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Persons with co-morbidities. i nia yd SIA wes are ARATE | iv. 1008 8 oF ng S eq] ‘eu 874/USDMA/792)2020) ‘hfRe19 eam @ PLT BG COVND con TERE AL 58. eo ma: i, COVID-Curfew ar soci @E ae fox cafes d fare anger weer ‘sf2FF 2005 (Section 51 to 60), HETANY aifSFTA 1897 Ya IPC BT ATT 188 Waar & sierfr orp wrdaré a wreeh | waded ferret ar aed 8 aquest yAtar awa or ag owe ran eH me 8 Sa area fers o7 wre, 2022 8 aftr aneelh tay wardh ety afta, tgs @Prafee), Para, seRTES MTA art Poh fia, a Abo oh at aero } siarenet BART Yio sift, er alee, Gers RT| RRS 10 eae PRT BY COVID- Caton HE A] ‘Hear_874/USDMA/792(2020) 6CIM eh ana WOR area wa oar wea faa area wa ofa wear area wath aa Government of India aa Department of Health and Family Welfare = Ministry of Health and Family Welfare Azadi ka D.O.No.Z.28015/318/21-EMR RAJESH BHUSHAN, IAS amvit Mahotsav “24 December, 2021 SECRETARY Lear CLL . This is regarding4he measures that need to be taken in view of initial signs of ‘surge in cases of Covid-19 as well as increased detection of the Variant of Concern (VoC), ‘Omicron’ in different parts of the country. 2. In this context kindly recall this Ministry's earlier guidance shared with States/UTs on multiple occasions regarding the recommended strategies for containment and restrictions, keeping the District as a unit. 3. At the district level there should be constant review of emerging data regarding the Population affected by COVID-19, geographical spread, hospital infrastructure and its utilization, manpower, notifying Containment Zones, enforcement of perimeter of containment zones etc. This evidence should be the basis for effective decision making at the district level itself. Such a strategy ensures that infection is contained at the local level itself before it spreads to other parts of the state. 4. ___ The main elements of the framework to be used by States and UTs to facilitate decision making at the District Level are as follows: i) Test positivity of 10% or more in the last one week OR ii) Bed occupancy of 40% or more on oxygen supported or ICU beds In case any one of these parameters are met in any District, district level containment measures and restrictions may be put in place forthwith. Equally important, the restrictions must be strictly enforced, 5. __ Based on current scientific evidence, the VOC Omicron is at least 3 times more transmissible than the Delta VOC. Besides, the Delta VOC is still present in different parts of the country. Hence, even greater foresight, data analysis, dynamic decision making and strict & prompt containment action is required at the local and district level. The decision making at the State/UT and district level must be very prompt and focussed. 6. __ The template above provides a normative framework. However, based on the local situation and population characteristics such as density etc., and keeping in mind the higher transmissibility of Omicron, States/UTs can take containment measures and restrictions even before these thresholds are reached. 7. _ Some of the strategic areas of intervention focusing on containment, test, track, surveillance, clinical management, vaccination and Covid Appropriate Behaviour to be taken up are as follows: Room No. 156, A-Wing, Nirman Bhawan, New Delhi-110 011 Tole “(OV 044-99NRARAI DANRIADA Eay «44. 9ANEAIED Emnai A -Containment: imposition of night curfew, strict regulation of large gatherings, curtailing numbers in marriages and funerals, restricting numbers in offices, industries, public transport etc. In case of all new clusters of Covid positive cases, prompt notification of “Containment Zones’, “Buffer Zones” should be done, strict perimeter control of Containment Zone as per extant guidelines must be ensured. Alll cluster samples must be sent to INSACOG Labs for Genome Sequencing without delay. B- Testing and surveillance: testing as per ICMR and MoHFW guidelines, door to door case search, testing of all SARW/ILI and vulnerable/co-morbid people, ensuring right proportion of RT- PCR tests in total tests being conducted daily, contact tracing of all Covid positive persons & their timely testing, utilizing the access to “AIR SUVIDHA' Portal by State Surveillance Officers (SSOs) & District Surveillance Officers (DSOs) to monitor the international passengers who have arrived in their States & Districts etc. C- Clinical Management: increase bed capacity, other logistics like ambulances, mechanism for seamless shifting of patients, availability and operational readiness of oxygen equipments, buffer stock of drugs to be ensured by prompt utilization of Emergency Covid Response Package (ECRP-II) funds released by Central Government & other available resources etc. The existing National Clinical Management Protocol remains unchanged for Omicron. Ensure stringent enforcement of home isolation as per extant guidelines. This would include among others: customized kit for persons undergoing home isolation, their regular monitoring through call centers as well as home visits etc. This will be a very critical activity in the days to come specially to ensure that persons under home isolation do not spread the virus to others in view of its higher transmissibility. D- Vaccination: ensure 100% coverage of left out first and second dose eligible beneficiaries. in an accelerated manner. Special focus to be given to those districts where the first & second dose coverage is less than the national average. The door-to-door vaccination campaign need to be strengthened. —- Community engagement and Covid Appropriate Behaviour: Ensure advance engagement and information so that there is no misinformation or panic, transparent communication on hospital and testing infrastructure availability, regular press briefings etc. Participation of community backed by strict enforcement is necessary for ensuring Covid ‘Appropriate Behaviour. 