GUIDELINES ON COVID-19 PREPAREDNESS AND CONTROL IN (CPCR)

District Administration, Ranchi

March 20, 2020

CONTENTS INTRODUCTION 1 OVERARCHING PRINCIPLES 2-3 CPCR MACHINERY 4-16 2.1 Control Team 5 2.2 Single-Window Helpline Team 6-7 2.3 Public Awareness and Media Management Team 8-9 2.4 Perimeter Surveillance Team 10 2.5 Material and Facility Management Team 11 2.6 Healthcare Training and Surveillance Team 12-14 2.7 Human Resources, Troubleshooting and Quarantine Planning Team 15 2.8 District Level Control Room 16 PERIMETER MEASURES 17 3.1 Airport 17 3.2 Railway Stations 17 3.3 Road Transport 17 MEASURES FOR PUBLIC PLACES/ COMMUNITY 18-19 4.1 Workplaces 18 4.2 Taxi and auto associations, vehicle showrooms 18 4.3 Resident Welfare Associations 18 4.4 Civil society/ religions associations 18 Gyms, swimming pools, clubs, malls, sports/ education coaching/ training 4.5 18 centres, private educational institutions 4.6 Restaurants and hotels 19 4.7 Shops 19 4.8 Parks, tourist places, etc. 19 4.9 Ranchi Municipal Corporation 19 4.10 Delivery personnel, drivers, workers 19 4.11 Banks 19 4.12 Salons/ road-side hair-cutting places 19 MEASURES FOR PUBLIC PLACES (GOVERNMENT FACILITIES) 20 5.1 Government offices/ buildings 20 5.2 Government schools/ colleges/ universities 20 5.3 Shelter homes/ orphanages/ remand/ observation homes 20 5.4 Flu corners 20 5.5 Anganwadi Centres 20 OTHER PREVENTIVE MEASURES 21 TESTING AND SCREENING FACILITIES 22 ISOLATION AND TREATMENT FACILITIES 23 REGULATIONS FOR PRIVATE HOSPITALS/ LABORATORIES 24 SPECIAL MEASURES FOR VULNERABLE GROUPS 25 APPENDIX 26

INTRODUCTION

In light of the declaration of COVID-19 as a pandemic by WHO, its notification as a ‘disaster’ under the Disaster Management Act, 2005, and the notification of the State Epidemic Disease (COVID-19) Regulations, 2020 (in exercise of powers of the Jharkhand state government under Epidemic Diseases Act, 1897) (APPENDIX-1) ; the District Administration, Ranchi (“Administration”) has developed these guidelines with the objective of ensuring all possible measures for meaningful control of this epidemic in the district.

As of March 20, 2020, there has been no reported case of COVID-19 in Jharkhand. However, in order to prepare for a possible outbreak in the district of Ranchi, there is a crucial need to generate societal awareness through verified sources, develop accessible facilities for sample testing, train healthcare and other personnel, prepare accessible isolation and treatment facilities, and create a support structure which incentivises people from all sections of the society to report symptoms and follow prescribed procedure – and thus effectively control COVID-19 in Ranchi.

In this context, this document:

(i) seeks to explain the machinery being developed specifically to address this epidemic. (ii) describes the rights, roles, and responsibilities of government and private bodies/ entities, individuals, and associations in . (iii) includes references to the advisories/ orders/ guidelines from international, central government, and state government levels which form the basis of the preparedness/ mitigation measures. (iv) explains the overarching principles guiding the district machinery and its orders/ actions.

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OVERARCHING PRINCIPLES It is important to remember a few overarching principles guiding the CPCR machinery. These principles pertain to all components of this document. 1.1 The CPCR Guidelines are not static; and are intended to be read in line with latest updates from the World Health Organisation (WHO); Ministry of Health and Family Welfare, Government of India (MoHFW); Indian Council of Medical Research (ICMR); National Centre for Disease Control (NCDC); the Jharkhand State Government; and other international, national, and state-level bodies authorised to disseminate information/ issue orders. Owing to the nature of the epidemic and the speediness of action required to address the same, daily updates - as notified by the Administration/ CPCR machinery - shall be deemed to add to or amend the relevant parts of these guidelines.

1.2 The Administration seeks to address panic, fear, and curiosity of the people of Ranchi in relation to the Covid-19 epidemic. The guidelines and actions prescribed are intended to increase transparency, inclusion, information exchange, societal awareness, and healthcare support in Ranchi. Therefore, the Administration aims to simultaneously curb any misinformation that causes or is likely to cause fear mongering and ill-informed panic in the district.

