All of you have made a number of important points while assessing the seriousness of the present situation, and made a number of necessary suggestions.It was very natural that special discussions have been held with those stateswhere the mortality rate is high and where the corona spread is gaining momentum. But the rest of the states can also have very good suggestions. So I would urge you to convey to me any positive suggestions that are necessary so that they are effective in formulating some strategy.
It is also clear from the presentation made by the Health Secretary on behalf of the Government of Indiathat a challenging situation is developing once again. The situation is very alarming in some states. In such a situation, it is very important to improve the governance system. I can understand that this year-long battle can also lead to fatigue and laxity in the system. But we should emphasise strengthening our governance system for the next two-three weeks.
While reviewing the situation today, there are some issues which are very evident and we need to pay special attention to them.
First, the country has crossed the peak witnessed during the first wave and this time the growth rate is faster than ever.
Secondly, several states, including Maharashtra, Chhattisgarh, Punjab, Madhya Pradesh and Gujarat, have also crossed the peak during the first wave. The numbers are growing in some more states. I think it is a matter of serious concern for all of us.
And thirdly, this time people have become much more casual than before. The administration also appears to be sluggish in most of the states.In such a situation, this sudden rise in corona cases has added to the woes. It is necessary to work on a war footing again to prevent the spread of corona.
Despite all these challenges, we have better experience and resources than before, and now we have vaccines. Along with public participation, our hardworking doctors and health workers, health-care staffhave helped in handling the situation and they continue to do so. All of you are expected to use your earlier experiences effectively.
Just imagine what was the situation last year. We didn't have testing labs. The availability of masks was also a matter of concern and there were no PPE kits. And the only way we could escape at that time was lockdown, so that we could ramp up arrangements as fast as possible and that strategy was very beneficial. We could create arrangements and resources and increase our own capability. We got whatever was available in the world and used them during the lockdown period.
But today, when we have all the resources, it is the test of our governance and our emphasis should be on micro containment zones. Our maximum stress should be on small containment zones.Wherever night curfew is in place, the phrase 'corona curfew' should be used there so that awareness regarding coronavirus is maintained.
Some people have this intellectual debate whether corona strikes at night. In reality, the use of this night curfew has been an accepted experiment globally because it reminds every person that he is living in the Corona era and lifestyle is also not affected to a large extent.
It would be better that the 'corona curfew' starts at 9 PM or 10 PM in the night and goes on till 5 AM or 6 AM in the morning so that other activities are not affected. And therefore, it should be popularised as 'corona curfew'. Corona curfew is helping make people aware (about the virus). So, we need to pay attention to this. As I said earlier, now that we have developed so many resources, there is a need to focus on containment zones and we will get good results. Yes, the government has to put in extra efforts, has to tighten the governance system and observe minutely everything. Believe me, it will bear fruits.
Secondly, we succeeded in bringing down the figure of active cases from 10 lakhs to 1.25 lakhs last time. The same strategy which made it possible is equally effective today. We achieved success at that time when there were not many resources. Today, we have better resources and experience as well. Therefore, we can bring down this peak very fast and not allow it to go up.
And experience says that we have to emphasize 'Test, Track, Treat', Covid appropriate behaviour and Covidmanagement. Now you see there is a topic and I would urge all the chief ministers to do an analysis or survey through your state machinery what used to happen earlier during Corona, people used to be scared even if there were minor symptoms and would immediately take action. Secondly, there are many asymptomatic patients this time and that’s why they feel that they are suffering from cold only.
Since the symptoms are not clearly visible, people in the family continue to live as before and as a result the entire family gets affected. We start paying attention only when the intensity increases. The root cause of the people who are getting affected in the family today is they have become careless as they are largely asymptomatic. What is the remedy? The remedy is proactive testing. The more we do the testing, the asymptomatic patients will be discovered and they can be home quarantined. They will not live the life with their family as before. Therefore, we can prevent the entire family from getting affected.
And, therefore, we need to discuss more about the testing than the vaccination. We need to emphasise on testing. We need to change the way we have been testing.
The important way to contain the virus is that we restrict hosting people. I have said it earlier also that this corona is something that does not come into the house unless you bring it. We need to awaken people and they have to follow the rules. And testing and tracking have an important role. We should not take the testing lightly.
We have to ramp up testing in every state so much that we have to bring the positivity rate below 5 per cent in any way. And you will remember that initially, when the reports of corona started coming in, it was being said that a particular state was doing better whereas some other was lagging behind as cases were rising exponentially. It had become a fashion to criticize states. In the very first meeting, I had told you not to worry about the rising number of cases, don’t be tense just because your performance was not up to the mark; rather concentrate on testing. And I am reiterating it today. Just because the numbers are increasing does not mean that you are doing something wrong. More positive cases emerge because of increased testing. But that is the only way out. And there are people who will criticize, let them. We will have to bear with criticism.
