COVID COUNSELING CENTRE: A decentralized approach for effective COVID management

Assam has been successfully managing the COVID-19 pandemic by adopting multi-pronged COVID response strategies, namely 4Ts – Testing, Tracing, Treatment and Transparency in action. The entire initiative is supported strongly by Government of Assam and being led from front by Health Minister of Assam and duly supported by strong team of senior bureaucrats, domain experts and members of Development Partners. To ensure that all these strategies work well, different activities were carried out to ensure availability of sufficient logistics, gap filling of different health facilities, involvement on private hospitals in managing non-COVID cases, training of staff engaged in COVID, active community and from frontline workers support, providing psychological support to patients, massive IEC campaign, bringing people from other states back to home, different safety net initiatives, implementation of "Ruthless Quarantine with Humane Heart for all influx", ramping up testing and support from Development Partners. The total COVID cases in Assam till May 17 was only 100, since the reporting of the 1st case on March 31, but the number started increasing with the opening of the lockdown since May 18, when resident of Assam started returning to state.

Assam took a conscious decision of ruthless quarantine with human heart, whereby anyone, who enters Assam by any means (air/railway/road) is to be quarantined at quarantine centres and to be tested before she/he is allowed to move further. Based on the test report, either she/he is admitted at hospital (if positive) directly from quarantine centre or s/he is allowed to go for strict home quarantine for the residual number of days out of total 14 days quarantine period. Out of the total 7400 positive cases till June 28, more than 90% cases came from different quarantine centres. If all of them would have moved to his/her family (without test) then what would have been the scenario, can better be imagined than expressed. Moreover, a huge sense of mental relief is given for all those, who tests negative.

Once a person is tested positive from a quarantine centre then immediately triaging is done, and all critical patients are sent to Medical College and patients with NCD and other co-morbidity conditions are sent to District Hospital and asymptomatic positive cases are kept at Model Hospital. To have maximum quarantine centres, State made 5 Regional Quarantine Centres functional at Kokrajhar, Guwahati, Jorhat, Silchar, Tezpur and these centres are made responsible for number of districts, attached to each one of them (zone wise). Over and above, each district made its own quarantine centres functional to accommodate positive cases at the district level. State further decentralized the quarantining process by creating quarantine centres at block level, legislative constituency level so that person, who is at the quarantine centre feels she/he is at home (as the quarantine centre is close to home). Districts Deputy Commissioners are given required fund and SoP on how to maintain quarantine centre, mainly on cleanliness, hygiene, food quality, security services etc. Majority of the hotels, lodges, hostels of educational institutes, guest houses of other departments have been requisitioned by the respective Deputy Commissioners and these are made as quarantine centres.

-- Dr. Dipjyoti Deka, SPM, NHM, Assam

Dr. Biraj Shome, Consultant, WHO

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