Identify, Isolate, Test and Treat : Response to COVID-19

Governments at various levels in India have acted in varying ways to bolster individual efforts, given how COVID-19 has overwhelmed healthcare systems around the world and the challenge in front of India’s healthcare systems to meet the needs of its population of 1.38 billion. Numbers were a major challenge for the more heavily populated parts of the country. Madhya Pradesh (MP), a state located in central India, saw a rapid initial spread of COVID-19, which proceeded at an alarming rate across the congested areas of a few urban centers. Using a multipronged approach, it was able to contain the virus, and now has a positivity rate of 3.5; below the national average of 10 on 10th July, 2020. Madhya Pradesh is the second largest state in India and the country’s fifth most populous state, with a population that is a little smaller than that of Turkey. More than 70 percent of the population lives in rural areas, where agriculture is the main source of most of their livelihoods.

The IITT approach

The government of Madhya Pradesh adopted a four pronged approach to tackle the pandemic, through strategy aiming at Identification, Isolation, Testing and Treatment (IITT). First, to identify coronavirus-affected areas, isolate them and test their residents, then to treat the patients if found positive.

  • Identification: Identifying people with COVID-19-like symptoms, through contact tracing and surveillance
  • Isolation: Isolating those who suspect they may have COVID-19 or have been exposed to the virus in quarantine and keeping the positives in isolation
  • Testing: Testing all people who fit the Indian Council of Medical Research (ICMR) criteria free of cost
  • Treatment: Appropriate treatment provided as per the symptoms This strategy has proved to be an effective approach to combat COVID-19, as the state government planned and undertook targeted measures and interventions.

Community-based Surveillance System

The state envisages a broader community engagement in surveillance activities. Accordingly, the state has devised community-based surveillance tools such as SARTHAK LITE, a citizen app, and COVID Rakshak, a system involving citizen volunteers who red-flag and report the persons who may have been exposed to the virus through community based action, leveraging technology. SARTHAK LITE enables citizens to access real-time, accurate information pertaining to collection centers, fever clinics, CCCs, DCHCs and DCHs in their vicinity: all aspects concerning COVID-19 management. It enables them to report the persons who may have been exposed to the virus within their homes and communities to facilitate early action by local administration. COVID Rakshak citizen volunteers are equipped with a fingertip pulse oximeter, supplied by the local administration after online registration on SARTHAK LITE. A COVID Rakshak uses the pulse oximeter to report citizens whose oxygen saturation levels may be less than 94% and thus are in need of immediate medical examination and care. With these tools, the state aims to broad-base surveillance, transforming it from a predominantly institutional use to a more community-based activity.


Outcome and the Way Forward

Sometimes, consistent effort and perseverance wins out. Madhya Pradesh’s response to the COVID-19 pandemic has been, in essence, a success story. From the early days in April when its caseload contributed as much as 10% to the total caseload in the country and the state was battling a high positivity rate, poor testing capacity and strained infrastructure, the state has come a long way. MP now contributes only about 2.8% to the total case load in the country. Importantly, the ‘I-I-T-T’ strategy not only enabled rapid control over the spread of the pandemic in the state but also helped to further strengthen public healthcare by making people more aware of the importance of good health and hygiene and making healthcare more accessible to public. While efforts are clearly on the right track, the administration needs to remain watchful to contain further spread of the virus.

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