The Centre urged the states and Union Territories on Wednesday to strictly monitor the home isolation cases of COVID-19 so that these patients do not intermingle in the community, while stressing on awareness regarding home-test kits through the rapid antigen test for a timely identification of the disease.
The states were advised to conduct surveillance and report district-wise severe acute respiratory illness and influenza-like illness cases on a daily basis and also to send these for genome sequencing to the mapped INSACOG laboratories.
They were advised to undertake test indicated proportion of international arrivals with genome sequencing of all the positive cases and identify sentinel sites for the Indian SARS-CoV-2 Genomics Consortium network to send samples for whole genome sequencing, according to a statement issued by the health ministry.
These directions were issued by Union health secretary Rajesh Bhushan as he chaired a high-level meeting on Wednesday to review the COVID situation in nine states -- Kerala, West Bengal, Tamil Nadu, Maharashtra, Assam, Andhra Pradesh, Himachal Pradesh, Mizoram and Arunachal Pradesh.
These states are either reporting a surge in the number of fresh COVID cases or a rise in the positivity rate, the statement said.
The public health measures for surveillance, containment and management of COVID-19 were also reviewed, it stated.
Dr Vinod Paul, member (health), NITI Aayog was also present at the meeting.
Expressing concern regarding the surge in the number of cases in these states in the last one month, Paul said, "We need to be mindful that COVID is not gone. Looking at the global scenario, we need to be at high alert. There is poor surveillance, poor testing and below-average vaccination in many states undergoing the present surge."
He urged the states to improve the testing in areas reporting a high positivity rate, increase surveillance in accordance with the revised surveillance strategy and speed up vaccination, the statement said.
Bhushan underlined the critical COVID control and management strategies.
All districts reporting a high positivity rate need to undertake adequate testing with a higher proportion of RTPCR tests.
Any laxity will result in deterioration of the situation in these districts, the Union health secretary said.
There is a need to effectively and strictly monitor the home-isolation cases so that these patients do not intermingle in their neighbourhoods, community, village, mohalla, ward, etc, and spread the infection.
The states were also urged to send positive samples from large clusters and outbreaks in the community and unusual events for whole genome sequencing.
They were asked to create added awareness regarding reporting those who opt for home test kits through the RAT for timely identification of those cases that need clinical management. All such positive patients to be advised for home isolation to prevent the infection spread in the community, the statement said.
The states were urged to accelerate the free COVID vaccination for the first, second and precaution doses.
They were further requested to intensify the implementation of free precaution doses for the 18-plus population under the "COVID Vaccination Amrit Mahotsav" till September 30.
The states were told that a focused implementation of COVID-appropriate behaviour is critical to control the spread of the infection.
They were advised to create awareness within the community on the infection spread and on these protocols, the statement said.
Dr Randeep Guleria, director, AIIMS-New Delhi, advised the states to be attentive to the clinical symptoms of Covid patients and not wait till their genome sequencing is done to identify whether a cluster is emerging.
The states need to be attentive to the changing pattern of clinical manifestation of hospitalised patients, Guleria said.
It was pointed out that the average number of tests per 10-lakh population is below the national average in Andhra Pradesh, Arunachal Pradesh, Assam, West Bengal, Maharashtra and Himachal Pradesh, while the share of RTPCR tests is very low in Mizoram, Arunachal Pradesh and Assam and below the national average in Himachal Pradesh, Kerala and West Bengal.
These states were asked to urgently address the declining trend of RTPCR tests and improve their average daily tests per 10-lakh population, the statement said.
It was noted that there remains a substantial scope in increasing the pace of vaccination in Arunachal Pradesh, Mizoram, Assam, Maharashtra, West Bengal, Tamil Nadu and Kerala. The states were also exhorted to ensure strict surveillance in all the districts of concern that have shown a positivity rate of over 10 per cent in the last week, the statement said.
The states were reminded of the Centre's new initiative -- "COVID Vaccination Amrit Mahotsav" -- which was launched on July 15 to provide free precaution doses from all the government Covid vaccination centres.
Everyone aged 18 years and above and who have completed six months or 26 weeks since the administration of the second dose of a COVID vaccine are eligible to receive the free precaution dose till September 30.