• Districts assigned testing targets
• RAT facility extended to PHCs and HCWs
• Community surveillance to be intensified
• Testing on payment/vaccination certificate for inbound travelers
Morung Express News
Kohima/Dimapur | July 15
As Nagaland continues to register high COVID-19 positivity rate, the State Health and Family Welfare department on Thursday underscored the need for testing in order to break the chain of transmission and prevent the virus from replication and mutation.
In an effort to ramp up COVID-19 testing in the State, and as directed by the High Power Committee (HPC) on COVID-19, the Health department has announced ‘Mission X5’, with directions and guidelines to guide and facilitate the Chief Medical Officers (CMOs)/Medical Superintendents (MS)/District Task Forces (DTFs) in the process.
Districts have also been assigned testing targets under the mission, which aims at increasing daily and weekly testing numbers by 5 times of the current rate of testing. All CMOs and MS have been directed to ensure the COVID-19 testing target assigned to the districts is achieved.
“Testing is not only a vital epidemiological tool but also help people determine if they are infected or not. Only through testing, cases including those who have no symptoms can be detected, isolated and treated,” the department stated in an order issued by its Principal Director, Dr Neikhrielie Khimiao on July 15.
With the current positivity rate in Nagaland at around 7%, the department noted that a higher percentage of positivity suggests higher transmission and that there are likely more people with Coronavirus in the community who have not been tested yet. COVID-19 testing in Nagaland is lowest in the country at 1,12,330 per million as compared to the National average of 3,10,790 per million, it further informed.
Low testing, poor health care seeking behavior, low vaccination coverage coupled with non-adherence to COVID appropriate behaviors and flouting quarantine norms, unless effectively tackled, would lead to grave consequences, the department cautioned.
Expansion of RAT facility
Under Mission X5, Rapid Antigen Test (RAT) facility is to be started all District Hospitals (DHs), Community Health Centers (CHCs), Primary Health Centers (PHCs), and Sub Center – Health and Wellness Centers (SC-HWCs). Testing facility should also be provided at strategic SCs/PHCs without doctors where skills can be imparted to the HCWs, the department directed. “Wherever Truenat/ RT-PCR testing is not feasible, testing should be done through RAT. However, all symptomatic be kept in all testing centers for collection of samples,” it added.
Districts have also been directed to prepare microplan with weekly target for each testing centre.
Strategies for the microplan include intensive contact tracing, random testing of high risk groups, and mandatory testing of all ILI/SARI cases detected through house-to-house visits and at health facilities.
Respective DTFs have been assigned to requisition vehicles available with various departments at the location for carrying out these activities. The DTF may also explore other sources such as vehicles belonging to church/village council or sponsoring hiring of vehicles for transportation of the samples, the department directed.
Those tested positive may be advised immediate home isolation/CCC care. All RAT negative symptomatic individual may be treated as suspect COVID-19 cases and also should be advised for home isolation while awaiting the test results, it added.
Intensive awareness campaign
DTFs have also been directed to use content and material provided by the Directorate on importance of addressing concerns of stigma, testing, contact tracing, disclosure of contacts, early Detection and Prompt Treatment (EDPT) to reduce mortality, breaking the chain of transmission and its impact on mitigating viral mutations as well as COVID-19 vaccination, as part of the Intensive Awareness Campaign. They should be used with necessary adaptation including translations into local languages and dialects, it added.
Contact tracing
There should be close coordination between the team at Health Facilities and Community Surveillance Team who are tasked with house-to-house visits for detecting ILI/SARI cases, the department stated.
As part of an intensified contact tracing, it said that, ideally, 25-30 contacts are to be traced for every positive case. All household members should be taken as contacts and should be mandatorily tested, it directed.
In the villages wherever positive cases are detected, the department advised involvement of village councils to trace all contacts. In case of refusal for testing or disclosure of contacts, powers under the Epidemic Act 1897 can be invoked by the competent authority, it added.
Periodic testing in high risk settings like shops, salons, taxis/ public transport, home delivery, offices, banks and HCWs are to be done every 15 days.
The department further directed DTFs to ensure RAT testing on payment or production of vaccination certificate by all in-bound travelers as per the SOPs at the Point of Entry including Railway station and Airport.
Samples for genome sequencing
To curb spread and timely detection of more transmissible variants, samples are to be collected and sent for Whole Genome Sequencing (WGS), the department stated.
Sentinel surveillance Sites have been selected in the State which includes BSL-2 Lab CIHSR, CIHSR Dimapur, DH Dimapur, State Referral BSL-3 Lab NHAK, NHAK, DH Mokokchung, BSL-2 Lab, Tuensang and DH Tuensang.
Each Site is to send 15 samples every 15 days to the designated lab for WGS. This will be coordinated by the State Referral BSL-3 Lab, Kohima.
