COVID Guidelines For Rural Areas: Provide Rapid Test Kits At All Public Health Facilities

New Delhi: With cases rising in rural areas of India in the second wave of COVID-19 pandemic, the Union government on Sunday issued fresh guidelines to check the spread of the deadly virus.

Peri-urban and rural areas should plan a minimum 30-bed COVID Care Centre for asymptomatic cases with comorbidities or mild cases where home isolation is not feasible, the Union Health Ministry said.

Also, Rapid Antigen Test (RAT) kits should be available at all public health facilities including sub-centres or health and wellness centres and Primary Health Centres.

Following are key SOPs/guidelines for rural areas:

* Provision of Rapid Antigen Test (RAT) kits should be made at all public health facilities including Sub-centres or Health & Wellness Centres and Primary Health Centres

* Symptomatic cases can be triaged at village level by teleconsultation with Community Health Officer (CHO), and cases with comorbidity or low oxygen saturation should be sent to higher centres

* COVID Care Centres (CCC) can admit a suspect or confirmed case, but there should be separate areas for them with preferably separate entry and exit for each. Suspect and confirmed cases should not be allowed to mix under any circumstances

* In every village, active surveillance should be done for influenza-like illness/severe acute respiratory infections (ILI/SARI) periodically by ASHA with help of Village Health Sanitation and Nutrition Committee (VHSNC)

* Every village should have adequate number of pulse oximeters and thermometers as monitoring of oxygen saturation is important for COVID patients

* Nearly 80-85 per cent COVID-19 cases are asymptomatic/mildly symptomatic; these patients do not require hospitalisation and may be managed at home or in COVID care isolation facilities

* Identified suspected COVID cases should link for testing to health facilities either through COVID-19 rapid antigen testing or by referral of samples to nearest COVID-19 testing laboratory, in accordance with ICMR guidelines

* A system be developed whereby pulse oximeters and thermometers are provided on loan to families with a confirmed case of COVID through ASHA/Anganwadi workers and village-level volunteers

* Home Isolation kit shall be provided to all such cases which should include required medicines such as Paracetamol 500 mg, Ivermectin tablet, cough syrup, multivitamins (as prescribed by treating doctor) besides a detailed pamphlet indicating precautions to be taken, medication details, monitoring proforma for patient condition during home isolation, contact details in case of any major symptoms or deterioration of health condition and the discharge criteria

* Follow-ups for patients undergoing isolation or quarantine could be done through household visits by a frontline worker/volunteer/teacher duly following required infection-prevention practices including use of medical mask and other appropriate precautions

* The health infrastructure planned for peri-urban, rural and tribal areas shall be aligned to the already mentioned 3-tier structure — COVID Care Centre (CCC) to manage mild or asymptomatic cases, Dedicated COVID Health Centre (DCHC) to manage moderate cases and Dedicated COVID Hospital (DCH) to manage severe cases, according to the document.

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