify;\">Local transmission will lead to clustering of cases.<\/p>\n<p style=\"text-align: justify;\"><span style=\"font-family: -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen-Sans, Ubuntu, Cantarell, 'Helvetica Neue', sans-serif;\">Cluster containment strategy will be:<\/span><\/p>\n<div class=\"page\" title=\"Page 4\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<ul style=\"text-align: justify;\">\n<li>Extensive contact tracing and active search for cases in containment zone.<\/li>\n<li>Testing all suspect cases and high risk contacts<\/li>\n<li>Isolating all suspect \/ confirmed cases and providing medical care.<\/li>\n<li>Quarantining contacts<\/li>\n<li>Implementing social distancing measures.<\/li>\n<li>Intensive risk communication.<\/li>\n<\/ul>\n<div class=\"page\" title=\"Page 4\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<p style=\"text-align: justify;\"><span style=\"color: #008000;\"><strong>Large outbreaks amenable to containment<\/strong><\/span><\/p>\n<div class=\"page\" title=\"Page 4\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<p style=\"text-align: justify;\"><strong>Geographic quarantine and containment strategy will include:<\/strong><\/p>\n<div class=\"page\" title=\"Page 4\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<ul style=\"text-align: justify;\">\n<li>Defining the area of operation<\/li>\n<li>Active surveillance for cases and contacts in the identified geographic zone.<\/li>\n<li>Expanding laboratory capacity for testing all suspect cases, high risk contacts and SARI cases.<\/li>\n<li>Operationalize surge capacities created for isolation (COVID-19 hospitals\/COVID-19 dedicated blocks) to hospitalize and manage all suspect \/ confirmed cases.<\/li>\n<li>Implementation of social distancing measures with strict perimeter control.<\/li>\n<li>Provide chemoprophylaxis with Hydroxy-chloroquine to all asymptomatic healthcare workers and asymptomatic household contacts of laboratory confirmed cases.<\/li>\n<li>Further intensification of risk communication through audio, social and visual media.<\/li>\n<\/ul>\n<div class=\"page\" title=\"Page 4\">\n<div class=\"section\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<h4 style=\"text-align: justify;\"><strong>Containment for large outbreaks through geographic quarantine<\/strong><\/h4>\n<div class=\"page\" title=\"Page 4\">\n<div class=\"section\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<p style=\"text-align: justify;\">Geographic quarantine (cordon sanitaire) strategy calls for near absolute interruption of movement of people to and from a relatively large defined geographic area where there is single large outbreak or multiple foci of local transmission of COVID-19.<\/p>\n<p style=\"text-align: justify;\">The stated strategy <span style=\"font-family: -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen-Sans, Ubuntu, Cantarell, 'Helvetica Neue', sans-serif;\">shall be applicable to such areas reporting large outbreak and\/or multiple clusters of COVID-19 spread over multiple blocks of one or more districts that are contiguous.<\/span><\/p>\n<div class=\"page\" title=\"Page 5\">\n<div class=\"section\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<p style=\"text-align: justify;\"><strong>Cluster Containment Strategy<\/strong><\/p>\n<p style=\"text-align: justify;\">It <span style=\"font-family: -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen-Sans, Ubuntu, Cantarell, 'Helvetica Neue', sans-serif;\">would be to contain the disease within a defined geographic area by early detection of cases, breaking the chain of transmission. Prevention of COVID-19 tp spread to new areas would include:<\/span><\/p>\n<div class=\"page\" title=\"Page 5\">\n<div class=\"section\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<ul style=\"text-align: justify;\">\n<li>geographic quarantine<\/li>\n<\/ul>\n<div class=\"layoutArea\">\n<div class=\"column\">\n<ul style=\"text-align: justify;\">\n<li>social distancing measures<\/li>\n<li><span style=\"font-family: -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen-Sans, Ubuntu, Cantarell, 'Helvetica Neue', sans-serif;\">enhanced active surveillance<\/span><\/li>\n<\/ul>\n<div class=\"page\" title=\"Page 5\">\n<div class=\"section\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<div class=\"page\" title=\"Page 5\">\n<div class=\"section\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<ul style=\"text-align: justify;\">\n<li>testing all suspected cases<\/li>\n<\/ul>\n<div class=\"page\" title=\"Page 5\">\n<div class=\"section\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<ul style=\"text-align: justify;\">\n<li>isolation of cases<\/li>\n<\/ul>\n<div class=\"page\" title=\"Page 5\">\n<div class=\"section\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<ul style=\"text-align: justify;\">\n<li>quarantine of contacts<\/li>\n<\/ul>\n<div class=\"page\" title=\"Page 5\">\n<div class=\"section\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<ul style=\"text-align: justify;\">\n<li>risk communication to create awareness<\/li>\n<\/ul>\n<blockquote>\n<div class=\"page\" title=\"Page 5\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<p style=\"text-align: justify;\">Large scale measures to contain COVID-19 over large territories have been tried in China. Mathematical modelling studies have suggested that containment might be possible especially when other public health interventions are combined with an effective social distancing strategy.<\/p>\n<\/div>\n<\/div>\n<\/div>\n<\/blockquote>\n<div class=\"page\" title=\"Page 5\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<p>&nbsp;<\/p>\n<p style=\"text-align: justify;\"><span style=\"color: #000080;\"><strong>Factors affecting large outbreak cluster containment<\/strong><\/span><\/p>\n<div class=\"page\" title=\"Page 5\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<ul style=\"text-align: justify;\">\n<li>Number and size of the cluster\/s.<\/li>\n<li>Effectiveness of geographic quarantine.<\/li>\n<li>How efficiently the virus is transmitting in Indian population, taking into account environmental factors especially temperature and humidity.