COVID-19 Update

Odisha’s COVID-19 strategy to involve private hospitals, hopes to reduce infection rate

Print edition : October 09, 2020

Daily wage labourers heading for work following lockdown relaxation, in Bhubaneswar on September 7. Photo: Biswaranjan Rout

By opening up more private hospitals for COVID care, easing pressure on hospitals in Bhubaneswar by getting those in the districts to take in more patients, and innovating with RT-PCR tests to prioritise patient care Odisha is hoping to bring down the rising infection rate.

In its fight against the pandemic Odisha performed well on all parameters initially and continues to do so in several aspects. However, the challenges have only grown bigger with the number of cases increasing by the day.

The capital city of Bhubaneswar, which is in Khordha district, has been hit badly in terms of numbers. With dedicated COVID hospitals in Bhubaneswar and other urban centres running out of beds, the government has amended its advisory for provisioning a COVID-19 unit in private hospitals with 30 or more beds.

The government has made it mandatory for all private hospitals with a bed strength of 30 or more in Bhubaneswar, Cuttack, Sambalpur, Berhampur and Rourkela Municipal Corporations limits to designate a minimum 50 per cent of their general beds and 80 per cent of ICUs for treatment of COVID patients. There is also the option to convert the entire hospital into a COVID hospital. Private hospitals have been ordered to charge patients at the rate communicated by the government.

In a move to prevent overcrowding and overstaying in hospitals, the government directed that patients be discharged after 10 days from the date of sample collection. The Bhubaneswar Municipal Corporation will prepare a district-wise list of patients who are on their ninth day of stay in the hospital and on the 10th day the district Collectors concerned will take steps to pick up patients who have recovered. In case of default, such patients will be transferred to COVID care homes in the city.

As many as 48 COVID hospitals have been set up in Odisha with a total of 7,328 beds and 710 ICU beds. A total of 1,180 beds and 236 ICU beds were available in four COVID hospitals in Bhubaneswar and 266 beds and 34 ICUs beds in Cuttack city.

When it was found that the COVID hospitals in Bhubaneswar were being used as referral hospitals, the government asked the district authorities not to rush the positive cases to hospitals in Bhubaneswar. About 40 per cent of the COVID hospital beds in the rest of the State remained vacant while there was overcrowding in Bhubaneswar and Cuttack.

The available facility at the district-level should be utilised to the fullest extent before referring a patient to hospitals in Bhubaneswar, the government told the district administrations. The medical officer of the district will inform the medical officer of the COVID hospitals in Bhubaneswar and obtain confirmation about the availability of the requisite facility before sending a patient to the capital city.

In another move, the government laid emphasis on mentioning the cycle threshold value in the RT-PCR testing. This value determines the viral load of the positive cases. If the cycle threshold value is known, then the cases can be prioritised for admission to COVID care centres (CCCs). The State has ramped up testing. A total of 25,67,777 tests were conducted by September 15.

Starting with the first case on March 15, Odisha’s tally surged past the 1.5 lakh mark on September 13, with 50,000 cases added in the last two weeks. By midnight of September 15, the total number increased to 1,62,920. While 1,25,738 persons had recovered, there were 36,473 active cases. A total of 709 persons had died in the State—656 were recorded as having died of COVID-19 and 53 were because of other reasons.

In a Twitter post on September 15, Chief Minister Naveen Patnaik said: “With effective strategies, proper treatment and health care infrastructure, Odisha has saved many precious lives and emerged as one of the top three States with lowest number of deaths. Odisha’s case fatality rate is 0.42 % compared to national average of 1.65 %.”

While Khordha district reported the highest number of 28,147 cases and remains the main cause for concern, Ganjam is second with 19,369 cases and Cuttack third with 14,113 cases. Of the 30 districts in the State, those that reported 5,000 and more cases include Puri (7,130), Rayagada (6,381), Jajpur (6,368), Mayurbhanj (6,019), Sundargarh (5,850), Balasore (5,610) and Koraput (5,036).

Ganjam started reporting fewer cases after the administration undertook a series of control measures. Khordha reported 976 cases on September 15, while Gajam tally stood at 68.

Odisha’s efforts to involve lawmakers in managing the pandemic has resulted in nearly 40 legislators and Members of Parliament of the State, including seven Ministers, getting infected. While many of them have recovered, some were still under treatment.

The government has directed all District Collectors and Municipal Commissioners to close down temporary medical centres (TMCs) and community care homes (CCHs) as these facilities had zero occupancy by the second week of September. Local administrations have also been asked to close down CCCs wherever there are no patients.

A total of 17,647 TMCs were set up at the gram panchayat level across the State to ensure institutional quarantine of migrant workers returning home. Subsequently, CCHs and CCCs were set up in both rural and urban areas to isolate suspected cases for testing and further action.

The government also had to tackle floods in several districts in the second half of August. Naveen Patnaik undertook an aerial survey of the flood-hit areas and directed the authorities to complete the assessment of damage and pay financial assistance for damaged houses as per the rules of the State Disaster Response Fund. He also announced a special package of Rs.300 crore for livelihood support for those affected by the floods. The package covers sectors such as agriculture, animal resources development and handloom and handicrafts.

Works under the Mahatma Gandhi National Rural Employment Guarantee Act is being intensified in flood-hit areas with a focus on repair and maintenance of gram panchayat roads, playgrounds, canals, earthen bunds, goat sheds and cowsheds, and fodder cultivation. The Chief Minister said muster rolls should be maintained in electronic form in order to check manipulation and ensure transparency.

Meanwhile, several migrant workers have started returning to their places of work even as the State is grappling with the rising number of infections and striving to strengthen treatment facilities in the worst-hit zones. The authorities are hopeful that the situation will improve in other districts as has already happened in Ganjam.

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