UNA UATE area wd uRare weary fr waned ya Ufa Bea HATE Government of India Department of Health and Family Wolfare Ministry of Health and Family Welfare D.O. No.06/S(HFW)/EMR/21 << venient wae Dear Dr. tayzshy, Although th jiectory of daily new cases ‘of COVID-19 has fallen down substantially in the country, there ia need for continued monitoring of weekly case positivity, as well as cases trajectory in each district to identify any early warning signals of spread of infection, 2. tis a point of concern that presently, Manipur has a weekly positivity of 12.9% (28" Jun “4h Jul) and has shown an increase from 10.9% in week of 7-13 Jun. About 8 out of 16 districts are reporting a positivity of more than 10%, which is a cause of grave cancer 3. A further analysis has highlighted the following critical areas of concern. - ° Cases’ 5 Although the state has shown a decline in new cases, 2 out of 16 districts (Bishnupur, Kangpokoi) are showing an increase in weekly new cases over past 4 weeks 5 The districts of 6 have reported more than 100 new cases in the week ending 4” July 2021 = Deaths: District of Bishnupur has shown an increase in the number of weekly deaths in last 4 weeks (13! June- 4 July). © Imphal East and Imphal West has 17 and 28 deaths respectively in the week (28" ‘June-4" July) which emphasis critical analysis on the district's deaths + Testing & Positivity: Imphal East, Imphal West and Thoubal districts have more than 100 new cases in the week ending 4” July with a weekly positivity rate of more than 10%, 4. The above-mentioned points are a cause for concern, and in order to not let the situation slip out of control, | would urge to focus on the following points and take necessary action at the earliest «Strict containment measures: It is imperative to note that containment is the most crucial strategy of flattening this current curve. Itis critical to plan effective containment measures and implement them stringently, and to strengthen all our efforts made for prompt contact tracing of the close contacts of positive cases and immediate quarantine /isolation of all suspected and confirmed cases as per MoHFW guidelines, -contd/- Room No. 155, A-Wing, Nirman Bhawan, New Delhi-110 014 ele : (0) 011-23061863, 23063221, Fax : 014-20061252, E-mail : eeeyhtw@nic.in2 «Ramp up testing: Several districts are reporting high positivity rates, which reflects the level aeniespread infection. A microanalysis needs to be done of area showing high positivity (10%) during the past weeks. Accordingly, all such areas should be targeted for increasing the testing exponentially while maintaining high proportion of RT-PCR tests The state eeeuld sim at maintaining positivity rate below 5% in each district duly focusing on increasing number of tests $0 as to aid early identification. «Healthcare Infrastructure planning: To ensure preparedness, State must maintain Hea eae vigil regarding bed occupancy of citical beds (Oxygen supported and !CU beds) cont he ocuupancy is more than 40% for any Ded category, the States should plan for augmentation of healthcare infrastructure in those districts. Trained human resources, infrastructure, logistics and procurement should be planned considering the geographical spread of the pandemic. Siate should also work towards eneuring tmaly oiscostTe of all infrastructure availability-based details on public portals or via media so as to avoid misinformation = Effective clinical management: With a distressing rise in fatalities, we must tum to Out clinical management protocol and focus on making it more effective, ‘smooth and prompt. It is important to monitor all cases under home isolation and put processes in place to ensure smooth hospitalization of patients, in case the same is required. All facilities also should be arora with respect to the overall fatality, including deaths being reported between 28 ooo vnours of hospitalization to identify any weak spots and to undertake required corrective action, « Ramping up vaccination: Vaccination must be used as an aid to the infection containment strategy. Ramping up vaccination sites, improving the efficiency and utilisation of vaccination deploying strategic vaccination centres near the containment zones, and now. String speedier vaccination of all citizens aged 18+ should be undertaken on a priority basis. « COVID Appropriate Behaviour: Levying effective fines on violation of social cistanclng & mask usage in public as well as stringent enforcement is critical to control the spread of infection further in the community 5. _Asmentionad in the recent order issued by the MOHFW dated 28" June. implemeniaiio” rework was shared with al Siates/UTs for intensive action and jocal cantainment in epectic torre defined geographic unite, to break and suppress the chain of infection. This was aise ior reiterated by the Ministry of Home Affairs and orders regarding the same ware issued aaererihe OM Act 208 vide letter no. 40-9/2020-DM.(A) dated 26th June 2021, The Stale is requested to share the action taken so far as per the directions issued under Disaster Management Act by MHA as mentioned above so as to ensure effective containment. contd/-6. There is an urgent need to strengthen our collective efforts to curb the spread of infection, and | am sure that under your continued able leadership the state would be able to manage COVID-19 effectively. Yours sincerely (Rajesh Bhushan) Dr. Rajesh Kumar Chief Secretary Government of Manipur Impnal-790001 Email; Cs-manipur@nic.in Districts of Manipur with more than 10% weekly positivity Deaths in the week of 28 June to 4 July BISHNUPUR 9 CHURACHANDPUR F IMPHAL EAST 19% IMPHAL WEST KAKCHING 13% 6 PHERZAWL 11% 0 TENGNOUPAL 2 THOUBAL 10.