Days after Bhilwara district in Rajasthan won praise from the Cabinet Secretary Rajiv Gauba over its successful Coronavirus containment model that literally brought the district out of full-blown Stage III Community Transmission stage, Agra in Uttar Pradesh has emerged as the latest model to systematically contain Coronavirus.
Touted as the ‘best model’ to tackle the Wuhan virus, the Centre showcased the Agra model at the daily COVID-19 briefing on Saturday, and also shared details of the model with other states as the best practice. Lav Aggarwal, Joint Secretary in the Health Ministry went on to say, “Corona Haarega, Agra Jeetega (coronavirus will lose, Agra will win).”
In fact, it was also discussed in the meeting of the District Magistrates convened by the Cabinet Secretary Rajiv Gauba a few days ago, and had also come up for discussion at the top political levels.
Agra model has been one of prompt response followed by intensive tracing operations in order to avoid further damage. It must be noted here that Agra was the first Coronavirus cluster in the country when two people who had travelled to Austria along with a Mayur Vihar resident of Delhi, came back to their Agra homes. Soon, the district reported six cases.
The success of the Agra model lies in the swift action that followed immediately after the first cases came up. An Integrated Disease Surveillance Programme official who oversaw the initial operations said, “The confirmation from the airport tests came at 2 am; we got into action immediately. A 3-km radius around the house was sealed and 259 teams were formed of two members each. We covered 1.63 lakh households in a few days, took about 1000 samples, used S N Medical College as our base. It was an exercise where nothing could be left to chance — a security guard was roped in to supply daily needs to the families.”
Every one of these 259 teams covered almost 100 houses a day, and doctors were also stationed at a nearby dispensary so that people having symptoms could consult them without any delay.
The Union Health Ministry issued a statement about the Agra containment model, which read, “The State, district administration and frontline workers coordinated their efforts by utilising 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, delineated impact of positive confirmed cases on the map and deployed a special task force as per the micro-plan made by the district administration.”
As a part of this aggressive containment strategy, an entire area of 3 kilometres radius was sealed completely in order to avoid the further spread of the Coronavirus. Further, a 5 km-radius buffer zone was created and identified as the containment zone.
In the containment zones, the urban primary health care system was roped in and 1,248 teams were deployed, each of them consisting of two workers, including ANMs/ASHA/AWW. These teams worked on a war-footing and carried out a massive screening exercise, reaching out to a total of 9.3 lakh people through household screening. Moreover, the authorities carried out prompt and effective first-contact tracing as a part of its thrust to effectively track down those who could have been affected by the novel virus.
And this is where the Agra model can be distinguished from the Bhilwara model, as the latter involved completely sealing the town instead of targeting the cluster zone. The Bhilwara administration had presented its model as: “City Border Sealed immediately. District Border Sealed immediately with check posts at all entry / exit points. Neighbouring Districts DMs requested to seal their borders with Bhilwara. (Double Check System) Railways and Roadways Services Stopped. Movement of Private Vehicles Stopped.”
In this sense, Agra model seems far more practicable- targeting the vulnerable 3 km-radius, as also the buffer zone which can be screened through much more quickly than screening households across the entire district. Moreover, sealing the entire district involves its own logistical bottlenecks, something that not every district across the country might be able to manage.
The Agra containment and rapid emergency response also relied extensively upon technology, right from mobile phone Global Positing System (GPS) to drones and even CCTV cameras, the authorities kept a check on the movement of people throughout its containment operations. Moreover, the drones were used to keep a check on large gatherings and ensuring food distribution to not among the needy people, but even animals. By keeping a check on the movement of people, Agra effectively ensured that social distancing was enforced in letter and spirit and no new clusters could come up in the city.
Any viable Coronavirus response system has three legs- social distancing, screening and isolation. Having achieved the first two, the Agra district authorities sought private aid to boost its quarantine facilities. Agra requisitioned some 3-star hotels as paid quarantine centres, and a total of 566 beds have been arranged as paid quarantines, apart from 3,000 beds for free for health workers, among others.
The district has witnessed 92 cases, out of whom eight have recovered and one has died, leaving 83 active cases and the number of beds that have been arranged are many times higher than those currently needed. The district has deliberately over-prepared in order to ensure that there is excess isolation capacity at all given times and there is some cushion in case there is a sudden spike in cases.
Today, Agra has the highest number of cases, but the district has controlled most of the damage coming its way. Had there been a single lapse, Agra could have easily become another Delhi or Mumbai. In fact, Agra was one of the first districts for whom the reference of community transmission was made.
On March 5, the Health Ministry had stated, “Since, in addition to COVID-19 cases related to travel, some cases of community transmission have also been observed, it has been decided to involve district collectors and States have been asked to form rapid response teams at district, block and village levels.”
This was well before the nationwide lockdown was announced, and any disaster in Agra would have meant repercussions throughout the densely populated Uttar Pradesh but the local administration backed by the Yogi government saved the day. Today, Agra has stagnated the number of cases and broken the chain of the spread of Coronavirus. One of the first affected districts in the country has shown the way for the entire nation- timely and adequate response is the key to containing COVID-19.
