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OPINION
Year : 2020  |  Volume : 18  |  Issue : 3  |  Page : 206-209

COVID-19: Preparedness and response by union territory of Jammu and Kashmir for containment of pandemic


Department of Community Medicine, Government Medical College, Srinagar, Jammu and Kashmir, India

Date of Submission15-Apr-2020
Date of Decision20-Apr-2020
Date of Acceptance29-Apr-2020
Date of Web Publication22-May-2020

Correspondence Address:
Dr. Sheikh Mohd Saleem
Department of Community Medicine, Government Medical College, Srinagar, Jammu and Kashmir
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/cmi.cmi_56_20

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  Abstract 


Like the rest of the world, the onslaught of COVID-19 has hit India and poses as a major challenge to its country people. On January 31, India faced the jolt of COVID-19 for the first time when the maiden case was reported in Kerala. The numbers grew steadily in the following days. In the initial stages, the virus was contracted through patients with foreign travel history. However, as the numbers surged, the cases of local transmission also came to the fore. Various directives were issued by the administration to limit the spread of the virus. This included the closure of schools, colleges, and universities and the cancelation of visas. While the cases showed no signs of subsiding, the restrictions were intensified with the closure of interstate transport and cancelation of all flights. On March 24, the countrywide lockdown was announced for 21 days as a major precautionary measure against the growing virus. While the country continues to contain the coronavirus pandemic and the possible economic slowdown due to it, the newly formed union territory (UT) of Jammu and Kashmir has been put under another lockdown – this time due to the disease. However, this time, there is one silver lining in the dark cloud. The administration had been active beforehand. It had stepped up its preparedness measures before the outbreak of the pandemic in the UT.

Keywords: Containment, COVID-19, preparedness, response


How to cite this article:
Saleem SM, Quansar R, Qurieshi MA. COVID-19: Preparedness and response by union territory of Jammu and Kashmir for containment of pandemic. Curr Med Issues 2020;18:206-9

How to cite this URL:
Saleem SM, Quansar R, Qurieshi MA. COVID-19: Preparedness and response by union territory of Jammu and Kashmir for containment of pandemic. Curr Med Issues [serial online] 2020 [cited 2020 Oct 24];18:206-9. Available from: https://www.cmijournal.org/text.asp?2020/18/3/206/284737




  Background Top


Like the rest of the world, the onslaught of COVID-19 has hit India and poses as a major challenge to its countrymen. Originating from China, the new form of the virus means that no one has immunity, and there is no vaccine.[1] Its novelty means that scientists are not sure yet how it behaves – they have little history to go on.

On January 31, India faced the jolt of COVID-19 for the first time when the maiden case was reported in Kerala. The numbers grew steadily in the following days. This can be gauged by the fact that the 1st week recorded around 200 positive cases and 500 in the 2nd week. In the initial stages, the virus was contracted through patients with foreign travel history. However, as the numbers surged, the cases of local transmission also came to the fore. With the threat of the deadly virus looming large over the country, the state governments decided to ease the crisis. Various directives were issued by the administration to limit the spread of the virus. This included the closure of schools, colleges, and universities and the cancelation of visas. While the cases showed no signs of subsiding, the restrictions were intensified with the closure of interstate transport and cancelation of all flights. Consequently, this led to the starting of the national coronavirus lockdown put in motion by Prime Minister of India, Mr. Narendra Modi.[2]

On March 24, the countrywide lockdown was announced for 21 days as a major precautionary measure against the growing virus. While the country continues to contain the coronavirus pandemic and the possible economic slowdown due to it, the newly formed union territory (UT) of Jammu and Kashmir (J and K) has been put under another lockdown – this time due to the disease. However, this time, there is one silver lining in the dark cloud. The administration had been active beforehand. It had stepped up its preparedness measures before the outbreak of the pandemic in the UT.[3]

Among the various measures, the Disaster Management Act, 2005 was put in place. The admin roped in different departments – Health Department, National Health Mission (NHM), Integrated Disease Surveillance Program (IDSP), ICDS, Education Department, Media, Telecom Sector, Municipal Corporation, and Law and Order Department. A meeting was held under the chairmanship of Lieutenant Governor of UT J and K for intersectoral coordination to frame different strategies to combat the spread of the pandemic. Various measures undertaken by different departments to limit the pandemic spread are described below.


  Education Department Top


The education department started the awareness campaign under the existing Rashtriya Bal Swasthya Karyakaram program in the schools regarding hand hygiene, social distancing, and cough etiquette. Extra staff was recruited on a war footing basis for household surveillance of all the students for any symptom of COVID-19 or foreign travel history. The students were asked to carry hand sanitizers to the school to inculcate habits of hand hygiene among them. On March 13, 2020, a bold decision to close all the schools was taken as a precautionary measure to contain the spread of COVID-19 among the masses.