<\/li>\n<li>Public health response in terms of active case finding, testing of large number of cases, immediate isolation of suspect and confirmed cases and quarantine of contacts.<\/li>\n<li>.<span style=\"font-family: -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen-Sans, Ubuntu, Cantarell, 'Helvetica Neue', sans-serif;\"><span style=\"font-family: -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen-Sans, Ubuntu, Cantarell, 'Helvetica Neue', sans-serif;\">Population density and their movement (including migrant population)<\/span><\/span><\/li>\n<li>Ability to ensure basic infrastructure and essential services.<\/li>\n<\/ul>\n<div class=\"page\" title=\"Page 6\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<h3 style=\"text-align: justify;\"><span style=\"color: #800080;\">Action Plan for Geographic Quarantine<\/span><\/h3>\n<p style=\"text-align: justify;\"><strong><span style=\"color: #ff0000;\">Legal Framework<\/span><\/strong><\/p>\n<div class=\"page\" title=\"Page 6\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<p style=\"text-align: justify;\">Central Government \/State Government should review the existing legal instruments that provide legal support to implement the containment plan.<\/p>\n<div class=\"page\" title=\"Page 6\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<p style=\"text-align: justify;\">Acts\/ Rules for consideration could be:<\/p>\n<p style=\"text-align: justify;\">(i) Disaster Management Act (2005)<\/p>\n<p style=\"text-align: justify;\">(ii) Epidemic Act (1897)<\/p>\n<p style=\"text-align: justify;\">(iii) Criminal Procedure Code<\/p>\n<p style=\"text-align: justify;\">(iv) State Specific Public Health Act.<\/p>\n<div class=\"page\" title=\"Page 6\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<p style=\"text-align: justify;\"><span style=\"color: #008000;\">States may invoke the provisions under Disaster Management Act, 2005 or under the Epidemic Act,1897 to delegate powers to identified authority to act in such a manner to control or contain the outbreak.<\/span><\/p>\n<div class=\"page\" title=\"Page 6\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<p style=\"text-align: justify;\"><span style=\"color: #008000;\">Indian Penal Code, 1860 under Section 270 provides power to act against those indulging in spread of disease. Section 144 of the Code of Criminal Procedure, when invoked, prohibits gathering of people.<\/span><\/p>\n<div class=\"page\" title=\"Page 6\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<h4 style=\"text-align: justify;\"><span style=\"color: #000080;\"><strong>Institutional mechanisms and Inter-sectoral Co-ordination<\/strong><\/span><\/h4>\n<div class=\"page\" title=\"Page 6\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<p style=\"text-align: justify;\"><span style=\"color: #0000ff;\">At the Union Government level<\/span><\/p>\n<div class=\"page\" title=\"Page 6\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<p style=\"text-align: justify;\">Group of Ministers (GoM) under the Chairmanship of Union Health Minister will be the apex body to take policy decisions.<\/p>\n<div class=\"page\" title=\"Page 6\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<p style=\"text-align: justify;\">Union Health Minister will have an advisory Group.<\/p>\n<div class=\"page\" title=\"Page 6\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<p style=\"text-align: justify;\">Public Health Working Group under Secretary (H) and Joint Monitoring Group under DGHS will provide technical inputs.<\/p>\n<div class=\"page\" title=\"Page 6\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<p style=\"text-align: justify;\"><strong>At the national level,<\/strong><\/p>\n<div class=\"page\" title=\"Page 6\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<p style=\"text-align: justify;\">Co-ordination with health and non-health sectors will be managed by <span style=\"font-family: -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen-Sans, Ubuntu, Cantarell, 'Helvetica Neue', sans-serif;\">National Crisis Management Committee (NCMC) \/ Committee of Secretaries (CoS)<\/span>, on issues, flagged by Ministry of Health.<\/p>\n<div class=\"page\" title=\"Page 7\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<p style=\"text-align: justify;\"><strong>At the State level<\/strong><\/p>\n<div class=\"page\" title=\"Page 7\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<p style=\"text-align: justify;\">Concerned State will activate State Crisis Management Committee or the State Disaster Management Authority.<\/p>\n<div class=\"page\" title=\"Page 7\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<p style=\"text-align: justify;\"><strong>Institutional arrangement at the operational level<\/strong><\/p>\n<div class=\"page\" title=\"Page 7\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<p style=\"text-align: justify;\">District Collector would be the nodal person for all preparedness and response activities within his jurisdiction.<\/p>\n<div class=\"page\" title=\"Page 7\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<p style=\"text-align: justify;\">He\/she will keep ready all administrative orders for social distancing, restriction of rail\/road\/air transport, perimeter control and continuity of essential services.<\/p>\n<div class=\"page\" title=\"Page 7\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<p style=\"text-align: justify;\">A compendium of all the administrative orders required for enforcing the non- pharmaceutical interventions would be prepared well in advance and kept ready to be executed during response phase.<\/p>\n<div class=\"page\" title=\"Page 7\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<p style=\"text-align: justify;\"><span style=\"color: #ff0000;\"><strong>Trigger for Action<\/strong><\/span><\/p>\n<div class=\"page\" title=\"Page 7\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<p style=\"text-align: justify;\"><strong>Epidemiological intelligence<\/strong> on increase in the incidence of a COVID-19 cases occurring within a defined geographic area will be trigger for action. This will be provided by IDSPs early warning and response (EWAR) system. Routine laboratory based surveillance of SARI cases is another trigger for action.