Leading by example: How NE India is battling Covid-19

GUWAHATI, 24th Apr: Alarms in Northeast India went off when the first case of COVID-19 from the region was reported from Manipur on March 24. In a period of 28 days till April 21, the region registered 53 cases of the novel coronavirus pandemic which is an average of about 2 cases every day. Till then, Assam led the tally among the Northeastern states with 34 cases followed by Meghalaya with 12. Sikkim is the only state in the region in particular, and in India in general, to not register even a single case of COVID-19 so far.
However, the cluster of the eight Northeastern states, which is seldom looked upon by ‘mainland India’, has set an example for the rest of the country on how to prepare and fight the deadly virus.
Assam health and family welfare minister Himanta Biswa Sarma in a recent press conference said that the state has managed to break the COVID-19 chain as all the positive patients are either in quarantine or has tested negative. He also said that there was no further contact between the society and positive patients and the state has successfully flattened the curve.
Considering Assam’s huge population, urban clusters and socio-economic characteristics, the rate of new cases remained much lower in comparison to other states such as Maharashtra, Delhi or Madhya Pradesh. The state has tactfully managed to separate the infected and their contacts from the healthy ones.
As per health experts, the impact of COVID-19 on a human body can range from no symptoms to severe illness featuring pneumonia. Everyone infected requires to be quarantined, either at home or at a medical facility but people with severe symptoms need to be hospitalised.
Assam is also preparing for the second phase of coronavirus, if and when that happens after the lockdown is lifted.
As soon as the first case of the region was reported in Manipur on March 24, prohibitory orders were issued in various districts of the state including Churachandpur, Bishnupur, Noney and Ukhrul ordered restriction on public movement outside to prevent further spread of the deadly virus. Sub-section (2) of Section 144 of the Code of Criminal Procedure (CrPc), 1973, was imposed. Further, many villages were also seen voluntarily locking down and prohibiting vehicular and public movement as precautionary measure.
As many as 486 people who came from COVID-19 affected countries or states were put under home surveillance, said state officials.
Authorities and Manipur police swung into action spraying disinfectants on streets leading to major markets, including the Ima Keithel, in Imphal. They also cleaned and sterilised the streets, footpaths and railings in the public areas as well as removed waste dumped on roads, said reports.
Similar work were also reported from various localities where locals sanitised their surroundings, including cleaning of drainage, maintaining hygiene in their home premises.
While cases from Tablighi Jamaat congregation began to emerge across the country, Manipur identified 14 attendees before another case came to the fore. And a day later, an attendee was tested positive for the virus.
The state sealed its borders with Myanmar at eight points, and Lilong area in Imphal was completely sealed off.
Likewise, in Assam on March 31, when a Tablighi Jamaat attendee was tested positive, becoming the first case in the state, a non-stop operation was carried out to trace nearly 500 people who took part in the religious congregation in New Delhi. Though 33 of the 34 cases in the state are directly or indirectly related to Jamaat, its swift action bore fruits as the Assam successful managed to sever the chain, with all the positive patients in quarantine and no contact between the society and positive patient. Two containment zones were identified in Guwahati and sealed off, restricting entry and exit from those places. Constant sanitisation is underway in the state.
On April 6, when Tripura reported its first case, area of 1-km radius around the patient’s residence was sealed. Also, the district administration sealed another 1-km area on either side as per protocol. The standard spraying and disinfecting procedures were put to action.
The person's travel history was revisited and 108 contacts were quarantined and tested.
Meanwhile, when a renowned doctor from Bethany Hospital, Shillong in Meghalaya became the first person to test positive for the virus in the state on April 13, a 48-hour curfew was immediately imposed in Shillong Agglomeration area.
Soon after, the entire corona task forces of the state sprang into action and within 18 hours of the report of the first case, 90 samples were tested. The government was also been able to establish 2,000 contacts, besides listing down the primary contacts of the patient. Similarly, the other states quickly took action and have managed to so far contain the spread of the virus. Meanwhile, Sikkim remains the only state in the country to be free from COVID-19 pandemic.
The fight against coronavirus essentially comes down to the availability of hospital beds, ventilators and Personal Protection Equipment (PPEs) for doctors, nurses and medical teams. With a large section belonging to the financially weaker section of the society it leaves public healthcare facilities as the only available option for them. As per National Health Profile, Northeast have a total of 35,296 beds in 1,946 government hospitals that leave one bed for approximately 1,275 people if we go by the 2011 census.
Patients found to be COVID-19 positive were sent to isolation wards creating a demand for more quarantine zones. Additionally, for critical cases, intensive care is needed. Currently, almost all suspected cases of coronavirus are referred to government hospitals and quarantine centres.
Wasting no time, the Assam government set up two quarantine centres with capacity of nearly 1,000 persons each in Guwahati. However, patients who are worst affected by the infection will require critical care in form of ventilator support. Among the north-eastern states, Assam is equipped with 303 ventilators followed by Meghalaya with 163 ventilators, Manipur with 90, Arunachal Pradesh with 23 and Nagaland with 17.
For those who develop trouble breathing, medical care outside of the home is needed. This may be in the form of supplemental oxygen and/or breathing treatments. These may be given in an urgent care or emergency room setting that is equipped with a ventilator and experts to operate the machine. Ventilators are used to manage and treat individuals with severe lung infections, commonly used in patients with chronic lung disease, severe asthma, chronic bronchitis, emphysema, or lung scarring in situations where patients are not able to maintain blood oxygen levels.

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