  Media and Telecom Sector Top


As media is regarded as a strong tool to spread awareness, during the preparedness phase, it was used as a source of behavior change communication among masses. The ways of spread, as well as ways of preventing the spread, were shared through Television and Newspapers as well. Different types of information, education, and communication material were printed in leading newspapers of the UT. The information was disseminated through electronic media as well. Radio channels were also used as a source of information dissemination. The telecom sector was also involved in the dissemination of information among the users. Famous caller tune of a “man coughing out loudly” followed by preventive information regarding COVID-19 was used to aware people in local languages such as Urdu, Hindi, and Dogri.


  Municipal Corporation Top


The municipal corporations/committees of all the districts were directed to carry out large-scale sanitation drives to promote cleanliness and sanitation. Informative hoardings along the roadsides depicting messages related to COVID-19 were displayed on a large scale. Municipal corporations procured state-of-the-art equipment and technology for disinfecting places, such as markets, religious places, parks, and busy areas of the town. A disinfection tunnel with quaternary ammonium compound (QAC) spray was installed at many hospital entries to prevent the spread of COVID-19. QAC such as chloroxylenol (4.5%–5.5%) and benzalkonium chloride has been found to be effective against coronavirus as substantiated by the available literature.[4],[5],[6] Such tunnels were deemed as strategies to combat coronavirus in India. Reportedly, China began using such disinfection tunnels in the city of Chongqing. In India, Tiruppur district of Tamil Nadu was the first to install such tunnels.[7]


  Law and Order Department Top


The law and order department was ordered to make necessary arrangements for assistance to the surveillance personnel and magistrates in the discharge of their duties under the provisions and regulations under the Disaster Management Act, 1897. The law and order department also implemented Section 144 by the order of district magistrates in various districts in a phased manner and did not allow people to gather at a place and restricted their movements across the state.

Rumor mongering and the spread of fake information which may cause panic among masses were prevented by imposing special sections of information technology. Initially, a partial lockdown was imposed by the cancelation of all public transport systems and the implementation of stringent measures to prevent the gathering of more than 4 people in one place. The police force and paramilitary were called into action to restrict the movement of people from one district to another.


  Other Measures by District Administration Top


With the rise of cases in other parts of the country, the administration decided to prevent major gatherings, especially at religious places. All the gardens, parks, and recreational places were closed, and people were not allowed to visit these places. Major shopping hubs such as markets and shopping malls were put under lock. Gyms, tuition centers, and restaurants were also closed. Biometric attendance was discouraged in all the offices and departments to prevent the spread. Large hoardings were displayed in major areas, markets, shopping malls, railway stations, and airports to aware the general public. A helpdesk was formulated at airports and railway stations. Transport department conducted disinfection of buses and in and around all major transport yards. At the airports, a self-declaration form was given to people whosoever come from outside to know about their travel history. A medical team was deployed at the airport to do the thermal scanning of the passengers using an infrared thermal image scanner (ITIS) so that COVID-19 suspects could be easily detected at the airport and put into isolation. Earlier ITIS was used as an effective tool for screening of passengers for influenza in some countries. It has a sensitivity of 80%–86% in detecting cutaneous temperature as reported in the literature.[8]

A wide range of publicity was done in panchayats and media regarding the prevention and safety measures, and slogans such as “STAY AT HOME” were shared at authorities which went viral on social media.


  Health Department Top


Directorate Health Services, Health and Medical Education Department, NHM, ICDS, and IDSP worked collectively to frame standard operating protocol (SOP) to be followed to tackle the pandemic. A national-level training was conducted in New Delhi where state officers, nodal officers, administrative officers, laboratory heads, clinicians, and microbiologists were trained regarding COVID-19. In the UT, many pieces of training were held in medical colleges, agriculture universities, police departments, universities, and legal authorities to make people aware of this disease as well as its preventive measures. The SOPs were routinely updated from time to time as per the guidelines issued by the World Health Organization. The same was communicated to all involved sectors.

At each district level, a surveillance team was constituted and was assigned their jobs, and the police department was assigned the job to help the surveillance teams. The district surveillance teams formed were headed by District Commissioner (DC) and which has to submit the report to the DC each day. There was the formation of nodal officers for each district along with the identification of quarantine and isolation centers in respective districts. The laboratory facility was assigned to two tertiary health care centers at the UT level. A rapid response team was constituted to do the necessary procedures in case a COVID-positive patient was detected.