<\/p>\n<div class=\"page\" title=\"Page 7\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<p style=\"text-align: justify;\"><span style=\"color: #800080;\"><strong>Rapid Response Teams (RRT)<\/strong><\/span><\/p>\n<div class=\"page\" title=\"Page 7\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<p style=\"text-align: justify;\">Emergency Medical Relief (EMR) division, Ministry of Health and Family Welfare will deploy the Central Rapid Response Team (RRT) to support and advice the State.<\/p>\n<div class=\"page\" title=\"Page 7\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<p style=\"text-align: justify;\"><strong><span style=\"color: #800080;\">Identify area under geographic quarantine<\/span><\/strong><\/p>\n<p style=\"text-align: justify;\">Large outbreak is defined as localized increase in the incidence of a COVID-19 cases occurring within a defined geographic area.<\/p>\n<div class=\"page\" title=\"Page 8\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<p style=\"text-align: justify;\">Area under geographic quarantine will be defined.<\/p>\n<p style=\"text-align: justify;\">There shall be<\/p>\n<p style=\"text-align: justify;\">(i) containment zone, surrounded by (ii) buffer zone<\/p>\n<div class=\"page\" title=\"Page 8\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<p style=\"text-align: justify;\"><strong>Boundary for geographic quarantine will be defined based on : <\/strong><\/p>\n<p style=\"text-align: justify;\">(i) geospatial distribution of each cluster contained within,<\/p>\n<p style=\"text-align: justify;\">(ii) largest administrative unit containing all clusters occurring within a state (with a minimum of 1 district),<\/p>\n<p style=\"text-align: justify;\">(iii) feasibility to implement strict interruption of movement of people,<\/p>\n<p style=\"text-align: justify;\">(iv) joint assessment by State and Central RRTs.<\/p>\n<div class=\"page\" title=\"Page 8\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<p style=\"text-align: justify;\"><strong>Buffer Zone<\/strong><\/p>\n<div class=\"page\" title=\"Page 8\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<p style=\"text-align: justify;\">Adjoining blocks of the affected district or rural districts of the affected city will be considered as the buffer zone.<\/p>\n<div class=\"page\" title=\"Page 8\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<p style=\"text-align: justify;\"><strong>Surveillance<\/strong><\/p>\n<p style=\"text-align: justify;\">Surveillance in containment zone, including contact listing, tracking and follow up shall be carried out.<\/p>\n<div class=\"page\" title=\"Page 8\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<p style=\"text-align: justify;\">Precise mapping of the outbreak shall be carried out.<\/p>\n<div class=\"page\" title=\"Page 8\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<p style=\"text-align: justify;\">Passive Surveillance shall be enhanced all throughout the area. <span style=\"font-family: -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen-Sans, Ubuntu, Cantarell, 'Helvetica Neue', sans-serif;\">All hospitalized patients with Severe Acute Respiratory Illness shall also be tested for COVID-19.<\/span><\/p>\n<div class=\"page\" title=\"Page 9\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<p style=\"text-align: justify;\"><strong>Perimeter Control<\/strong><\/p>\n<div class=\"page\" title=\"Page 9\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<p style=\"text-align: justify;\">Perimeter control will ensure that there is no unchecked outward movement of population from the containment zone except for maintaining essential services.<\/p>\n<div class=\"page\" title=\"Page 9\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<p style=\"text-align: justify;\">Thermal screening, IEC shall be carried out at all entry and exit points.<\/p>\n<div class=\"page\" title=\"Page 9\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<p style=\"text-align: justify;\">All vehicular movement, movement of public transport and personnel movement will be stopped. <span style=\"font-family: -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen-Sans, Ubuntu, Cantarell, 'Helvetica Neue', sans-serif;\">For personnel and vehicles requiring regular movement, a pass\/ID card may be issued with details recorded and communicated.<\/span><\/p>\n<div class=\"page\" title=\"Page 9\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<p style=\"text-align: justify;\">District administration will post signs and create awareness.<\/p>\n<div class=\"page\" title=\"Page 9\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<p style=\"text-align: justify;\">Details of all persons moving out of perimeter zone for essential\/ emergency services will be recorded.<\/p>\n<blockquote>\n<div class=\"page\" title=\"Page 9\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<p style=\"text-align: justify;\"><span style=\"color: #800000;\">Those entering such geographically quarantined areas shall be given a chemo-prophylactic dose of hydroxy-chloroquine.<\/span><\/p>\n<div class=\"page\" title=\"Page 9\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<p style=\"text-align: justify;\">Vehicles moving out of the perimeter control will be decontaminated with sodium hypochlorite (1%) solution.<\/p>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/blockquote>\n<div class=\"page\" title=\"Page 9\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<div class=\"page\" title=\"Page 9\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<div class=\"page\" title=\"Page 9\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<p style=\"text-align: justify;\"><strong>Laboratory support<\/strong><\/p>\n<div class=\"page\" title=\"Page 9\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<p style=\"text-align: justify;\">All test results should be available within 12-24 hours of sampling. ICMR along with the State Government will ensure that there are designated agencies for sample transportation to identified laboratories.