But the only way out is testing. If the testing leads to a higher figure of positive cases, let it be. The states should not be judged just because of the numbers. Therefore, this is my request to you to come out of this pressure and instead focus on testing. Even if there are more positive cases, let it be. Only then, we will be able to find a solution.
Our target should be 70% RT-PCR tests. There have been reports, though I have not verified them that those who are taking the samples through RT-PCR are lethargic. They are not doing the tests properly. If not done properly, the tests are bound to yield negative results. Therefore, it needs to be prevented. It does not matter whether there is an increase in the positive cases. The treatment can be done only if there are positive cases. If the tests are not done properly, it will spread in the family and will ultimately affect the entire neighbourhood.
In the last meeting also, we discussed the need to increase RT-PCR tests. Therefore, I reiterate there should be proper tests. You must have noticed that there are some labs which are giving negative reports to everybody whereas there are others which are giving positive. This is not a good picture. Something is missing somewhere which we need to check. Some states will need to ramp up their infrastructure. The faster we do it, the better it will be.
If there is a need to increase shifts in labs then I think it should be done. As I said earlier, we have to put emphasis on testing in containment zones. Not a single person should be left without testing in the containment zones. You will see the faster results.
We need to scale up tracking, testing and containment at the administrative level. We should target a minimum of 30 contacts to be traced within 72 hours. If a person is tested positive, we need to track at least 30 people who have met him. There should be clear demarcation of containment zones. It should not be vague. Don’t make the entire locality a containment zone if there are two flats on the six-storey building from where positive cases have been discovered. Don’t seal the nearby tower. Otherwise, what will happen? It is very easy to seal the entire tower or the locality as it does not require that much effort. Don’t go in that direction.
All of you are alert to the situation. I request you that there should not be any laxity in our alertness. We need to ensure that our efforts don’t become lax due to Covid fatigue. Some states have formed teams to periodically cross check the contact tracing which have given good results.
The SOPs by the Health Ministry for the containment zones have been prepared with a lot of experience and those SOPs have been updated from time to time. Wherever these SOPs are adhered to properly, we are getting good results. Therefore, my suggestion is that proper attention is paid to it.
We all have expressed concern regarding the mortality rate in our discussions. We need to contain it to the minimum. Actually, the root cause of the problem is that anybody who leads a routine life and considers it to be a minor disease spreads it to the entire family. He goes to hospital only after the situation deteriorates. By the time testing is done, considerable time is lost. There should be information regarding deaths from each hospital. At which stage it was discovered, when the patient was admitted, whether the patient had other diseases, the factors behind the death. If we have comprehensive data, it will be easier to save lives.
All of you are aware that AIIMS Delhi organizes webinars on the issue every Tuesday and Friday and doctors from across the country take part. It should continue. All the hospitals of the states should join these webinars so that they are aware of the National Clinical Management Protocols. These processes should be explained to the medical faculty. Similarly, there should be periodical review of ambulances, ventilators and oxygen availability. As compared to the previous peak, oxygen is not being used as widely this time. Therefore, we should analyse everything and verify the reports.
We have crossed the figure of 40 lakh vaccinations in a day. Many important points on vaccination have come to our fore in this discussion. Involve your officers in the vaccination drive. India is no different from the richest countries around the world which have all the facilities available as far as the criteria regarding vaccination are concerned. You just need to study them. All of you are educated people, just go through it.
Efforts are underway to increase the capacity of vaccination manufacturing to the maximum along with the development of new vaccines. Discussions have also taken place regarding the stocks and wastage of vaccines. You are very much aware how much vaccines can be developed. It is not possible that such huge laboratories can be set up in no time. Whatever is available to use, we need to prioritize that. If we keep the entire stock in a particular state and expect to get good results,this is not the right approach. We need to manage it while keeping the interests of the entire country. The very big part of Covid management is prevention of vaccine wastage.
The nation-wide strategy was made only after discussions and consent from the state governments. I request you to focus on vaccinating all those who are above 45 years in the high focus districts. You achieve this at least. I give you a suggestion. Sometimes, it helps in changing the atmosphere. The birth anniversary of Jyotiba Phule is on 11th April and on 14th April, there is the birth anniversary of Baba Saheb. Can we organise a "Tika Utsav" or vaccine festival and create an atmosphere of “Tika Utsav”?
