Hospitalisations may rise as COVID crisis \'evolving\': Government

New Delhi: As the daily count of Covid-19 infections rocketed to 179,723 across the country, nearly an eight-fold rise in a week, the Union health ministry on Monday warned the states and Union territories that the situation was “dynamic and evolving” and that the need for hospitalisation may change rapidly.

While the hospitalisation of active cases in the ongoing Covid-19 surge, fuelled by new Omicron variant, has been five to 10 per cent in contrast to the 20-23 per cent in the brutal second wave last year, the ministry advised retired medical professionals or MBBS students could be roped in for teleconsultation services and providing skill training of community volunteers in basic care and management at Covid care centres.

In a fresh set of guidelines on testing of samples, the Indian Council of Medical Research (ICMR) has said that contacts of Covid-19 patients do not need to be tested unless identified as high-risk based on age or co-morbidities. The top government body said at-risk contacts of patients will be those above 60 and individuals with co-morbidities like diabetes, hypertension, chronic lung or kidney disease, malignancy and obesity.

The ICMR Advisory on Purposive Testing Strategy for Covid-19 said tests may be undertaken as per the discretion of the treating doctor with certain considerations. It said that asymptomatic patients undergoing surgical or non-surgical invasive procedures, including pregnant women in/near labour who are hospitalised for delivery, should not be tested unless warranted or unless symptoms develop.

The ICMR said no emergency procedure, including surgeries, should be delayed due to the lack of a test. Also, patients should not be referred to other facilities for lack of testing facilities. The advisory said individuals undertaking inter-state domestic travel do not need to get tested.

The advisory said testing can be undertaken either through RT-PCR, TrueNat, CBNAAT, CRISPR, RT-LAMP, Rapid Molecular Testing Systems or through Rapid Antigen Test (RAT). It said that a positive point-of-care test (home or self-test/RAT) and molecular test is to be considered confirmatory, without any repeat testing, and symptomatic individuals, testing negative on home/self-test or RAT, should undertake the RT-PCR test.

Cautioning the states/UTs on hospitalisations, Union health secretary Rajesh Bhushan said in a letter: “In the present surge, five to 10 per cent of active cases needed hospitalisation so far. The situation is dynamic and evolving. Therefore, the need for hospitalisation may also change rapidly.”

Mr Bhushan advised the states/UTs advised to keep a daily watch on the total number of active cases, cases in home isolation, hospitalised cases, cases on oxygen beds, ICU beds and on ventilatory support. He said the spike in Covid-19 cases in many areas seems to be driven by the Omicron variant as well as the continued presence of Delta, and laid stress on the need to augment human resources, particularly healthcare workers, for Covid management.

The ministry urged the states and UTs to earmark different categories of beds in private clinical establishments for Covid care. “It must also be ensured that charges levied by such health facilities are reasonable and there is a mechanism to monitor and initiate action in cases of over-charging, if any.”

The health secretary also suggested requisitioning of more ambulances or private vehicles to improve referral transport and facilitate seamless transfers of Covid-19 cases from home isolation or Covid care centres to Covid dedicated hospitals.

On the vaccination front, India started administering “precautionary” (booster/ third) dose vaccines for Covid-19 to healthcare and frontline workers and people aged above 60 with co-morbidities. The beneficiaries were provided the same precautionary jab that they received as the first two doses. Those who had got Covaxin as their first two doses were given the same vaccine as their precautionary jab. Those who got two doses of Covishield were also given the same vaccine as their precautionary jab.

Of about six crore eligible beneficiaries -- 2.75 crore above 60, one crore healthcare workers and two crore frontline workers -- over 10 lakh people were given the precautionary dose on Monday.

The Centre also made it clear that no time limit has been set for the operationalisation of Covid vaccination centres, and states and UTs can run these till 10 pm daily based on availability of human resources and infrastructure. In a letter to states/UTs, health ministry additional secretary Manohar Agnani said there was an impression that the Covid vaccination centres can operate only from 8 am to 8 pm daily, which was not correct.

India on Monday saw a single-day rise of 1,79,723 infections, taking the total tally to 3,57,07,727. The Omicron count has also gone over 4,050 across 27 states and UTs. The number of active cases has increased to 7,23,619, the highest in around 204 days, while the death toll has risen to 4,83,936, with 146 fresh fatalities.

In Delhi, 17 more deaths due to Covid-19 and 19,166 infections were reported in a day as the positivity rate rose to 25 per cent, the highest since May 4 last year. The city had reported the same number of Covid deaths on Sunday too. In just 10 days, Delhi has recorded 70 Covid deaths. A total of 1,912 Covid patients are in hospitals. Of them, 65 are on ventilator support, the government data showed.