<\/p>\n<div class=\"page\" title=\"Page 9\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<p style=\"text-align: justify;\">Designated laboratory will provide daily update (daily and cumulative) to District, State and Central Control Rooms.<\/p>\n<p style=\"text-align: justify;\"><strong>Testing criteria<\/strong><\/p>\n<div class=\"page\" title=\"Page 10\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<p style=\"text-align: justify;\">(i) All symptomatic individuals who have undertaken international travel in the last 14 days<\/p>\n<p style=\"text-align: justify;\">(ii) All symptomatic contacts of laboratory confirmed cases,<\/p>\n<p style=\"text-align: justify;\">(iii) All symptomatic health care workers,<\/p>\n<p style=\"text-align: justify;\">(iv) All hospitalized patients with SARI and<\/p>\n<p style=\"text-align: justify;\">(v) Asymptomatic direct and high-risk contacts of a confirmed case should be tested once between day 5 and day 14 of coming in his\/her contact.<\/p>\n<div class=\"page\" title=\"Page 10\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<p style=\"text-align: justify;\"><strong>Hospital care<\/strong><\/p>\n<div class=\"page\" title=\"Page 10\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<p style=\"text-align: justify;\">Persons testing positive for COVID-19 will remain hospitalized till such time as two of their samples are tested negative as per discharge policy. About 15% of the patients are likely to require hospitalization, and an additional 5 % will requires ventilator management.<\/p>\n<div class=\"page\" title=\"Page 10\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<p style=\"text-align: justify;\"><span style=\"color: #ff0000;\">Three tier arrangement for managing suspect\/ confirmed cases <span style=\"font-family: -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen-Sans, Ubuntu, Cantarell, 'Helvetica Neue', sans-serif;\">will be implemented to decrease burden on the COVID Block\/ hospital.<\/span><\/span><\/p>\n<div class=\"page\" title=\"Page 10\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<ul style=\"text-align: justify;\">\n<li>mild cases will be kept in temporary makeshift hospital facilities by converting hotels\/ hostel\/ guest houses\/ stadiums near a COVID-19 hospital.<\/li>\n<li>Moderate to severe cases, who require monitoring of their clinical status (patients with radiological evidence of pneumonia) will be admitted to COVID hospital.<\/li>\n<li>Some of the severe cases may progress respiratory failure and \/or progress to multi-organ failure and hence critical care facility\/ dialysis facility\/ and Salvage therapy [Extra Corporeal Membrane Oxygenator (ECMO)] facility for managing the respiratory\/renal complications\/ multi-organ failure shall be required. If such facilities are not available in the containment zone, nearest tertiary care facility in Government \/ private sector needs to be identified, that becomes a part of the micro-plan.<\/li>\n<\/ul>\n<div class=\"page\" title=\"Page 10\">\n<div class=\"layoutArea\" style=\"text-align: justify;\">\n<div class=\"column\"><\/div>\n<\/div>\n<div class=\"column\" style=\"text-align: justify;\"><strong><span style=\"font-family: -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen-Sans, Ubuntu, Cantarell, 'Helvetica Neue', sans-serif;\">Surge Capacity<\/span><\/strong><\/div>\n<div style=\"text-align: justify;\"><\/div>\n<div style=\"text-align: justify;\">If situation warrants, surge capacity <span style=\"font-family: -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen-Sans, Ubuntu, Cantarell, 'Helvetica Neue', sans-serif;\">of the identified hospitals will be enhanced, private hospitals will be roped in and sites identified for temporary hospitals will be operationalized.<\/span><\/div>\n<div>\n<div class=\"page\" title=\"Page 11\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<p style=\"text-align: justify;\"><strong>Pre-hospital care<\/strong><\/p>\n<div class=\"page\" title=\"Page 11\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<p style=\"text-align: justify;\">Ambulances need to be in place for transportation of suspect\/confirmed cases, <span style=\"font-family: -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen-Sans, Ubuntu, Cantarell, 'Helvetica Neue', sans-serif;\">shall be manned by personnel adequately trained in Infection Prevention and Control (IPC), use of PPE and protocol that needs to be followed for disinfection of ambulances.<\/span><\/p>\n<div class=\"page\" title=\"Page 11\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<p style=\"text-align: justify;\"><strong>Infection Prevention Control Practices<\/strong><\/p>\n<div class=\"page\" title=\"Page 11\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<p style=\"text-align: justify;\">There shall be strict adherence to Infection prevention control (IPC) practices in all health facilities.<\/p>\n<div class=\"page\" title=\"Page 11\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<p style=\"text-align: justify;\">Designated hospitals will ensure that all healthcare staff is trained in washing of hands, respiratory etiquettes, donning\/doffing &amp; proper disposal of PPEs and bio- medical waste management.<\/p>\n<div class=\"page\" title=\"Page 11\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<p style=\"text-align: justify;\">Medical personnel working in isolation and critical <span style=\"font-family: -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen-Sans, Ubuntu, Cantarell, 'Helvetica Neue', sans-serif;\">care facilities where aerozolisation is anticipated, will wear full complement of PPE. <\/span><span style=\"font-family: -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen-Sans, Ubuntu, Cantarell, 'Helvetica Neue', sans-serif;\">Support staff engaged in cleaning and disinfection will also wear full complement of PPE.<\/span><\/p>\n<p style=\"text-align: justify;\"><strong><span style=\"font-family: -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen-Sans, Ubuntu, Cantarell, 'Helvetica Neue', sans-serif;\">Clinical Management<\/span><\/strong><\/p>\n<div class=\"page\" title=\"Page 12\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<p style=\"text-align: justify;\">Suspect cases with co-morbid conditions, if any, will require appropriate management of co-morbid conditions.