We should vaccinate as many eligible people through a special campaign and decide on zero wastage. If there is zero wastage in four days during “Tika Utsav”, it will also increase our vaccination capacity. We should make optimum utilization of vaccination capacity. And for this, if we have to increase the number of vaccination centres, we should do it. Let’s see how we can mobilize things from April 11 to 14 and there will be satisfaction of achievement. It will greatly help in changing the situation. I have also told the Indian government to provide as many vaccine doses as possible. This should be our endeavour to vaccinate maximum eligible people during the “Tika Utsav”.
I will also urge the youth of the country to help those above 45 years around them to get vaccinated. This is my special appeal to the youth. You are healthy, resourceful, and you can do so many things. If the youth of the country follow the protocols of Corona like maintaining distance, wearing masks etc, then Corona can’t come nearer to them.
We should emphasize on precautions among the youth. Rather than forcing the youth for the vaccination, we should inspire them to follow protocols. If the youth decide to take it as a challenge, he will not only follow the protocols but will make sure that others also follow the same. We can come back to the same level when we reached the peak of the positive cases and the decline began. We can move ahead with this belief.
The government has developed a digital system which is also helping in the vaccination of the people. People are also commending it. However, there are some people, the poor families who are not very much aware of the technology. I would like to tell the youth to come forward to help such families. We should utilize the services of NCC, NSS, government systems so that people can be relieved. We should worry about it.
There is a very large section of people in cities who are poor, elderly and are living in slums. These things should be conveyed to them. Our governments should mobilize volunteers, civil society and our youth in this regard. We must make efforts to vaccinate them on a priority basis and we will derive satisfaction with this work of virtue. Along with vaccination, we also have to ensure that there is no negligence even after vaccination. The biggest crisis is that people start believing that nothing will happen to them now. From day one, I am saying medicines as well as strict adherence.
We need to repeatedly tell people that it is essential to follow rules, like wearing masks and other protocols, even after vaccination. It is very necessary to recreate awareness among people regarding masks and other protocols who have become irresponsible. Once again, we need to involve influential people, social organizations, celebrities and opinion makers of society in this awareness campaign. I also urge you to make maximum use of the institute called Governor.
Under the leadership of the Governor and under the guidance of the Chief Minister, all states should at least hold all-party meetings and firm up actionable points. This is my request that the Governor and the Chief Minister should together hold virtual webinars with all the elected representatives. It should start with urban bodies and then rural bodies. The webinars should be with all the elected people. It will send a positive message that it should not be politicized and all of us have to do it together. This effort should be made.
Since the Chief Minister is preoccupied with so many things, a summit or a webinar with the religious leaders and others can also be organized under the leadership of the state Governor. A summit can also be held with the Civil Society. Similarly, it can be done with celebrities, writers, artists, players, etc.
I am of the view that such a movement should be run through the Governor to bring together people from different walks of life and they should be emphasized to follow the protocols and undergo tests. What has happened is that we have forgotten about testing and shifted to vaccination. Vaccines will reach the people as and when it is available. Earlier, we won the battle without vaccines. We were not even sure whether there would be vaccines. Today, we don’t have to fear it.
The way we fought this battle, we can win this battle again. As I said I can see the reason how the entire family is becoming affected. You also verify this. I am not claiming this. I just want to draw your attention that it spreads initially due to asymptomatic reasons and later engulfs the people who are already battling some disease or the other. Later, the entire family gets into trouble.
Therefore, this is my request that we have to overemphasize on testing and proactively. Today, we have resources. Labs have been set up in every district of the country. We started with one lab and today labs are there in every district. How it can be contained if we don’t use these labs.
As far as the question of politicization of the issue is concerned, I have witnessed it from day one and have been facing various kinds of statements, but I don’t open my mouth. I am of the view that it is our sacred duty to serve the people of the country. God has given us the responsibility to serve the people in this difficult period and we have to discharge it. Those who want to politicize the issue have been doing it. I have no words for them. But all the chief ministers should call all political parties in their respective states, discuss the issue with them and will help change the situation. I am hopeful we will come out of this troubled period within no time.
Once again, this is my mantra – medicine as well as strict adherence. Don’t compromise on the issue. I said this last time also that if someone has a cold and he took medicines, but is raining outside and he says that he won’t use an umbrella while stepping out. It can’t be like this. If you have a cold, have taken medicines; you will have to carry an umbrella if it is raining outside and will have to wear a raincoat. Similarly, Corona is like that. We will have to follow all the protocols.
As we contained the Corona last time, we will do it this time as well. I am confident and have complete faith in you that if you take the initiative, worry about the situation and focus on testing (we will overcome the crisis). Vaccination is a long drawn out process which we will have to run for a longer period. Now, we should focus on the ‘Tika Utsav’ and try to achieve a breakthrough. One small occasion can help in creating a new trust.
I will wait for your suggestions.