The pandemic management and monitoring strategy of Yogi Adityanath-led Uttar Pradesh government got international recognition and high praise by the World Health Organisation (WHO). The state has further achieved the landmark milestone of completing over two crore Covid-19 tests, the highest in the country which speaks volume about the state’s robust healthcare system and management.
“The UP government’s strategic response to Covid-19 by stepping up contact-tracing efforts is exemplary and can serve as a good example for other states”, said Dr. Roderico Ofrin, WHO Country Representative.
The global health body appreciated the efforts made by Chief Minister Yogi Adityanath and his government for the management especially in tracking the high-risk contacts. Over 70,000 front-line health workers worked across the state to reach out to high-risk contacts of Covid-19 positive cases. The state’s Covid-19 case positivity rate for the month of December has also remained lower than 1.5%. The sharp decline in the daily positivity rate has demonstrated that the rate of spread of the infection is being contained.
Acknowledging contact tracing as an essential public health tool for controlling the pandemic, Dr. Ofrin stated, “Systematic tracking of contacts through a proper mechanism is key, along with a well-trained health workforce to implement the surveillance activities.”
It is worth mentioning that the government has increased the testing to keep a check on Covid-19 infections and also requested the people of the state to remain alert and follow all the precautions. Uttar Pradesh has already set a record in the country for having done most tests in the country. On an average, more than 1.75 lakh Covid tests are being done every day in the state underlining growth of capacity building, again the highest in the country.
As per the Indian Council of Medical Research, more than 14.5 crore Covid-19 tests have been conducted in the country out of which UP boasts of conducting more than 2 crore tests which is almost 14% of all the Covid-19 tests undertaken in the country.
Govt preparations
Taking challenge to combat pandemic, the Chief Minister Yogi Adityanath started round the clock monitoring conducting daily meeting of top officers to assess and analyse ground realities. His proactive approach of being positive in most negative situation was very inspiring gesture for his core team of management adding an extraordinary example of health administration and that too under most horrible circumstances.
The preparations begun much before the danger bells rang. It was in the month of February 2020 itself when the first case of Covid-19 was reported. Fully realising that ‘the sweat in peace time saves blood in the war time’, Yogi immediately assessed his health infrastructure and charted out requirements even before the other states and even countries started taking cognisance of Coronavirus.
The Uttar Pradesh government started with the basics and organised training for the medical staff to sensitise them about the Covid-19, its prevention protocol, treatment flow chart and other logistics. The next step was to procure needed equipment and protective gears for medical staff working in the hospitals.
The herculean task in hand was most challenging but the resolve was steely. Nobody thought that the history was in the making as the Corona management in Uttar Pradesh turned out to be an outstanding administrative success at WHO level.
The successful implementation of Covid strategy was multi-pronged which consisted of containment of virus, treatment of infected persons, more testing, employment to returnee migrants and taking care of the well-being of the people of the state so big as of about 24 crore.
Team-11
In a novel initiative, later resembled in other states, the CM set up a Team-11 comprised of 11 top senior officers, to review the measures taken by the government in management of Covid. Each officer was given a specific task to be carried out by him in coordination of other officers. CM used to take meetings of Team-11 on a daily basis. The prompt monitoring in such a manner helped the state control the spread of Corona better than any other state in the country.
The officers/team was selected keeping in view the issues public was likely to face because of Covid restrictions. For example in the Agriculture sector, it was for the government to ensure hassle-free harvesting and in the Industrial sector, it was to be looked into that all important industries like those dealing with medicines, medical equipment’s were run without any difficulty. Similarly, attention was to be paid to those units which were dealing with essential commodities.
As a pro-active protective measure, the CM had sealed the inter-state and international borders of the state even before the country-wide Lockdown was imposed. In order to mobilise required funds to supplement health services, the UP government created the ‘Covid Care Fund’. Bed capacity in the Covid hospitals was increased. These steps were instrumental in keeping as low as 1.3percent
Janta Curfew
The Janta Curfew was imposed countrywide on the appeal of Prime Minister Narendra Modi on March 22. The PM had termed it as the best preventive measure. Moving ahead in this direction, UP Chief Minister was the first to announce three-day Lockdown but not before ensuring that the citizens get all necessary items during this period. The Centre declared nationwide Lockdown from the midnight of March 24. During this also, the state government catered to all the needs of the people ensuring they do not have to move out from their houses. The government arranged a doorstep delivery mechanism for this.
Emphasis on testing
Covid sample testing is the only way to identify a Corona-infected person. Initially, Uttar Pradesh did not have sufficient testing facilities. Imagine, the state had only one testing lab and the testing capacity of just 60 on March 22. It was all about how you muster and marshal your available resources. The result is evident by the fact that there are over 234 labs in the state including 131 government labs which conduct testing of about 1.75 lakh samples every day. Uttar Pradesh has already set a record of having conducted a total of over 1.30 crore tests.
The state government was prompt to engage itself into an expeditious purchase of equipments like PPE kits, High Flow Nasal Canula (HFNC), Ventilators, Oxygen cylinders to provide ICU care. The training to doctors and paramedics, which had started early in March itself, was also intensified.