<\/p>\n<div class=\"page\" title=\"Page 12\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<p style=\"text-align: justify;\">For patients with Severe Acute Respiratory Illness (SARI), having respiratory distress may require, pulse oxymetry, oxygen therapy, non-invasive and invasive ventilator therapy.<\/p>\n<div class=\"page\" title=\"Page 12\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<p style=\"text-align: justify;\"><strong>Psychosocial support<\/strong><\/p>\n<div class=\"page\" title=\"Page 13\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<p style=\"text-align: justify;\">National Institute of Mental Health and Neuro Sciences (NIMHANS) will be the nodal agency to plan and execute psycho-social support. NIHMANS will prepare a Psycho-Social Support plan and implement the same in the COVID affected areas.<\/p>\n<div class=\"page\" title=\"Page 13\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<p style=\"text-align: justify;\"><strong>Pharmaceutical interventions<\/strong><\/p>\n<div class=\"page\" title=\"Page 13\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<p style=\"text-align: justify;\">There is no approved specific drug or vaccine for cure or prevention of COVID-19.<\/p>\n<div class=\"page\" title=\"Page 13\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<blockquote><p>Hydroxychloroquine has been recommended as chemoprophylaxis drug for use by asymptomatic healthcare workers managing COVID-19 cases and asymptomatic contacts of confirmed COVID-19 cases.<\/p>\n<div class=\"page\" title=\"Page 13\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<p>A combination of Hydroxychloroquine and Azithromycin has been advocated for use in severe cases of COVID-19 under medical supervision.<\/p>\n<p><span style=\"color: #008000;\"><strong>Non-Pharmaceutical interventions<\/strong><\/span><\/p>\n<\/div>\n<\/div>\n<\/div>\n<\/blockquote>\n<div class=\"page\" style=\"text-align: justify;\" title=\"Page 13\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<div class=\"page\" title=\"Page 13\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<p><strong>Preventive public health measures<\/strong><\/p>\n<div class=\"page\" title=\"Page 13\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<p>There will be intensive social mobilization among the population in geographic quarantine zone for adoption of community-wide practice of frequent washing of hands and respiratory etiquettes. The community will also be encouraged to self-monitor their health and report to the ASHA\/Anganwadi worker visiting home or to nearest health facility.<\/p>\n<div class=\"page\" title=\"Page 13\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<blockquote>\n<p style=\"text-align: justify;\"><span style=\"color: #0000ff;\">Quarantine and Isolation are important mainstay of cluster containment. These measures help by breaking the chain of transmission in the community.<\/span><\/p>\n<\/blockquote>\n<div class=\"page\" title=\"Page 14\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<p><strong>Quarantine<\/strong><\/p>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<div class=\"page\" title=\"Page 13\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<div class=\"page\" title=\"Page 14\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<p style=\"text-align: justify;\">Quarantine refers to separation of individuals who are not yet ill but have been exposed to COVID-19 and therefore have a potential to become ill.<\/p>\n<div class=\"page\" title=\"Page 14\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<p style=\"text-align: justify;\">Those above 60 or with co- morbidities will be shifted to designated quarantine facility. This will help identify early development of symptoms among them, their testing and shifting to isolation facility.<\/p>\n<div class=\"page\" title=\"Page 14\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<p style=\"text-align: justify;\"><strong>Isolation<\/strong><\/p>\n<div class=\"page\" title=\"Page 14\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<p style=\"text-align: justify;\">Refers to separation of individuals who are ill and suspected or confirmed of COVID-19.<\/p>\n<div class=\"page\" title=\"Page 14\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<p style=\"text-align: justify;\">Ideally, patients can be isolated in individual isolation rooms or negative pressure rooms with 12 or more air-changes per hour.<\/p>\n<div class=\"page\" title=\"Page 14\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<p style=\"text-align: justify;\">Under no circumstances these cases should be mixed up.<\/p>\n<div class=\"page\" title=\"Page 14\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<p style=\"text-align: justify;\"><strong>Social distancing measures<\/strong><\/p>\n<div class=\"page\" title=\"Page 14\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<p style=\"text-align: justify;\">For the cluster containment, social distancing measures are key interventions to rapidly curtail the community transmission of COVID-19 by limiting interaction between infected persons and susceptible hosts.<\/p>\n<div class=\"page\" title=\"Page 14\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<ul style=\"text-align: justify;\">\n<li>Closure of schools, colleges and work places<\/li>\n<\/ul>\n<div class=\"layoutArea\">\n<div class=\"column\">\n<ul style=\"text-align: justify;\">\n<li>Cancellation of mass gatherings<\/li>\n<\/ul>\n<div class=\"page\" title=\"Page 15\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<ul style=\"text-align: justify;\">\n<li>Advisory to avoid public places<\/li>\n<\/ul>\n<div class=\"page\" title=\"Page 15\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<ul style=\"text-align: justify;\">\n<li>Cancellation of public transport (bus\/rail)<\/li>\n<\/ul>\n<div class=\"page\" title=\"Page 15\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<ul style=\"text-align: justify;\">\n<li>Enforcement of Geographic quarantine.