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It is suggested that the existing terms as “local transmission”, “community transmission” etc., should be done away with. Instead, the nomenclature should be based on transmission potential existing at that particular locations, for deciding the public health and case management actions as follows. The demarcation of the “zones” (for which transmission potential would need to be worked out), should be based on definable populations, as “a particular large slum” or “a defined Mohalla in a city” or “a community development block / Gram panchayat area in rural areas”. The nomenclature of different zones according to transmission potential and the suggested actions in these zones are as follows:-

NomenclatureTransmission Potential In Terms Of(Either Of (B) Or (C)Suggested Surveillance And Containment MeasuresSuggested Diagnostic And Treatment Measures
Total Detected Cases Per Lakh PopulationNew Cases Detected In A Day (Average Of 7 Days From Sunday To Saturday) Per Lakh Population
(A)(B)(C)(D)(E)
Low transmission-risk zone< = 49< = 1.991. NO restrictions on movements by air, land or rail2. No restriction on public utilities except that intense-transmission-risk  indoor gatherings be banned (theatres, spectators in Stadia, coaching centers, shopping malls, barbers / beauticians, and religious congregations to be restricted3. Open up Universities / Professional Teaching Institutions4. Encourage reporting of persons with symptoms of ILI to healthcare facilities5. Screening for fever for all persons attending any healthcare facility or transportation point (railway / bus / airport)5. Testing of all persons with any symptom of ILI AND History Of Travel Or Stay In Moderately High Or High Transmission Zones or contact with a COVID positive person and isolation till result available5. Aggressive contact tracing of positive cases and their quarantine plus testing if they develop symptoms during quarantine period1. Higher priority to RT PCR testing (conventional /CBNAAT / TrueNat)2. Mild cases: Isolate and treat at home; advise to come to healthcare facility if moderately severe symptoms develop.3. Moderately severe  and severe cases: treat at hospital4. Random population sero-surveys for antibody levels.
Low Moderate transmission risk zone50 to 992 to 3.991. Slight restrictions on movements (no movement from 9 p.m. to 6 a.m.). Otherwise no restriction on private or public transport2. Slight restrictions on  public utilities (closure of Restaurants, theatres, schools / college, Shopping malls, not more than 5 persons in a shop at a given time, barbers and beauticians, religious congregations) to be restricted3. Open the Universities / Professional Education Institutions4. Encourage reporting of persons with symptoms of ILI to healthcare facilities5. Screening for fever for all persons attending any healthcare facility or transportation point (railway / bus / airport)5. Testing of all persons with any symptom of ILI or contact with a COVID positive person and isolation till result available6. Aggressive contact tracing of positive cases and their quarantine plus testing if they develop symptoms during quarantine period1. Higher priority to RT PCR testing (conventional / TrueNat)2. Mild cases: Isolate and treat at home; advise to come to healthcare facility if severe symptoms develop.3. Moderate and severe cases treat at hospital
High Moderate transmission risk zone100 to 1994 to 5.991. General containment of the City / town / Panchayat area; NO entry or exit into or outside that city / town / panchayat area but movement allowed within the city except for areas within that town / panchayat which fall into high transmission risk zone (see below)2. Closure of public utilities, excepting for essential items (as grocery, medicines, milk, etc) or for  health care reasons3. Contact tracing of only symptomatic positive cases4. House to house survey of areas identified as “high transmission risk zones” within that town or city or Panchayat (see below), for any person with signs / symptoms of ILI / SARI1. Give priority to “point of care testing” using rapid antigen detection tests.2. Test all persons with any symptom of ILI (or all close contacts of 7 days past duration, of positive cases) with point of care rapid antigen test3. Treat Mild and moderate cases through home isolation4. Treat severe cases or moderate cases with 2 or more co-morbidities at hospital
High transmission risk zone>= 200>= 61. Strict containment of the defined area; NO entry or exit allowed except for healthcare reasons2. Closure of all public utilities and transportation, excepting for health care in the demarcated area3. Close down all places with high-transmission risk (various areas of human congregation as defined above as well as Universities / colleges)4. No contact tracing5. House to house survey of entire zone for any person with signs / symptoms of ILI / SARI6. Undertake random population sero-survey for antibody levels in the defined area / population1. Give priority to “point of care testing” using rapid antigen detection tests.2. Treat Mild and moderate cases through home isolation3. Treat severe cases or moderate cases with 2 or more risk co-morbidities at hospital4. Random population sero-surveys for antibody level

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4 COMMENTS

  1. 1. Tribal
    2.B & C both needed
    3. Only COVID Negative employees to work in industry , positive will be isolated, contacts quarantined
    4. Universal safety precautions to be followed by all

  2. 1. Ward in cities
    2. Universal safety precautions to be followed by all
    3. Resources needed & manpower needed for surveillance should be counted
    4. In low transmission zone school closed , restaurants closed

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