8. Kindly activate the War rooms/EOCs and keep analyzing all trends and surges, no matter how small and keep taking proactive action at the district/local level. Regular reviews with field officers and proactive action in this regard will definitely control the spread of infection and flatten the curve A ATTFIP Yours sincerely — (Rajesh Bhushan) Chief Secretary/Administrator of all States / UTsWe afta He Ace, Hae. Home Secretary ARR BIE AJAY BHALLA, as Government of iia = aie ier/North Block a4 Reall/New Delhi D.O. No. 40-3/2020-DM-I (A) 27th December, 2021 Dear Chief Secretary, Kindly refer to the Ministry of Home Affairs (MHA) Order of even number issued today, for ensuring implementation of the measures that need to be taken, in view of initial signs of surge in cases of COVID-19, as well as increased detection of the Variant of Concern (VoC), ‘Omicron’, in different parts of the country, as conveyed vide Ministry of Health and Family Welfare (MoHFW) D.O. letter dated 21st December, 2021 2. The country has witnessed an overall decline in active cases. However, the new variant, Omicron (designated as a VoC by the WHO on 26t November 2021), is reported to be at least 3 times more transmissible than the Delta VoC, and is posing a new challenge for the COVID containment measures. In the countries with Omicron-driven surge, the growth trajectory of cases has been very steep. In our country, 578 Omicron cases have already been reported in 19 States/UTs. 3. Globally, Omicron cases have already been reported in 116 countries. Further, surge in cases is also being reported across various countries, especially in the USA, the UK, Europe (France, Italy, Spain), Russia, South Africa, Vietnam, Australia, etc. 4. In this background, in the MoHFW advisory dated 21.12.2021, a normative framework has been provided. With distinct presence of the Delta variant and detection of Omicron cases in many States, there is need for greater foresight, data analysis, dynamic decision making, and strict and prompt containment actions at the local and district levels, based on the assessment of the situation. 5. On 23 December, 2021, the Hon’ble Prime Minister has reviewed the status of COVID-19, Omicron VoC and preparedness of health systems across the country. After review, he has directed that we should be ‘Satark’ and ‘Saavdhan’. As per his directions, it is important to maintain a high level of vigil and alertness at all levels. State Governments should ensure that the health systems in the States are strengthened to meet any challenge posed by the new variant. Further, the State Governments/UT Administrations should ensure that oxygen supply equipment are installed and are fully functional and the buffer stock of essential drugs should also be maintained. «.contd.p/2..-2- 6. I would like to reiterate that all the States/UTs must observe all precautions, and not let the guard down. Local/District Administration, based on the normative framework and assessment of the situation, should promptly take appropriate containment measures. States may consider imposing need based, local curbs/restrictions, to control the crowd during the festive season. 7. I would also like to emphasise that there should be continued focus on the five-fold strategy, ie. Test-Track-Treat-Vaccination and adherence to COVID Appropriate Behaviour, to avoid the possibility of surge in COVID-19 cases, especially keeping in view the new VoC. The State enforcement machinery should strictly enforce the norms of COVID Appropriate Behaviour, i.e., wearing of face masks and maintaining safe social distancing in all public areas/ gatherings. 8. As mentioned in my earlier DO letter, dated 30 November, 2021, with a view to discourage any misinformation in respect of the new VoC, which creates anxiety among the public, all States and UTs should proactively and regularly hold media briefings at the highest level to disseminate the right information to them. States/UTs should also educate them about various preventive measures undertaken by them and also advise them to strictly follow COVID Appropriate Behaviour. 9. 1 would, therefore, urge you to issue necessary directions to the districts and all other local authorities concerned, to take necessary measures for prompt and effective management of COVID-19, strict compliance with various advisories issued by the MoHFW on the new VoC and strict enforcement of COVID Appropriate Behaviour. With regards, Yours sincerely, yee (Ajay B ) Chief Secretaries of all States