Identification of foreign returnees in Andhra Pradesh has become a big challenge while many districts in Jammu and Kashmir, Bihar, Arunachal Pradesh, Haryana, Maharashtra and Chattisgarh lack personal protective equipment (PPE)and medical facilities. These revelations came in a survey -- COVID-19 National Preparedness Survey 2020 - carried out by the Department of Administrative Reforms and Public Grievances.
The survey also stated that people's awareness about the threat of COVID-19 pandemic is very high. "A total of 92 per cent of respondents said people are aware of the threat and 75 per cent said that people are taking precautions to cope with the threat of COVID-19," the survey stated.
It also said that there were responses that awareness generation is needed in some districts.
"Sixty Nine per cent respondents took the view that people are handling the COVID-19 lockdown in a peaceful and orderly manner on being questioned on public being alarmed and panicking, whilst 31 per cent agreed that people are alarmed and panicking," the survey stated.
The availability of adequate isolation beds in districts and sub-district hospitals was agreed by approximately 50 per cent officers; with 28 per cent disagreeing to its availability, the study highlighted.
The Survey was conducted from March 25 to March 30, 2020 to attain a bird's eye view of the governance challenges while coping with the greatest health crisis India faced since Independence. The survey recognizes the contributions made by millions of Indians in fighting the pandemic at local, district, state and national levels.
The respondents agreed that government machinery has reached out to the people with 95 per cent officers providing positive feedback that the Government machinery has guided and assured the people in the region or area to adopt a rational approach to social distancing.
"The essential services and goods availability were largely addressed in the country with 92 per cent district collectors and officers agreeing to it. There were no disruptions in the essential services and goods availability," the survey pointed out.
The Prime Minister's appeal of Janata Curfew was very effective on the ground in meeting its objectives of motivating people to adopt social distancing while staying at home with 91 per cent respondents agreed in this category.
"The survey identified the need for enhanced hospital preparedness in District/Sub-District Hospitals, with 40 per cent of officials responding that hospitals were adequately prepared. The District Collectors and officers, felt that inadequate availability of Personal Protection Equipment (masks, gloves etc.) in District/Sub-District Hospitals is an area of concern," it stated.
It also pointed out that Arunachal Pradesh districts have identified lack of proper health facilities, shortage of sample collection kits, testing facilities, PPEs and non-availability of ICU and ventilators.
Assam districts have said that major challenge is people not following lockdown properly. There is non-availability of PPE equipment which increases the possibility of spread through doctors and paramedics staff. People are migrating within state and coming from other states like Mizoram.
Bihar districts have also said there is lack of PPE and medical facilities. Some districts reported that there is a lack of basic medical accessories such as masks and sanitizers.
"Chattisgarh districts said major challenge lies in Llck of medical facilities and staff and shortage of Personal protection equipment," the survey stated.
Delhi said the major challenge is to do enough testing of suspected cases. Also, there is a need for better equipment for the hospital. High migrants inflow, risky slum areas and lack of PPEs for the staff are the major challenges, Delhi districts said.
Haryana districts have said their major challenge was labour movement and migration inflow, to track and test them and non-availability of PPE and ventilators. Himachal Pradesh districts have said only few testing kits are available. People's movement is a challenge.
Jammu & Kashmir districts said major challenge lies in inadequate personal protection equipment and has no supply of drugs for approved treatment.
In districts in Madhya Pradesh, the survey found that health infrastructure is in poor condition, district does not have any private hospitals or doctors. Here burden falls on govt health infrastructure and only one ventilator is available.
Similarly, in Maharashtra, districts said availability of medical supplies such as PPEs, masks, sanitizers, ventilators etc is main concern. Lack of trained staff is another.
In Nagaland, there is no testing centre in the state, and there are shortages of ambulances and oxygen cylinders. There is lack of essential goods as these have to come from outside the state and the sealing of inter-state borders has resulted in numerous challenges faced by vehicles carrying essential commodities in navigating checkpoints.
It was also suggested there is a need to develop and issue standard operating procedures and guidelines for interstate movement of people across state borders. It pointed that immediate address of issues relating to procurement, logistics and supply chain for medical equipment needs to be done.
"Create more testing centers and capabilities for all district/sub-district hospitals along with isolation wards for fast & seamless results and initiate steps to avoid unnecessary delays," the survey pointed.
The study stressed that there should be regular check on pricing of essential commodities to be made mandatory.
The objectives of this preparedness survey were to develop a comparative analysis of COVID-19 preparedness across states; to highlight the main priorities and constraints, as they are perceived by the civil servants working in the field to access enabling factors in making institutional, logistics and hospital preparedness.
It has also been done to capture trends to identify systemic and process related deficiencies, in combating COVID-19 in the districts of India.
The questionnaire of the proposed survey was circulated to the respondents through the DARPG portal www.darpg.gov.in on March 25, 2020. Individual officers, including district collectors and district magistrates and IAS officers from 2014- 018 batches were asked to register themselves into the portal and submit replies to the questionnaire.
The online feedback mechanism for COVID-19 from the period March 25 to March 30 resulted in registration of 410 district collectors and IAS officers (Batches 2014-2018) on the portal. Furthermore, 266 complete feedback application forms were submitted online on COVID-19 from across the nation providing a holistic view on the ground challenges to combat the outbreak in India.