Trace, Test and Treat: How AP Govt's Medicare Strategy Helped Contain COVID19

Amaravati: The year that has gone by has left behind memories which one intends to forget quickly with the Conorna pandemic looming large, but YS Jagan Mohan Reddy led government in Andhra Pradesh has tackled the pandemic effectively besides taking other initiatives in medicare to keep the State healthy and made tremendous efforts in this direction.

The State made rapid strides in developing infrastructure and facilities in controlling the pandemic by widening the network and pressing into the service the Village Secretariat system and closely monitoring the situation almost on a daily basis to get encouraging results as the State stood first in the number of tests per million in the country and its recovery rate was higher and mortality rate lower than that of the national average. The number labs was started in record time.  Trace, Test and Treat was the policy followed and the ANMs, Village and Ward Volunteers along with sanitation workers and medical personnel have done a commendable job in containing the pandemic. A household survey was taken up by the volunteers on every demanding situation and adequate medical staff was recruited in the Covid Centres.

The State has brought 15 procedures to treat COVID patients under Dr YSR Aarogyasri scheme on April 6, 2020 and also brought post-Covid care under Aarogyasri scheme. The State machinery is in full preparedness as per the Central guidelines for the distribution of COVID vaccine as per the priority norms set and the vital cold storage links are being established.

YSR Aarogyasri was strengthened with more disciplines coming under its cover and the revamping of existing Government hospitals under Nadu Nedu and giving the green signal to start 16 more teaching hospitals, covering tribal areas as well will go a long way in medicare.  

The year started with Chief Minister YS Jagan Mohan Reddy, fulfilling his election promise, launching the pilot project on January 3, in West Godavari district to provide medical cover to any treatment that costs Rs 1,000 or more bringing 2,059 ailments under its purview from the earlier 1059.
The scheme was extended to Vizianagaram, Visakhapatnam, Guntur, Prakasam, YSR Kadapa and Kurnool districts from July 16 covering 2200 ailments. Later, it was implemented in Srikakulam, East Godavari, Krishna, SPS Nellore, Chittoor and Ananthapur districts to cover the entire State, the number procedures was increased by 234 taking the total to 2436 on November 10.  The scope of Aarogyasri is being widened extensively and the scheme is applicable to those whose annual income is up to Rs 5 lakh. The State Government has issued 1.1 lakh new health cards with QR code till Nov 6. Smart health cards, 1.35 crore were issued based on Navasakam survey. Under Aarogyasri, 130 super specialty hospitals (Hyderabad-77, Bengaluru-26 and Chennai -27) were identified for 716 procedures.

During the year, the State has recruited 508 new Aarogya Mithras and 670 new help desks were set up in the network hospitals. About 1,404 ambulances of 108 and 104 were pressed into service.

For the first time ever, the State has brought in YSR Aarogya Asara, paying up to Rs 5,000 to patients who had undergone surgery  to support them during recovery period and further providing monthly pensions ranging from Rs 3000-10000 to people suffering from chronic ailments. The state government is revamping all the existing hospitals right from PHC’s to teaching hospitals under the Nadu Nedu project, developing as per National Standards and starting 16 new medical colleges with a budget of Rs 16,000 Crore. As of now, there are 1406 network hospitals (693 private, 713 Government) and 2,436 procedures are available under the scheme.

Covid

With the Covid outbreak in the state since March, the State Government has taken every measure to prevent spread of the virus and reduce the rate of mortality and intensity of morbidity. The State government has adopted a three- pronged strategy of tracing, testing and treatment to contain the spread and intensity of COVID 19.

The data as on December 25, states that about 1.15 Crore tests were conducted, covering nearly 20 percent of the State population standing first in the country. About 8.80 lakh were infected with an average positivity rate is 7.64 percent, the death rate logged was just 0.81 percent much lower than the national average.

Effective control system was put in place, by developing the testing facilities, setting Covid care centres, and establishing a structured network right from 104 toll-free number to telemedicine. The number of virology labs quickly went up to 150 from zero. The State has followed decentralized model of sample collection centers and about 1519 facilities acted as sample collection centers ranging from teaching hospitals to primary health centers and mobile units. Doctors, para- medical staff, employees of village and ward secretariats, volunteers, sanitation workers, ASHA workers and ANMs played a vital role during the pandemic.

A dedicated 104 call centre became operational from third week of July, providing information regarding testing facilities, symptoms, health facilities, test results, ANMs, MOs, Covid hospitals and bed availability also help in getting sample collected, testing done, hospital admission, arrange transport from home to triage centers. The state has been spending on average 4 crore per day on COVID management at the peak period.

The Village and ward secretariats staff, along with volunteers has worked in close association with ANMs and ASHA workers in contact tracing, conducting six rounds of fever survey, creating awareness on elimination of stigma on COVID 19, isolating positive patients and tracking their health day by day for 28 days, distribution of three masks to each person, disseminating IEC material on COVID appropriate behavior and distribution of home isolation kits to all the COVID persons under home isolation.

In the backdrop of a possible second wave, the State has been taking all measures and at the same time has braced up the official machinery for the distribution and storage of Covid vaccine as per the Central guidelines.

The year has brought in medical awareness among the people while village secretariat system and other initiatives of the Government had put the State ahead others in tackling the issue.