A Multi-Pronged Approach That Helped Odisha Fight The Pandemic

Bhubaneswar: The fight against the most devastating Pandemic of the 21st century was not so easy. While it had no parallels in the recent past, it needed to be tackled in a systematic approach. Millions of vulnerable people were to be saved from the alien disease and the infected were to be treated. All this needed man, money and expertise. Also important was an exemplary leadership that aspired for minimum casualty and maximum effort in fighting Covid-19.

Odisha, which saw its first case of Covid-19 in the first week of March 2020, is one of the few states in India that took containment measures much before others initiated. Even the Center was behind Odisha in taking preventive steps. Odisha Government set up a Control room early in the month of January to keep an eye on the developments going on in the country and the world over. Review meetings were held regularly with senior officials from various departments participating and deliberating on Covid-19 developments.

Odisha’s effective handling of the pandemic is the outcome of a proactive leadership combined with the dedication of the administration and Covid warriors. Without the cooperation of the common people it would not have been easy to fight the alien disease. When we look back today to understand how the lines were drawn and the battle was fought, the answer lies in the multipronged approach.

Odisha’s efforts primarily concentrated on the following approaches:

• Early preparation and stringent control measures
• Effective governance and evidence based decision making
• Enhanced surveillance, testing and treatment measures
• Supporting and encouraging healthcare and frontline workers involved in COVID response
• Effective rollout of COVID-19 vaccination of the due beneficiaries

A. Early Preparation And Stringent Control Measures

The preparedness to handle any case of COVID-19 started as early as from January 2020 onwards. Activities undertaken before the 1st case detected included setting up of State control room in January 2020, which helped in looking closely to the matter and started preparing for the State in terms of setting guidelines and SOPs on local perspective. State level orientation of District Public Health response Teams were carried out on 10th and 11th March 2020 in collaboration with World Health Organization. This followed by the district and block level orientation training. Capacity Building of all Doctors, paramedics, Frontline workers etc., were done in a dedicated way. In total approximately 33.3 lakhs health workers, Front line workers and PRI members were oriented on COVID-19. This helped in better implementation of various public health and therapeutic activities like surveillance, quarantine, testing, micro-planning and providing treatment. Another important initiative of the pre pandemic time was the discussion regarding COVID-19 Regulation Act, 2020 in assembly on 13th March 2020. Public demonstration of hand washing by CM Naveen Patnaik along with all the members of the assembly set an example among the community and influenced the public in a positive way to comply the COVID appropriate behavior.

Important Public Health response were implemented on a war footing manner as soon as the State got its 1st case of COVID-19 in Bhubaneswar. Various coordination committees and verticals were formed on 17th March 2020.the biggest response those days was the State implemented lock down on 21 March. More over Odisha also became the 1st State to extend the lock down followed by which the Government of India also declared the extension of lock down. There are four phases of Lock down followed by which the GOI issued phased Unlock in a strategic and coordinated manner.

Odisha signs MoU for 1000 bedded Dedicated COVID Hospital in Bhubaneswar on 25th March. In a short span of time Dedicated COVID Hospitals were set up across the States. Dedicated COVID Health Infrastructure was established in a record time. 53 dedicated COVID hospitals were established with more than 10,000 bed capacity. Having dedicated COVID hospital was one of the well thought strategy that kept the COVID patients away from other patients which in turn proved to be protective for the Non-COVID patients. This enabled special focus on COVID patients for ensuring better treatment and reducing the overall fatality as envisioned by CM Naveen Patnaik. One important component of Odisha’s way of COVID 19 response was the public-private partnership.

On 15th July 220, the state government established Plasma banks. They were established to ensure availability of convalescent Plasma therapy to the people on need. Many COVID recovered persons come forward to donate plasma. Plasma therapy helped to reduce the fatality among the moderately affected patients. Chief Minister Naveen Patnaik rolled out the Infection Prevention and Control (IPC) strategy on 10th June 2020. All Government and Private Hospitals were mandated to comply with the IPC strategy. This became helpful in controlling the cross infection in healthcare set up.

The second important strategy of the Government of Odisha was Effective Governance and evidence based decision making. As soon as the first case was detected, the State Government launched its aggressive action. Thematic areas on COVID-19 response were assigned among senior secretaries. On 17th March 2020, Verticals and Coordination teams were formed. Considered to be one of the most effective strategy, this supported roll out of all measure public health activities in a multi-lateral fashion. Chief Minister Naveen Patnaik used to review on weekly basis and the Chief Secretary reviewed the developments on a daily basis. Most importantly majority of decisions taken were based on the technical information, evidence or opinion of experts from WHO, UN, ICMR etc.

