In order to contain the COVID-19 spread within smaller geographies, different States have come up with their own different models. At least three of the regional models for cluster containment — Agra (Uttar Pradesh), Bhilwara (Rajasthan) and Pathanamthitta (Kerala) — have been mentioned in several high-level meetings with the states during the past week.
Agra model:
The Agra model emerged in early March, when two men who had travelled to Austria with a relative — later Delhi’s first COVID-19 case — went home to Agra where, days later, six positive cases were found.
This was followed by a localised yet massive combing operation for contacts, carried out by the district administration and Integrated Disease Surveillance Programme personnel and a congested area, within a 3-km radius was cordoned off immediately after the positive reports arrived.
The State, District administration and frontline workers coordinated their efforts by utilizing their existing Smart City Integrated with Command and Control Centre (ICCC) as War Rooms.
Under the cluster containment and outbreak containment plans, the district administration identified epicentres and deployed a special task force as per the micro plan made by the district administration.
Further, 1,248 teams carried out intensive contact tracing over 1,65,000 Each of the 1,248 teams had 2 workers including ANMs/ASHA/AWW reaching out to 9.3 lakh people through household screening. Additionally, effective and early tracking of first contact tracing was thoroughly mapped.
The Agra model is important because it has proved effective in areas of high case density, which are being referred to as hotspots.
Bhilwara Model:
Rajasthan’s Bhilwara was one of the early hotspots for COVID-19. It is now in the spotlight due to a ruthless containment strategy, also being described as the Bhilwara model.
The first positive case in Bhilwara, reported on March 19, was a doctor at a private hospital. By March 26, the number of positive cases at the hospital was 17, all of them hospital staff and patients.
The outbreak emerged as a massive crisis for the Rajasthan government as the doctors, before testing positive, had communicated with several people, including nursing staff and patients.
Strategy deployed in Bhilwara:
The city was completely isolated with Section 144 CRPC being imposed. In the first phase, essential services were allowed; in the second phase, there was a total shutdown with the city and district borders sealed and check posts set up at every entry and exit point.
The District Magistrates of neighbouring districts too were asked to seal their borders and containment zones of around 3 km around the epicentre and buffer zone of 7 km was formed.
The containment and buffer zones were turned into ‘No-Movement’ zones and cluster mapping was done for COVID-19 cases. Through this, six areas were identified and special teams were deployed for continuous screening of suspected cases.
At last count, 3,072 teams in Bhilwara had surveyed 2,14,647 households comprising 10,71,315 people and found 4,258 cases of influenza-like illnesses that had to be tested for COVID-19.
Four private hospitals were acquired with 25 isolation beds each. Quarantine centres were set up in 27 hotels with 1,541 rooms, which eventually housed 950 people, while 7,620 people were kept in home quarantine.
There was door-to-door supply of essential groceries, fruits, vegetables and milk. Raw and cooked food packets were distributed to the needy and there was a complete shutdown of industries, factories & brick-kilns.
Pathanamthitta model:
Technology has been the hallmark of the Pathanamthitta model in Kerala. The district saw its first cases in early March, when a three-member Italy-returned family ended up infecting several relatives while socialising with them.
Border sealing and contact tracing happened here too, but more than just screening contacts, every person who had entered the district was screened and a database created so that they could be easily reached at short notice.
In addition, graphics were created showing the travel route of the positive cases and publicised. This included details of all places the family had travelled to, and the potential contacts they would have made there between February 29 and March 6.
As people realised from the route maps that they had indeed come in contact with a COVID-19 positive person, many walked up to be screened or treated.
Those under quarantine were checked daily on phone thorough a call centre even as 14 teams of health workers monitored some 4,000 people who had entered the district before its sealing.
There was also an app called Corona RM, through which those under home quarantine were monitored and if they broke quarantine it could be immediately detected through the use of GPS.
Through these measures the growth of new cases has slowed down in Kerala, with six of the last 10 days witnessing a single-digit rise.
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