Contact tracing
Uttar Pradesh government’s strategy about contact tracing of the Covid patients, which also won the WHO recognition’, came handy in controlling the menace and established as an effective preventive measure.
An aggressive contact tracing strategy using Rapid response teams and ensuring testing for almost every identified close contacts of Covid positive patient came across as a defining tool in the whole Covid management process.
Thousands of surveillance teams were formed to conduct surveys of the houses, acquaintances and contacts of the patients. In fact, an unprecedented surveillance effort to identify Influenza Like Illness(ILI)/ Severe Acute Respiratory Infection (SARI) patients using multiple rounds of house to house visit by frontline workers was afoot to identify potential threat perception in terms of Covid. It helped them tested and referred for early treatment.
Covid Hospitals
The state had no Covid hospitals in March when the state had gone into Lockdown and the Covid positive cases started pouring in. The problem was the absence of exclusive Covid hospitals. Again, the challenge was accepted and now the state of UP has a total of 674 Covid hospitals inclusive of 571 Level One Covid Hospitals, 77 Level Two Covid hospitals and 26 Level Three Hospitals. The total availability of beds in these hospitals has been increased to 1.57 lakh no mean achievement considering that the population size of 24 crore is being catered to and this number was zero in March.
It was again a colossal task to muster health infrastructure of such monumental proposition. The rapid ramp up of treatment infrastructure in terms of ICU beds/ Oxygen supplies/ Ventilators and ensuring adherence to standard treatment protocols was ensured in all the districts. The uninterrupted supply of medicines and the logistics was another aspect which was taken acre of well during the crisis. UP Medical Supplies Corporation ensured that procurement did not become a barrier to covid response efforts.
Indeed, it was due to clear command lines and uncluttered instructions which helped build up a strong health ecosystem which could deal with such a medical emergency with consummate ease.
As of now, all 75 districts of the state have at least one or more Level-2 Covid hospitals having provisions of ICU beds.
ICCC
Identifying the sturdy mechanism of monitoring is the need of the hour, the UP CM directed to set up the Integrated Control and Command Centre (ICCC) at the office of the Relief Commissioner at state headquarters. The similar ICCCs were also established at every district headquarter to be manned by the concerned District Magistrate and Chief Medical Officer (CMO).
ICCC became the focal point of Covid management from contact tracing, ensuring home visit by health team for patients who were put in home isolation to ensuring testing for all eligible persons. Besides, the continuous dialogue with Covid patients was maintained through CM helpline, all patients were given a call to know their wellbeing and any issue faced at hospital level.
Apart from these, the streamlined ambulance services, introduction of online OPD services, tele-medicine and tele-consultation facilities were the other logistics employed by the government during Covid management.
The state government also ensured the supply chain of oxygen was maintained and even a new oxygen plant was inaugurated in Modi Nagar, Ghaziabad during Covid times.
As added facility for the Covid positive patients, a unique portal UPCovid19tracks was developed in a record time. This functioned as the single source of information helping track every patient longitudinally by all stakeholders- State government, Testing Labs, Hospitals etc. providing real time information on the basis of which responses could be adjusted dynamically.
Migrant Crisis
The influx of about 40 lakh migrants and their rehabilitation was a major challenge for the government. The government’s decision to hire trains to bring the migrants was another major challenge. As many as 1660 trains ferried to bring in migrants from various places. The condition of the migrant who returned from various places of the country was also pitiable. The returnee migrants, who were sent to home quarantine, after proper medical check-up, were given ration kits with 30-day ration. As a rare goodwill gesture, every migrant being sent to home was given sustenance allowance of Rs one thousand each along with the ration kit. In addition to this, about 53 lakh construction labourers, street vendors, carriage pullers and daily wagers of rural areas were also given rupees one thousand each through Direct Benefit Transfer (DBT).
Every needy is being taken care of
The government claimed distributing free food grains from April, irrespective of the place from where the ration card was issued to the beneficiary. The government paid two-month pension in advance to as many as 86,71,781 beneficiaries under the scheme of old age pension, destitute pension, Divyang pension and pension for lepers. Also, in the month of June, the pension was paid under PM Poor Welfare Scheme Package. 35818 Gram Sewaks were paid a total of 225.39 crore during the Lockdown. More than 17,64 lakh MNREGS labourers were given jobs in 53487 Gram Panchayats, as much as 4508. 25 crore honorarium was paid to them by creating 22.90 crore man-days. Incidentally, UP tops in the country on this count as well.
Jobs to all
The government made MNREGS job cards of returnee migrants and also of those who desired to work in the villages. It was ensured that they get work close to their homes. The skill mapping of about 40 lakh labourers was done so that they get jobs according to their skill set. A labour employment commission was set up for social and economic security of labourers. Over 8 lakh MSME units were made functional where over 51 lakh labourers are employed. 10744 crore of loan was distributed among 4.35 lakh industrial units under Atmanirbhar Yojana.
In addition to this, over 5.81 lakh new units were started and the loan worth over 15541 crore was distributed under Atmanirbhar Yojana and over 25 lakh jobs were created. The loans worth 2447 crore were distributed online to 98743units on a single day on May 14, 2020. The government came up with a new Startup Policy to motivate youth towards self-employment. About 50,000 persons are expected to get direct and one lakh persons, indirect employment.
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