Odisha was among the pioneer states to frame and implement the “COVID-19 regulation act” that enables strict and fast implementation of public health measures for containment of COVID-19 Pandemic. Delegation of power to Sarpanches for local managements like initiating containment zones, procurement of logistics for TMCs etc. was a turning point in the fight against the pandemic. Prompt and seamless procurement of drugs, equipment and logistics so as to deliver the masks, sanitizers and PPE kits across the state in adequate numbers proved to be another success for the administration. Regular briefing of the press and dissemination of information by the I&PR department to prevent unnecessary panic among public. Four phases of IEC campaign is conducted to educate and aware people on various developments on Pandemic and its prevention and treatment measures. Government popularized administration of “Favipiravir” during home isolation for the eligible patients.

One of the important strategies of Odisha’s Covid fight was Effective management of Migration. 7.6 lakhs Pravasi Odias were successfully shifted while 16,824 TMCs were created for their quarantine. This was a point to point management of the migration with coordinated efforts of assigned departments and teams.

Enhanced surveillance, testing and treatment measures played a crucial role in the state. IT enabled surveillance and contact tracing was done in coordinated fashion by the Health &FW, IT and Home department. This helped in tracking the home quarantine of patients and identifying the contacts based on real time mobile location. Door to door surveillance was done for identifying ILI/ SARI and comorbidities (DM, Hypertension, TB etc.). In this way all houses were reached and details of suspected COVID cases and comorbid patients were taken. They were tested for COVID-19 by RT-PCR method. The strong surveillance detected those cases which could have been remained un-detected and helped us better control the pandemic as depicted in the “Epidemic Curve” above.

Initial thrust was on Expansion of lab facilities and scale of testing capacities to enhance number of tests per day. Although all samples were sent to NIV Pune lab, very soon the RMRC lab was made functional for testing COVID-19 in RT-PCR technique. Without much delay, the state increased the capacity in terms of human resources, technologies and procurement of logistics through OSMCL to established as much as 24 RT-PCR labs, 32 TruNAT and other labs. Collaboration was made with private parties and central institutes so as to enhance the testing capacity to as high as 60,000 tests in a day. In comparison to 140 test per million per day, the state was testing as high as 1200 tests per million per day during the peak time.

Supporting and encouraging healthcare and frontline workers involved in COVID response was the mainstay of Odisha government during the pandemic period. Odisha Government issued orders for stringent action to those who harass the health care workers in any way. Logistics and other support during the working hours was provisioned including food, hostel facility and dedicated vehicles for transportation. Special incentives were being given to all cadres of Health care workers and the support staffs. Financial support from CM’s relief fund was provisioned to COVID warriors who succumbed to death and were able to get financial support from the Government of India. Add to that financial and job support schemes were provisioned for the Next of Kin of the deceased individuals.

Effective rollout of COVID-19 vaccination of the due beneficiaries. Odisha made an advance listing of beneficiaries of 3.5 lakhs HCWs and 1.9 Lakhs FLWs for timely roll out of vaccination of elderly (more than 60 years) and comorbid ( more than 45 to 59 years with diseases) persons. Odisha has achieved the target to vaccinate 1 lakh person per day to ensure early protection of elderly and vulnerable population.

When it comes to performance indicators, Odisha has the best parameters. The latest data shows that the test positivity of the current week to be 0.29%, with Current Growth rate (7 day moving average) at 0.02% (as on 13th March). The state’s Recovery rate stood at 99.2% with 652 Active cases and 71 new cases as on 14th March. Low Case fatality of 0.55% is one of the lowest among the country and has been consistently low at around 0.5% since more than 10 months in a row. On statistical analysis Odisha outperformed the National average in almost all indicators and makes its position among the top performing states and union territories.

What the State is doing in view of Resurgence of cases in other States: It is noticed that the daily number of confirmed COVID-19 cases are on increasing trends in many states like Maharashtra, Kerala, Punjab and Karnataka etc. The Government of Odisha is closely watching the situation and has been alert in this regard. In order to detect any case imported via air and rail route, screening in these locations have been made mandatory.

Surveillance of ILI/SARI and any such migrant have been strengthened and testing of all suspected have been made mandatory with RT-PCR testing. The officials are in touch with experts for further measures to be taken and reviewed our preparedness level if unfortunately the cases will increase.