  Response Top


The first case was confirmed on the March 18, 2020, in the Srinagar district with international travel history. As soon as a case was detected, the case was put in isolation and her immediate contacts were quarantined and efficient contact tracing was done in the area of residence with the help of rapid response teams. All the possible contacts were traced and put under quarantine and the immediate contacts were tested for the same. The whole area was locked down and was sanitized by the municipal corporation. The travel history of the case was put under surveillance, and the people who had traveled along the case were also put under quarantine.

After that day, the people with foreign travel history were screened at airports, and if any fever was detected, they were put under quarantine. After some days, screening was also started on the national highway and persons coming from outside via road were also screened. The interstate transport was closed and train services were also suspended. No traffic from outside the UT was allowed to enter the UT. There was a complete lockdown of all the services and offices exempting the essential services. Section 144 was imposed with more vigor and vigilance. The lockdown was imposed even during night hours. Police and NGOs were told to spread the message through roads and streets through mikes. With more increase in the number of cases, the obligatory prayers in local mosques were banned and religious leaders were roped in to make people aware of this ban. No more than 3 people were allowed to offer prayers in the mosque together. To make this lockdown more efficient, even First Information Report (FIR)was sort for people who would violate the law and order. On April 14, the Prime Minister of India extended the lockdown till May 3, 2020, which is commonly famous as Lockdown 2.0 among masses. Experts believe that the lockdown will help in flattening the curve, while some argue that lockdown is just to buy time for preparedness. Many smaller nations of the world have even tried developing herd immunity among the population but have, in turn, suffered by losing a significant proportion of population in the older age groups. In India, about 9% of population is above 60 years of age, and if we try to develop herd immunity, we may lose a significant portion of this population which will account for enormous deaths. The fact is that there is as such no perfect model to contain the COVID-19 pandemic. We, at UT of J and K, are trying to make effective use of the Lockdown 2.0. If we will be able to trace and locate all the covid-19 cases and their contacts, isolate them from rest of the community for the period of maximum incubation period. We can definitely have a better position in containing the pandemic.


  Conclusion Top


The response measures put in place for COVID-19 containment by the UT of J and K have proved to be somewhat successful as the reported cases are much less than the numbers predicted earlier. The coordination between various sectors is the prime key to face such challenges in the future.

Acknowledgment

Authors are highly grateful to the Head, Department of Community Medicine, Prof. Dr. S. Muhammad Salim Khan for his support and guidance during the study.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Amanat F, Krammer F. SARS-CoV-2 Vaccines: Status Report. Immunity 2020;52:583-9.  Back to cited text no. 1
    
2.
Hindustan Times. 82 Districts under Lockdown Over Covid-19: What is Shut and Where. Hindustan Times; 2020. Available from: https://www.hindustantimes.com/india-news/82-districts-under-lockdown-over-covid-19-what-s-open-and-what-is-shut/story-c1AEMZXuuXN6FvmrAdRvsJ.html. [Last accessed on 2020 Apr 21].  Back to cited text no. 2
    
3.
PM Modi Speech: India Coronavirus Lockdown date Extended till May 3, PM Narendra Modi Announces. Indian Express; 2020. Available from: https://indianexpress.com/article/india/pm-narendra-modi-april-14-coronavirus-lockdown-speech-6360981/. [Last accessed on 2020 Apr 21].  Back to cited text no. 3
    
4.
Merchel Piovesan Pereira B, Tagkopoulos I. Benzalkonium Chlorides: Uses, Regulatory Status, and Microbial Resistance. Appl Environ Microbiol. 2019;85(13):e00377-19. Published 2019 Jun 17. doi:10.1128/AEM.00377-19.  Back to cited text no. 4
    
5.
Gerba CP. Quaternary ammonium biocides: Efficacy in application. Appl Environ Microbiol 2015;81:464-9.  Back to cited text no. 5
    
6.
Feliciano L, Li J, Lee J, Pascall MA. Efficacies of sodium hypochlorite and quaternary ammonium sanitizers for reduction of norovirus and selected bacteria during ware-washing operations. PLoS One 2012;7:e50273.  Back to cited text no. 6
    
7.
India's Disinfectant Tunnels– Emerging Strategies to Combat Coronavirus. Invest India; 2020. Available from: https://www.investindia.gov.in/team-india-blogs/indias-disinfectant-tunnels-emerging-strategies-combat-coronavirus. [Last accessed on 2020 Apr 21].  Back to cited text no. 7
    
8.
Priest PC, Duncan AR, Jennings LC, Baker MG. Thermal image scanning for influenza border screening: Results of an airport screening study. PLoS One 2011;6:e14490.  Back to cited text no. 8
    




 

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  In this article
Abstract
Background
Education Department
Media and Teleco...
Municipal Corpor...
Law and Order De...
Other Measures b...
Health Department
Response
Conclusion
References

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