As per the Ministry of Health and Family Welfare, India has now progressed from the local transmission phase to the “large outbreaks amenable to containment phase” in relation to the COVID-19 pandemic. In response to this, the Ministry has released a ‘containment document’ for large outbreaks with the aim to halt the chain of transmission and minimize morbidity and deaths.
Strategic Approach to Large Outbreaks
India plans to adopt a strategic approach for potential scenarios which may occur. This includes instances of travel-related cases reported in India, local transmission of COVID-19, large outbreaks that can be contained, widespread community transmission of the disease, and the possibility of India becoming endemic for COVID-19. The outlined strategies are aimed at tackling each of these situations should they arise.
A “large outbreak”, as defined by the document, is characterized by a localized increase in the incidence of coronavirus cases within a specific geographic area. This could potentially occur within a village, town, or even a city.
Containment Strategy and Measures
The document outlines containment measures for such large outbreaks, which involve almost total restriction of people’s movement to and from the area where there is a single sizable outbreak or multiple points of local transmission of COVID-19.
This involves the employment of a cluster containment strategy, a key part of the document. Such a strategy would encompass geographic quarantine, social distancing measures, enhanced active surveillance, testing all suspected cases, isolating confirmed cases, quarantining contacts, and conducting risk communication for creating public awareness about preventive public health measures.
Geographic quarantine will be applicable to areas reporting large outbreaks and/or multiple clusters of COVID-19 spread over many blocks of one or more contiguous districts.
The Countainment Operation Timeline
According to the guidelines, the containment operation would be considered over 28 days from the discharge of the last confirmed case. This is subject to the condition that the discharged case has tested negative in accordance with the designated health facility’s discharge policy.
Factors Influencing the Success of The Containment Strategy
The success of containment operations via geographic quarantine depends on a myriad of variables. They include the number and size of the cluster or clusters, the virus’s transmission efficiency in the Indian population, and environmental factors such as temperature and humidity.
The effectiveness of the public health response also plays a crucial role. This pertains to active case finding, large-scale testing, the immediate isolation of suspected and confirmed cases, the quarantining of contacts, and the geographical features of the area.