<\/li>\n<\/ul>\n<div class=\"page\" title=\"Page 15\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<p style=\"text-align: justify;\"><strong>Material Logistics<\/strong><\/p>\n<div class=\"page\" title=\"Page 16\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<p style=\"text-align: justify;\">State Government has to ensure adequate stock of Personal Protective Equipment (PPE). The quantity required for a containment operation will depend upon the size and extent of the cluster and the time required for containing it. States will also ensure that the PPE are being used in accordance with the guidelines on rational use of PPE.<\/p>\n<p style=\"text-align: justify;\"><strong>Stay arrangements for the field staff<\/strong><\/p>\n<div class=\"page\" title=\"Page 16\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<p style=\"text-align: justify;\">Field staff brought in for the surveillance activities and that for providing perimeter control need to be accommodated within the containment zone.<\/p>\n<div class=\"page\" style=\"text-align: justify;\" title=\"Page 17\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<p><strong>Communication channels<\/strong><\/p>\n<div class=\"page\" title=\"Page 17\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<p>During house to house surveillance, ASHAs\/ other community health workers will interact with the community for:<\/p>\n<p>(i) reporting symptomatic cases<\/p>\n<p>(ii) contact tracing<\/p>\n<p>(iii) information on preventive public health measures.<\/p>\n<div class=\"page\" title=\"Page 17\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<p>Awareness will be created among the community through miking, distribution of pamphlets, mass SMS and social media. Also use of radio and television (using local channels) will ensure penetration of health messages in the target community.<\/p>\n<div class=\"page\" title=\"Page 17\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<p><strong>Media Management<\/strong><\/p>\n<div class=\"page\" title=\"Page 17\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<p>Central level, only Secretary (H) or representative nominated by her shall address the media. At the State level, only Principal Secretary (H), his\/her nominee will speak to the media. At the District level DM\/DC will address the media.<\/p>\n<div class=\"page\" title=\"Page 17\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<p>Regular press briefings\/ press releases to keep media updated on the developments and avoid stigmatization of affected communities.<\/p>\n<div class=\"page\" title=\"Page 18\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<p><strong>Information Management<\/strong><\/p>\n<div class=\"page\" title=\"Page 18\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<p>A Control Room (if not already in place) shall be set up at State and District headquarters. This shall be manned by State and District Surveillance Officer (respectively) under which data managers (deployed from IDSP\/ NHM) responsible for collecting, collating and analyzing data from field and health facilities. Daily situation reports will be put up.<\/p>\n<div class=\"page\" title=\"Page 18\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<p>Aggregate data on daily basis on the following (for the day and cumulative):<\/p>\n<ol>\n<li>Total number of suspect cases<\/li>\n<li>Total number of confirmed cases<\/li>\n<li>Total number of critical cases on ventilator<\/li>\n<li>Total number of deaths<\/li>\n<li>Total number of contacts under surveillance<\/li>\n<\/ol>\n<p><span style=\"font-family: -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen-Sans, Ubuntu, Cantarell, 'Helvetica Neue', sans-serif;\">A Control Room shall be set up inside the geographic quarantine zone to facilitate collection, collation and dissemination of data from various field units to District and State Control Rooms.<\/span><\/p>\n<div class=\"page\" title=\"Page 18\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<p><strong>Alerting the neighboring Districts\/States<\/strong><\/p>\n<div class=\"page\" title=\"Page 18\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<p>Also suitable provisions shall be created for enhancing horizontal communication between adjacent districts, especially for contact tracing exercise and follow up of persons exiting the containment zone.<\/p>\n<div class=\"page\" title=\"Page 19\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<p><strong>Capacity building<\/strong><\/p>\n<div class=\"page\" title=\"Page 19\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<p>Large human resource requirement will be there to manage:<\/p>\n<p>(i) Field activities including surveillance,<\/p>\n<p>(ii) Clinical care at hospitals,<\/p>\n<p>(iii) laboratory testing and<\/p>\n<p>(iv) support staff to provide support services.<\/p>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<div class=\"page\" title=\"Page 19\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<p style=\"text-align: justify;\"><strong>Training content<\/strong><\/p>\n<div class=\"page\" title=\"Page 19\">\n<div class=\"layoutArea\" style=\"text-align: justify;\">\n<div class=\"column\">\n<p>Trainings for different target groups shall cover:<\/p>\n<\/div>\n<\/div>\n<div class=\"layoutArea\" style=\"text-align: justify;\">\n<div class=\"column\"><\/div>\n<\/div>\n<div class=\"layoutArea\">\n<div class=\"column\">\n<ul style=\"text-align: justify;\">\n<li><span style=\"font-family: -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen-Sans, Ubuntu, Cantarell, 'Helvetica Neue', sans-serif;\">Field surveillance, contact tracing, data management and reporting<\/span><\/li>\n<li>Surveillance at designated exit points from the containment zone<\/li>\n<li>Sampling, packaging and shipment of specimen<\/li>\n<li>Hospital infection prevention and control including use of appropriate PPEs and bio- medical waste management<\/li>\n<li>Clinical care of suspect and confirmed cases including ventilator management, critical care management<\/li>\n<li>Risk communication to general community and health service providers<\/li>\n<\/ul>\n<div class=\"page\" title=\"Page 19\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<p style=\"text-align: justify;\"><strong>Target trainee population<\/strong><\/p>\n<div class=\"page\" title=\"Page 19\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<p style=\"text-align: justify;\">Various sections of healthcare workforce <span style=\"font-family: -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen-Sans, Ubuntu, Cantarell, 'Helvetica Neue', sans-serif;\">and workforce from non-health sector. Training will be tailored to requirements of each of these stated sections.