© [Regd. No. TN/CCN/467/2012-14. GOVERNMENT OF TAMIL NADU [R. Dis. No. 197/2009. 2020 [Price: Rs.5.60 Paise. TAMIL NADU GOVERNMENT GAZETTE EXTRAORDINARY PUBLISHED BY AUTHORITY No. 181] CHENNAI, MONDAY, may 4, 2020 Chithirai 21, Saarvari, Thiruvalluvar Aandu–2051 Part II—Section 2 Notifications or Orders of interest to a Section of the public issued by Secretariat Departments. NOTIFicationS BY GOVERNMENT REVENUE AND DISASTER MANAGEMENT DEPARTMENT DISASTER MANAGEMENT ACT, 2005 - COVID-19 - DEMARCation OF Containment ZONE to CONTROL CORONA VIRUS - GUIDELINES AND LIST OF Containment ZONE. [G.O. Ms. No. 221, Revenue and Disaster Management (DM-II), 4th May 2020, CˆF¬ó 21, ꣘õK, F¼õœÀõ˜ ݇´-----2051.] No. II(2)/REVDM/232(x)/2020. SARS COV-2 virus causes COVID-19. Corona virus infection spreads from person to person directly through respiratory droplets produced when an infected person coughs and sneezes (<20% of transmission). People also become infected by touching surfaces frequently touched by hands (>80 %). It is important to ensure we identify pockets of critical interventions for a focused management of Covid 19 at field level. A district will be considered under Green Zone, if there are no confirmed cases so far or there is no reported case since last 21 days in the district. The list will be revised on a weekly basis or earlier and communicated to States for further follow up action in consonance with the directions issued by Ministry of Home Affairs under the Disaster Management Act’2005. The List of the districts as per above classification is attached herewith in Annexure. It is further highlighted that based on field feedback and additional analysis at state level, States may designate additional red or orange zones as appropriate. However, States may not relax the zonal classification of districts classified as red/orange as communicated by the Ministry. For the districts having one or more municipal corporations, the corporations and other areas of districts may be treated as separate units. If one or more of these units have reported no cases for last 21 days, they can be considered as one level lower in zonal classification, in case the district is in Red/Orange Zone. District authorities should, however, exercise due caution in such areas so that these areas remain free from COVID19 cases. It is critical to ensure that necessary action for containment so as to break the chain of transmission of virus is initiated in both red and orange zone districts reporting confirmed. [1] II-2 Ex. (181)–1 2 TAMIL NADU GOVERNMENT GAZETTE EXtraordinary The containment zones in these districts have to be delineated based on: l Mapping of cases and Contacts l Geographical dispersion of cases and contacts l Area with well demarcated perimeter l Enforceability Depending on above factors, for urban areas - residential colony / Mohallas / municipal wards or police-station area / municipal zones / town etc., as appropriate can be designated as containment zones. Similarly, for rural areas – villages / clusters of villages or group of police stations/ gram panchayats/blocks etc., as appropriate can be designates as containment zones. The area should be appropriately defined by the district administration/local urban body with technical inputs from local level. In the sprit of effective containment, it is advisable to err on the side of caution. Further, a buffer zone around containment zone has to be demarcated. Necessary action should then be initiated in these areas as part of the containment Action Plans already communicated including- l Stringent Perimeter control Establishing clear entry and exit points No movement except for medical emergencies and essential goods & services No unchecked influx of population People transiting to be recorded & followed through IDSP l Active search for cases through house to house surveillance by special teams formed for the purpose l Testing of all cases as per sampling guidelines l Contact tracing l Clinical management of all confirmed cases Similarly, in buffer zones, extensive surveillance for cases through monitoring of ILI/SARI cases in health facilities has to be taken up. Strategies for Corona Virus Infection Prevention and Control 1. Strategies to prevent the entry of the virus into a country or state or district or in a local area include thermal screening, entry and exit hand wash, self quarantine, hospital isolation of persons with symptoms. 2. Respiratory Hygiene including remaining inside the home when anyone has cold, cough, fever, sneeze after getting medical advice and test for COVID-19, cough etiquette, hand washing and surface cleaning and disinfection practices including hospitals, public transport and similar locations. 3. Avoiding all kinds of mass gatherings 4. Effective seamless lab-based surveillance by testing all severe Acute Respiratory Illness (SARI) cases, Influenza Like Illnesses (ILI), contact testing, testing people with low immunity. 5. If tested positive, isolation and admission in COVID hospital as per doctor advise. 