The Triple-T model implemented by the State has brought down the daily positivity rate from 16 per cent to merely 0.5 per cent. Other states must follow suit
Predictions were once being made that coronavirus cases in Uttar Pradesh would exceed one lakh a day in May. On the contrary, the state has done a phenomenal job by bringing down daily case-count to just 1,497 on May 31 after the 38,000-peak on April 24. With more than 4.84 crore people having been tested for the coronavirus, the state has been strictly following the track-treat-test protocol responsible for an impressive 96.6 per cent recovery in active covid cases.
Every day, more than three lakh people are tested for the presence of SARS-CoV-2 virus; Uttar Pradesh became the first state to test 3.7 lakh people a day. Its Triple-T strategy is being effectively implemented in its 97,941 villages. This door-to-door inspection model has helped bring down the case fatality rate, winning applause from WHO. Under this, 1,41,610 teams and 21,242 supervisors have been deployed to ensure that every suspected case is tracked to the last mile.
Each two-member team is responsible for testing covid-symptomatic individuals using Rapid Antigen Test (RAT) kits; those who test positive are isolated and given a medicine kit with clear-cut instructions. Since the objective is to eliminate the chain of virus transmission, the Rapid Response Team (RRT) also tests all contacts of the covid-positive patients using RT-PCR. This ensures that no contact is left untraced. Irrespective of the falling cases, this strategy continues to be implemented with full vigor.
The RRT also educates people about the benefits of adhering to covid-appropriate behaviour. Symptomatic people are instructed about the quarantine and isolation protocol. The surveillance committee is also responsible for facilitating quarantine facilities in the schools, community centres and village health centres for all those who cannot afford home isolation. This micro-planning, door-to-door inspection and concurrent follow-up and monitoring strategy stands at the core of the Covid-19 resolution in the state. Integrated Command & Control Centres (ICCC) and covid helpdesks have been set-up in every district to provide free teleconsultation services to both covid and non-covid patients, cutting down the need for hospital visits.
While in the first wave the demand for Liquid Medical Oxygen (LMO) was restricted to 300 MT, it escalated to more than 1,000 MT a day in the second surge. The shortage was met by incoming oxygen express trains and tankers airlifted by the air force; 20,000 oxygen concentrators were also provided for the same. The government decided to set-up 300 permanent oxygen plants. Under the state's oxygen transport and tracking model, oxygen hubs have been established and a dashboard called 'OxyTracker' has been developed which tracks the tankers on real-time basis, thereby increasing transparency and efficiency. A plan is in action for establishing a state-wide oxygen grid all the way from Saharanpur to Deoria.
Three large hospitals have been set-up — a 500-bed hospital in Shilpgram, a 750-bed Covid-dedicated hospital in Varanasi and a 255-bed hospital in Lucknow; the number of L2 and L3 beds have been increased to 80,000. To reduce the response time in critical covid cases, 350 advanced life-support ambulances have been added to the transport fleet. District-wise, six oxygen plants are already functional and running in Ayodhya while 18 are in process; in Aligarh, 161 ventilators, 246 oxygen concentrators and 85 ambulances were allocated to deal with the second covid surge. In Mathura district, 96 additional ventilators and 32 covid-dedicated ambulances were deployed.
Curbing vaccine hesitancy, the state has successfully vaccinated more than 1.80 crore people. Both Covishield and Covaxin are available in all 75 districts which in itself is an achievement considering reports of vaccine shortages in various states. As a part of its measures to protect children from the third covid wave, parents having children less than 12 years of age are being given special discounts as an incentive to get inoculated. This will serve dual purpose; not only will it encourage people to get vaccinated but also provide an additional protection to children who are not yet eligible to take the Covid-19 vaccine.
To ensure compliance, two nodal officers in every large district and an officer in the smaller ones have been assigned to monitor covid protocol including quarantine and isolation; gram panchayats and mohallamandals have also been roped in for the same. With rising cases of black fungus, a 12-member team has been allocated for providing training and treatment guidelines for affected patients. With myriad steps taken, the number of active Covid-19 cases have reduced by 2,72,956 from 3,10,000 on April 30 to 37,044 on May 31 — in a matter of a month. Out of the number of active cases, 20,762 are in home isolation. This reduction in active cases has provided a breather to the healthcare workers also. What makes this fall in cases even more laudable is that this decline has come despite a softer lockdown imposed in the state vis-à-vis a harder lockdown in other states; industrial activity and essential services continued to function apart from the vaccinations and medical emergencies which were exempted from the curfew. The Triple-T strategy ensured that for all reduction in cases, the livelihoods remained secured; by keeping the industries up and running, the daily-wage workers werenot forced to lose out on their wages.
As per the current data, two districts have become covid-free while in 16 others, the case numbers have declined to a single-digit. In 53 districts, the case-count has come down to less than 100, with only four districts having more than a hundred cases. Real-time monitoring and ground visits by Chief Minister Yogi Adityanath and aggressive campaigning against the highly contagious virus have helped Uttar Pradesh in tiding over this crisis. Despite being infected by the virus himself, the Chief Minister toured 30 districts of Lucknow, Moradabad, Bareilly, Gorakhpur, Varanasi and Ayodhya involving people in the mitigation strategy and seeking their opinions. He has been on foot throughout the surge-monitoring and ensuring that the vaccination centres are well-quipped to carry out the vaccination drive on a war-footing.
Behind every successful model is the relentless and untiring leader who makes sure that policies carried out on the ground mirror those written on paper. By educating the public about the importance of vaccination and disease prevention, Adityanath has left no stone unturned in restricting the virus.
The state's scientific and welfare-centric covid strategy has helped in averting what could have been one of the most horrifying humanitarian crises of unfathomable magnitude. No wonder, despite having a population of 24-crore people, the daily covid-case count has dwindled to 1,497 in comparison to 18,600 cases in Maharashtra (with a population of 12 crore), 28,864 in Tamil Nadu (7-crore population) and 19,894 in Kerala (3-crore population).
With its eyes on the third wave now, the government is taking all necessary steps to establish dedicated paediatric ICUs in every district and a 100-bed PICU ward in each medical college. The goal is to protect children from the ghastly virus as they remain vulnerable on account of not having been vaccinated. The amalgamation between the Triple-T model, partial corona curfew and adequate vaccination push has helped reduce the heavy covid caseload in Uttar Pradesh. Foresightedness and preparation are key to a pandemic and Uttar Pradesh's 'Yogi model' exhibits that perfectly.
(Rajat Arora is an interventional cardiologist and Director at Yashoda Group of Hospitals, Delhi-NCR. The views expressed are personal.)