<\/span><\/p>\n<div class=\"page\" title=\"Page 19\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<p style=\"text-align: justify;\">The training resources available at IGOT platform of GoI may be utilized.<\/p>\n<div class=\"page\" title=\"Page 19\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<p style=\"text-align: justify;\"><strong>Replication of training in other Districts<\/strong><\/p>\n<div class=\"page\" title=\"Page 19\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<p style=\"text-align: justify;\">Unaffected Districts are also trained along the same lines so as to strengthen the core capacities of their RRTs, doctors, nurses, support staff and non- <span style=\"font-family: -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen-Sans, Ubuntu, Cantarell, 'Helvetica Neue', sans-serif;\">health field formations. These trainings should be accompanied with functional training exercises like mock-drills.<\/span><\/p>\n<div class=\"page\" style=\"text-align: justify;\" title=\"Page 20\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<p><strong>Financing of containment operations<\/strong><\/p>\n<\/div>\n<\/div>\n<\/div>\n<div class=\"page\" title=\"Page 20\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<p style=\"text-align: justify;\">Funds will be made available to the district collector from NHM flexi-fund. The SDRF funds can also be used as per notification issued by Ministry of Home Affairs.<\/p>\n<p style=\"text-align: justify;\"><strong>Scaling down of operations<\/strong><\/p>\n<div class=\"page\" title=\"Page 20\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<p style=\"text-align: justify;\">Operations will be scaled down if no secondary laboratory confirmed COVID-19 case is reported from the geographic quarantine zone for at least four weeks after the last confirmed test has been isolated and all his contacts have been followed up for 28 days.<\/p>\n<div class=\"page\" title=\"Page 20\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<blockquote>\n<p style=\"text-align: justify;\"><span style=\"color: #ff0000;\">If the containment plan is not able to contain the outbreak and large numbers of cases start appearing, then a decision will need to be taken by State administration to abandon the containment plan and start on mitigation<\/span> <span style=\"color: #ff0000;\">activities.<\/span><\/p>\n<\/blockquote>\n<p><span style=\"color: #800000;\"><strong>To read the official document, please click on the link below:<\/strong><\/span><\/p>\n<p><a href=\"https:\/\/www.mohfw.gov.in\/pdf\/3ContainmentPlanforLargeOutbreaksofCOVID19Final.pdf\">Containment Plan for COVID-19<\/a><\/p>\n<hr \/>\n<p><strong>Ministry of Health &amp; Family Welfare<\/strong><\/p>\n<p style=\"text-align: right;\">[Document dt. 04-04-2020]<\/p>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>Background On 7-01- 2020, Chinese authorities identified a new strain of Coronavirus as the causative agent for the disease. The virus has <\/p>\n","protected":false},"author":8808,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[4,1193],"tags":[40483,39839,39924,40480,40479,40482,40481],"class_list":["post-227923","post","type-post","status-publish","format-standard","hentry","category-legislationupdates","category-notifications","tag-containment-plan-for-large-outbreaks","tag-coronavirus","tag-covid-19","tag-early-warning-and-response","tag-epidemiological-intelligence","tag-national-crisis-management-committee","tag-state-crisis-management-committee"],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v27.4 (Yoast SEO v27.4) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>Novel Coronavirus Disease 2019 | Containment Plan for Large Outbreaks by MohFW | SCC Times<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.scconline.com\/blog\/post\/2020\/04\/04\/novel-coronavirus-disease-2019-containment-plan-for-large-outbreaks-by-mohfw\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Novel Coronavirus Disease 2019 | Containment Plan for Large Outbreaks by MohFW\" \/>\n<meta property=\"og:description\" content=\"Background On 7-01- 2020, Chinese authorities identified a new strain of Coronavirus as the causative agent for the disease. 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Districts were earlier designated as hotspots \/ red-zones, orange zones and green zones primarily based on the cumulative cases reported and\u2026","rel":"","context":"In &quot;Hot Off The Press&quot;","block_context":{"text":"Hot Off The Press","link":"https:\/\/www.scconline.com\/blog\/post\/category\/news\/hot_off_the_press\/"},"img":{"alt_text":"","src":"https:\/\/i0.wp.com\/www.scconline.com\/blog\/wp-content\/uploads\/2020\/03\/outbreak-coronavirus-world-1024x506px-1.jpg?resize=350%2C200&ssl=1","width":350,"height":200,"srcset":"https:\/\/i0.wp.com\/www.scconline.com\/blog\/wp-content\/uploads\/2020\/03\/outbreak-coronavirus-world-1024x506px-1.jpg?resize=350%2C200&ssl=1 1x, https:\/\/i0.wp.com\/www.scconline.com\/blog\/wp-content\/uploads\/2020\/03\/outbreak-coronavirus-world-1024x506px-1.jpg?resize=525%2C300&ssl=1 1.5x, https:\/\/i0.wp.com\/www.scconline.com\/blog\/wp-content\/uploads\/2020\/03\/outbreak-coronavirus-world-1024x506px-1.jpg?resize=700%2C400&ssl=1 2x, https:\/\/i0.wp.com\/www.scconline.com\/blog\/wp-content\/uploads\/2020\/03\/outbreak-coronavirus-world-1024x506px-1.jpg?resize=1050%2C600&ssl=1 3x"},"classes":[]},{"id":230674,"url":"https:\/\/www.scconline.com\/blog\/post\/2020\/06\/09\/bom-hc-all-asymptomatic-frontline-workers-working-in-hospitals-containment-zones-in-vidarbha-region-entitled-to-be-tested-for-covid-19-on-rt-pcr-method\/","url_meta":{"origin":227923,"position":1},"title":"Bom HC | All asymptomatic frontline workers working in hospitals &#038; containment zones in Vidarbha region entitled to be tested for COVID-19 on RT-PCR method","author":"Bhumika Indulia","date":"June 9, 2020","format":false,"excerpt":"Bombay High Court:\u00a0A Division Bench of R.K. 