6. Isolation and treatment of positive cases in hospitals and based on the experience and need, steady strengthening of hospital capacity both in Govt sector and private sector, including the separation of fever OP and IP from other hospital services. 7. Special care for pregnant mothers and children and special arrangements for the hospitals catering to special patient groups like cancer, geriatrics, transplants and other similar categories. 8. Home quarantine/ facility quarantine of high-risk contacts. TAMIL NADU GOVERNMENT GAZETTE EXtraordinary 3 9. Secluding senior citizens from younger people by creating awareness, back to village homes at least for next six months. 10. Indian system of medicines for boosting immunity among patients, contacts, high risk population groups. 11. Localised containment and lock down strategies Strategies aimed at Delaying the spread l Essentially for any kind of Influenza Like Illness (ILI) the strategy is delaying the spread of the infection in the community as much as possible, since it will enable the society, government and health care system to get prepared to handle the situation. l Broader flattened epidemic curve is the goal since it will enable the younger society to develop herd immunity and in the process the lightning ability of the virus will be severely crippled. Containment Strategies 1. General Principles l Prevention of further spread in the locality by restricting the movements and implementing all known scientific interventions is the key objective of containment strategy l Although administrative units are preferred, case patient movement and local epidemiology are the factors to be considered for decidingthe locations/areas to be brought under containment zone. l If administrative units overlap with each other, all concerned local bodies should be involved in containment operations. 1. Single or less than 5 Positive Cases 1.1.Village Panchayat In the village panchayat, village (habitation/hamlet) containing the residence of positive case is demarcated as containment zone. l If the individual stayed in a village (habitation / hamlet), such village (habitation / hamlet), may be brought under containment zone. If the positive cases spread across village panchayat, the concerned village panchayat will be brought under containment zone. l If the residence happens to be at the border of the concerned village panchayat, then neighbouring village also be included in containment zone. l The Block Medical Officer, Block Development Officer, Block Health Supervisor after a rapid appraisal of the case and geographical situation in consultation with the DDHS can decide the number of villages to be brought under containment zone. 1.2. Urban Area(Corporation/Municipality) l The street containing the residence of the positive case is demarcated as the containment zone. l If the street is very long a reasonable stretch to be brought under containment to restrict movement. l If the residence happens to be the corner of the street, then the adjoining street also be included in containment zone. l Quick aerial view from the roof top a nearby high rise building and rapid appraisal of the movement of the positive case and local people, City Health Officer and Commissioner. 1.3.Urban Area (Town Panchayath) l The street containing the residence of the positive case is demarcated as the containment zone. l If the residence happens to be the corner of the street, then the adjoining street also be included in containment zone. l The Block Medical Officer, Executive Officer of the Town Panchayath and Block Health Supervisor after a rapid appraisal of the case and geographical situation in consultation with the DDHS can decide the area to be brought under containment zone. 4 TAMIL NADU GOVERNMENT GAZETTE EXtraordinary 2.Cluster of Cases: If there are five and more positive cases in a locality then it will be considered as clusters. 2.1.Village Panchayat l If a number of cluster falls in a village or group of villages then group of such villages can be brought under containment. l The Block Medical Officer, Block Development Officer, Block Health Supervisor after a rapid appraisal of the cases and geographical situation in consultation with the DDHS can decide the number of Village Panchayats to be brought under containment zone. l In a block with larger geographical area, sparse population and distance between the case village / hamlet / habitation and other surrounding village / hamlet / habitation is more than two kms and there is no movement between the affected villages, containment areas can be restricted to a group of affected villages. l In case of thickly populated blocks with smaller geographical area like the suburban blocks the whole block may be brought under containment. l If the cluster happens to be at the border area of a block, then the adjoining block also be included in the containment zone. 2.2.Urban Areas (Corporation/Municipality/Town panchayat) 2.2.1.Corporation: l If the cluster falls within the Ward, then the Ward in which the residences of the positive cases are located should be demarcated as the containment zone.