Cluster Containment Models: Bhilwara, Pathanamthitta and Agra

By Saroj Singh|Updated : May 18th, 2020

During the outbreak of the virus in India, different states adopted different strategies to curb its spread. To cope with the viral outbreak, also several districts have been adopting innovative models for the same. The Indian Health Ministry has recommended all states should implement Agra’s Cluster Containment Strategy to prevent community spread of the virus

Cluster Containment Models: Agra, Bhilwara and Pathanamthitta

All indications and the big focus of the government right now is dealing with the problem areas, the cluster outbreaks, the hotspots where there are many more cases. Cluster containment strategy of the government is a micro plan to contain the local outbreak to avert the community spread. The primary purpose of this micro plan is to provide the viral outbreak in a and defined geographical area. The demographic details vary with each district and accordingly, the concerned authorities are recording the buffer zones.

After taking into consideration, it has been found out that Bhilwara, Pathanamthitta and Agra models have set an example. These models are briefly described further.

  1. Agra’s cluster containment strategy

Agra model has emerged as the best model so far for successfully tackling the cluster containment. The Union Ministry of Health and Family Welfare has considered Agra’s Model as best in practice. 

  • The district administration and frontline workers coordinated there at first by utilizing their existing smart city integrated with command and control centre as war-rooms under the cluster containment in Agra. 
  • The district administration identifies the epicentres, delineated impacts of positive confirm cases on a map and deployed special task force.
  • As per the micro plan made by the district administration, for reaching out to people, the central helpline was established, and the multifunctional team was set-up for coordinative responses. 
  • The cluster containment strategy adopted by Agra is being shared with other states as the best practice.

As per the Health Ministry, the cluster containment approach will promptly check and sensitize every household within a 3 km radius of the house of an infected person and all those who have come in contact with the effect to prevent community spread of the virus. 

Highlights of the model

Based on the number of the outbreak of cases in an area, the containment zone is decided. The various steps that include are as follows:

  • Identification of hotspot: The prolonged strategy begins with the tracing the epicentre or the hotspots of the viral spread. 
  • Sensitization: After the area is identified as the epicentre, cluster containment plan is brought in to sensitize households within the 3 km radius. Also, a buffer zone having an area of additional 5 kms shall be identified which is 7kms in the rural areas.
  • COVID war-room: this room is set-up to operate as an integrated control and command centre helps with coordinated response management. 
  • Isolation centre set-up: to provide medical facilities that will be able to test and treat the patients.
  • Doorstep delivery: To prevent community spread distribution of food items and other essentials at doorsteps with the help of e-pass facilities.
  • Citizen Self-registry platform: to provide food and shelter facilities for the homeless, a citizen self-registry platform is a set-up to provide immediate important information and updates to the citizens about the risks and also offer health helpline details. 

The nodal person for the cluster containment will be the District Collector or District Magistrate in the concerned district. The responsibilities regarding the field activities are being assigned to the various functionaries including Anganwadi workers, Block Extension Educator, Municipal or Village Panchayat Staff, Supervisory Officer, Block NHM Officer or any other designate of DM. 

2. Bhilwara Model 

The central authorities have also appreciated the Bhilwara model in terms of the containment strategy. There is no denying the fact that Bhilwara is considered as the epicentre of the coronavirus in Rajasthan. There has been an erupt in the outbreak of the viral cases in several people, but the district administration soon adopted the strict strategy to curb its outbreak. 

Highlights of the model 

  • The first case was reported on March 19 but there reported many cases till March 30.
  • The various measures were adopted by the administration involving mass-screening along with imposing the curfew and, identify the clusters.
  • Two thousand teams have done the screening of around 28 lakh people and the people who are being diagnosed with any symptoms, are being enforced for home quarantine. 
  • All the borders of the containment zones have been sealed by the administration so that none of the people could catch the spread of infection.

3. Pathanamthitta Model

Pathanamthitta is a fast-growing town and a municipality situated in the Central Travancore region in the state of Kerala. The authorities here adopted technology to lower down the outbreak of the virus in this area. The technology adopted forms the basis of the containment model. This model helped a lot in decreasing the number of cases.

Highlights of the model

  • After the detection of the first positive case, the authorities framed a database concerning all those people who have entered the district. 
  • route map in the form of graphics was also created to spread awareness among the people. 
  • It adopted the technology that forms the basis of the containment model. In getting themselves screened and provided a massive help in the detection of cases in the early stages
  • Also, the people under quarantine were being provided with an app named CoronaRM to locate the places where they are being quarantined. So, in this manner, check and surveillance are maintained upon these people in terms of their activities.  

Components of the containment model as suggested by the GoI:

The central government has provided various guidelines for coping with this epidemic. The common strategy which it has announced for all the states involves Cluster Containment Strategy along with defining the area of operation and the action plan in terms of geographic quarantine. This has been briefly described as under: 

I. Cluster containment strategy of the government 

The strategy of Cluster Containment involves an extensive contact tracing. After that, there should be the testing of those cases which are at higher risks. This is followed by isolating the suspected cases from the confirmed cases. Then, the quarantine of people who comes in contact with an infected person is to be done.

  • Contact tracing at an aggressive level 
  • Testing high-risk cases
  • Isolating suspects and confirmed cases 
  • Quarantine for contacts

II. Defining an area of operation: It involves defining the geographical area first. Then, active surveillance is needed, which involves door to door surveillance. The lab capacity is to be expanded further where the testing of SARI cases along with the high-risk cases, should be made a priority. There should be the availability of hydroxychloroquine for all the asymptomatic persons in the healthcare set up and for those providing the treatment to patients.

  • Geographical area to be defined
  • Active surveillance in the area 
  • Expand lab capacity
  • Testing SARI (Severe Acute Respiratory Illness) cases, high-risk cases  
  • Hydroxychloroquine will be given to all asymptomatic persons in a healthcare set-up

III. Action Plan for Geographic Quarantine

Concerning the Geographic quarantine, the action plan involves the cooperation at the inter-sectoral level is to be done. Then, there is the deployment of a Rapid Response Team, which is followed by rapid tests. There should be the clinical management of an infection along with the psychological support, should be made available to the patients.

  • Inter-sectoral cooperation (various ministries are in coordination)
  • Rapid response teams to be deployed
  • Surveillance
  • Clinical management and psychological support. 

With the adoption of containment models with a cluster-based approach, involving a group of agencies at work at the local, district administration and then to the state level will undoubtedly help avert the community spread of the virus. Doing so, the government has also ensured that local people are sensitized and remain precautious of the community spread by practising social distancing norms. 

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