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Borkar, JJ., while addressing a petition, held that, \"...neither the Central Government nor the State Government can keep the fate of the frontline workers hanging and compel them to perform their jobs and discharge the duties without fear or\u2026","rel":"","context":"In &quot;Case Briefs&quot;","block_context":{"text":"Case Briefs","link":"https:\/\/www.scconline.com\/blog\/post\/category\/casebriefs\/"},"img":{"alt_text":"","src":"https:\/\/i0.wp.com\/www.scconline.com\/blog\/wp-content\/uploads\/2016\/09\/Bombay-HC.jpg?resize=350%2C200&ssl=1","width":350,"height":200,"srcset":"https:\/\/i0.wp.com\/www.scconline.com\/blog\/wp-content\/uploads\/2016\/09\/Bombay-HC.jpg?resize=350%2C200&ssl=1 1x, https:\/\/i0.wp.com\/www.scconline.com\/blog\/wp-content\/uploads\/2016\/09\/Bombay-HC.jpg?resize=525%2C300&ssl=1 1.5x, https:\/\/i0.wp.com\/www.scconline.com\/blog\/wp-content\/uploads\/2016\/09\/Bombay-HC.jpg?resize=700%2C400&ssl=1 2x, https:\/\/i0.wp.com\/www.scconline.com\/blog\/wp-content\/uploads\/2016\/09\/Bombay-HC.jpg?resize=1050%2C600&ssl=1 3x"},"classes":[]},{"id":227242,"url":"https:\/\/www.scconline.com\/blog\/post\/2020\/03\/18\/covid-19-sc-takes-suo-motu-cognisance-of-nonavailability-of-mid-day-meals-for-children-due-to-coronavirus-shutdown\/","url_meta":{"origin":227923,"position":2},"title":"COVID-19| SC takes suo motu cognisance of nonavailability of mid-day meals for children due to Coronavirus shutdown","author":"Prachi Bhardwaj","date":"March 18, 2020","format":false,"excerpt":"Supreme Court: A 3-judge bench of SA Bobde, CJ and BR Gavai and Surya Kant, JJ took suo motu cognisance of nonavailability of mid-day meals for children due to the closure of schools due to coronavirus spread and issued notices to all state governments and union territories. \"it is necessary,\u2026","rel":"","context":"In &quot;Case Briefs&quot;","block_context":{"text":"Case Briefs","link":"https:\/\/www.scconline.com\/blog\/post\/category\/casebriefs\/"},"img":{"alt_text":"","src":"https:\/\/i0.wp.com\/www.scconline.com\/blog\/wp-content\/uploads\/2017\/09\/Supreme-Court_Colour.jpg?resize=350%2C200&ssl=1","width":350,"height":200,"srcset":"https:\/\/i0.wp.com\/www.scconline.com\/blog\/wp-content\/uploads\/2017\/09\/Supreme-Court_Colour.jpg?resize=350%2C200&ssl=1 1x, https:\/\/i0.wp.com\/www.scconline.com\/blog\/wp-content\/uploads\/2017\/09\/Supreme-Court_Colour.jpg?resize=525%2C300&ssl=1 1.5x, https:\/\/i0.wp.com\/www.scconline.com\/blog\/wp-content\/uploads\/2017\/09\/Supreme-Court_Colour.jpg?resize=700%2C400&ssl=1 2x, https:\/\/i0.wp.com\/www.scconline.com\/blog\/wp-content\/uploads\/2017\/09\/Supreme-Court_Colour.jpg?resize=1050%2C600&ssl=1 3x"},"classes":[]},{"id":228340,"url":"https:\/\/www.scconline.com\/blog\/post\/2020\/04\/15\/covid-19-no-prisoner-shall-be-released-without-taking-appropriate-steps-if-he-she-has-suffered-from-coronavirus-disease\/","url_meta":{"origin":227923,"position":3},"title":"COVID-19| No prisoner shall be released without taking appropriate steps if he\/she has suffered from coronavirus disease","author":"Prachi Bhardwaj","date":"April 15, 2020","format":false,"excerpt":"Supreme Court: After the Court \u00a0had,\u00a0on March 23, 2020, directed each State\/Union Territory to constitute a High Powered Committee to determine which class of prisoners can be released on parole or an interim bail for such period as may be thought appropriate, the 3-judge bench of SA Bobde, CJ and\u2026","rel":"","context":"In &quot;Case Briefs&quot;","block_context":{"text":"Case Briefs","link":"https:\/\/www.scconline.com\/blog\/post\/category\/casebriefs\/"},"img":{"alt_text":"","src":"https:\/\/i0.wp.com\/www.scconline.com\/blog\/wp-content\/uploads\/2017\/09\/Supreme-Court_Colour.jpg?resize=350%2C200&ssl=1","width":350,"height":200,"srcset":"https:\/\/i0.wp.com\/www.scconline.com\/blog\/wp-content\/uploads\/2017\/09\/Supreme-Court_Colour.jpg?resize=350%2C200&ssl=1 1x, https:\/\/i0.wp.com\/www.scconline.com\/blog\/wp-content\/uploads\/2017\/09\/Supreme-Court_Colour.jpg?resize=525%2C300&ssl=1 1.5x, https:\/\/i0.wp.com\/www.scconline.com\/blog\/wp-content\/uploads\/2017\/09\/Supreme-Court_Colour.jpg?resize=700%2C400&ssl=1 2x, https:\/\/i0.wp.com\/www.scconline.com\/blog\/wp-content\/uploads\/2017\/09\/Supreme-Court_Colour.jpg?resize=1050%2C600&ssl=1 3x"},"classes":[]},{"id":227183,"url":"https:\/\/www.scconline.com\/blog\/post\/2020\/03\/17\/rbi-covid-19-operational-and-business-continuity-measures\/","url_meta":{"origin":227923,"position":4},"title":"RBI | COVID-19- Operational and Business Continuity Measures","author":"Bhumika Indulia","date":"March 17, 2020","format":false,"excerpt":"The World Health Organization (WHO) has declared the recent outbreak of the novel coronavirus disease (COVID-19) a pandemic indicating significant and ongoing person-to-person spread in multiple countries, with the uncertainty about the extent of spread and the likely impact on the global economy. Several confirmed cases have also been detected\u2026","rel":"","context":"In &quot;Business News&quot;","block_context":{"text":"Business News","link":"https:\/\/www.scconline.com\/blog\/post\/category\/news\/business_news\/"},"img":{"alt_text":"","src":"","width":0,"height":0},"classes":[]},{"id":228326,"url":"https:\/\/www.scconline.com\/blog\/post\/2020\/04\/15\/mha-issues-consolidated-revised-guidelines-for-containment-of-covid19-select-permitted-activities-allowed-w-e-f-20th-april-2020\/","url_meta":{"origin":227923,"position":5},"title":"MHA issues Consolidated Revised Guidelines for containment of COVID19 ; Select permitted activities allowed w.e.f 20th April, 2020","author":"Bhumika Indulia","date":"April 15, 2020","format":false,"excerpt":"Government of India issued an Order on 14th\u00a0April, 2020 that the lockdown measures stipulated in the Consolidated Guidelines of Union Ministry of Home Affairs (MHA) for containment of COVID-19 epidemic in the country, will continue to remain in force upto 3rd\u00a0May, 2020. 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