COVID-19: We will write to states to resume immunisation, says Centre

NCDC says 9 coronavirus disease hotspots in country, ministry says there are many

By Banjot Kaur
Published: Tuesday 31 March 2020

The Centre will coordinate with states to ensure that routine immunisation activities, ante-natal check-ups for pregnant women and other such essential medical services are not hampered during the nation-wide lockdown, a senior government official said on March 31, 2020.

Lav Agarwal, joint secretary in the Union Ministry of Health and Family Welfare (MoHFW), said this while responding to a query by Down To Earth (DTE) during a press conference. A couple of states including Bihar, Rajasthan and Kerala have issued notifications suspending these services.

Agarwal did not clarify if these orders were issued on the MoHFW’s suggestion. 

Since the Union government had instructed that children less than 10 years be confined to homes, all vaccination sessions, including the ones carried out at health sub-centres and anganwadi centres were to be withheld, the Kerala government’s order on March 24, said.

The order issued by the Rajasthan government on March 27 said all outreach activities pertaining to immunisation were to be suspended. “If cold chains are functional at hospitals where deliveries are happening, then the neonate may be given BCG injection,” the order read, adding all kind of mobilisation for vaccination should be stopped.

“Not only are healthcare workers exposed to infection during such drives but there is also a problem of supply chain of vaccines due to lockdown. We expect it to improve in a few days,” a source in the Rajasthan health department, said.

Immunisation activities carried out by visiting homes as well as the vaccination of Japanese Encephalitis had to be stopped due to the lockdown, NK Sinha, Bihar’s state immunisation officer, has said in an order issued to all district immunisation officers on March 23. However, he clarified in the order that these activities would continue at health facilities. 

“There is no protective gear for community health workers. How can they be asked to continue their visits to homes without protection without risking infection?” a senior official in the Bihar health department told DTE on condition of anonymity.

The World Health Organisation has made it very clear that no essential health services, particularly immunisation and childbirth care, should be affected during lockdown. Its director general, Tedros Adhanom Ghebreyesus, even issued a statement to that effect on March 30.

“While assurance given by Agarwal is welcome, it would remain a verbal promise unless the Centre issues guidelines to states in this regard,” Chhaya Pachauli, a Jaipur-based health activist, associated with Jan Swasthya Abhiyan, said.

“Doing away with immunisation, antenatal clinics and other such routine health services can have a long-term impact on their beneficiaries. The governments should have thought about this in advance,” she added.

India's COVID-19 hotspots

Agarwal reiterated that India had many hotspots of novel coronavirus disease (COVID-19). Despite being asked several times by the media, he did not give any numbers and said that if any part of a given district had a confirmed case, it was a hotspot for him.

However, sources in the National Centre for Disease Control (NCDC) said there were nine hotspots in the country:

  • Delhi (Nizamuddin and Dilshad Garden)
  • Kerala (Kasarargod and Pathanamthitta)
  • Maharashtra (Mumbai and Pune)
  • Ladakh
  • Rajasthan (Bhilwara)
  • Punjab (SBS Nagar)

If an area has more than 10 cases, it is defined as a cluster. And if an area has several clusters, it becomes a hotspot.

The joint secretary also evaded a question about how many healthcare workers had been infected with the virus in India. “Some doctors are infected but I do not think they got infected while treating COVID-19 patients. Instead, they were infected by their friends and colleagues who had travelled abroad,” he said.

ICMR epidemiology division head R Gangakhedkar also said that not one but three strains of novel coronavirus had been found in India so far.

“This is so because infections were imported from different countries where the strain of virus was different. However, the strains are nearly homologous and therefore their variation will neither impact severity of the disease in India nor the ongoing research on therapeutics and vaccines here,” he said.  

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