1.3 No person should, irrespective of caste, religion, race, financial ability, bodily ability, age, sex, gender identity, educational qualifications, tribe, profession/ work, etc. :

1.3.1 face hostility, ridicule, or discrimination before government or private bodies; especially on the basis of misinformed/ prejudiced assumptions of hygiene, contagiousness, moral standing, social status, etc. 1.3.2 be denied healthcare support or treatment, except in compliance with WHO/ ICMR/ MoHFW/ NCDC guidelines or specific district order(s) made in good faith.

However, special or prior treatment/ facilities may be provided to those who fall within categories deemed to be vulnerable to the COVID-19 infection and its effects (including senior citizens; persons with HIV-AIDS, Tuberculosis, Diabetes, auto-immune diseases, cancer, and other immune-suppressive conditions; persons with cardiovascular disease or lung disease; persons undergoing treatment which includes immunosuppressant medication; pregnant women; etc.).

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1.4 In case a person declares experiencing or is found to display symptoms of COVID-19, they should be made to feel welcome to approach relevant authorities for prompt testing and further information/ treatment. While precautionary and protective measures should be adopted in line with relevant advisories, such persons should, at all times and by all persons, be treated with respect and consideration. If such person is found to be non-compliant with instructions from the CPCR machinery even after adequate counselling and warning, the Administration may exercise appropriate powers under the Indian Penal Code, 1860 (Section 188 - Disobedience to an order lawfully promulgated by a public servant) or any other appropriate legal provision, in a fair and proportionate manner.

1.5 Unless specifically mentioned in this document or future orders issued in good faith by the Administration, no essential or non-essential government service/ facility provided by/ via the District Administration shall be stalled. COVID-19 preparedness and control measures shall take place in addition to the provision of such services/ facilities; and the Administration shall exercise its powers under various applicable rules and directions to recruit additional human resources and build additional capacity in its machinery, as and when required. This includes expedited measures for creating and operationalising procurement for PPE/ scanning, appointment/ deputation for training, specimen collection, screening, isolation/ quarantine wards, and treatment/ symptom management.

1.6 With the passage of time and changes in the nature and effect of the epidemic, the CPCR machinery shall continue functioning in line with directions/ guidelines from WHO, MoHFW, ICMR, NCDC, and central/ state government. Such functioning should continue in compliance with the guidelines irrespective of the socio-economic status of persons primarily affected by COVID-19 at any given stage of the epidemic. However, modifications may be made to the machinery and the range/ extent of measures adopted, depending on the severity of the situation.

Owing to the nature of the epidemic, addressing it meaningfully is dependent on collaboration and cooperation between the government (with inter-departmental convergence), private entities, and the civil society. Therefore, the Administration seeks support from all relevant departments, entities, and persons to successfully control and mitigate the effects of COVID-19 in Ranchi.

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CPCR MACHINERY

This section describes the CPCR machinery in Ranchi District, and a brief explanation of the background and functions. The SoP for district control room has been relied upon to develop this

structure. At the district level, the CPCR machinery shall consist of the following teams and organs:

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2.1 CONTROL TEAM

The Control Team shall be the apex body in the CPCR machinery. All other teams shall send their reports to this team, for smooth and coordinated functioning.

2.21 Composition-  Deputy Commissioner-cum- Chairperson, District Disaster Management Authority, Ranchi (Head)  Senior Superintendent of Police, Ranchi  Deputy Development Commissioner-cum- CEO, Zila Parishad, Ranchi  Sub-Divisional Officer (SDO), Ranchi  SDO, Bundu  Civil Surgeon-cum-Chief Medical Officer, Ranchi  District IDSP Officer, Ranchi  Dr Deepawali (MO, NHM) and Ms Annapurna Devi (Regional Consultant, UNICEF), State Monitoring Officials for COVID-19 (Ranchi)  Dr Manoj Kumar, Rajendra Institute of Medical Sciences (RIMS), Ranchi; PI, State Nodal VRDL for Jharkhand 2.22 Functions-  The control team shall be the ultimate decision-making authority at the district level.  The members shall formulate the overall district plans and issue orders, in consultation with relevant stakeholders.  The members shall meet at least once in every three calendar days (and more frequently as required) to review reports from all other teams, discuss and modify plans of action, proceed against any non-compliant department, entity, or person. The frequency may be modified later in consonance with the severity of the epidemic at the relevant time.  The control team/ any other person or entity authorised by the control team shall issue signed letter to person requiring quarantine or isolation/ treatment.

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2.2 SINGLE-WINDOW HELPLINE TEAM 2.21 Nodal Officer – District Informatics Officer, Ranchi 2.22 Functions-

A single 24*7 helpline shall be set up for all residents of Ranchi district. The personnel involved will be working out of the District-Level Control Room

The call centre is to be set up with 3 laptop, 3 mobile/ landline telephone facility. Each Call Centre Operator is to be assigned both a telephone and a computer. One outgoing mobile facility also available for answering pending calls. Two WhatsApp numbers also be made available in control management room. Depending on the configuration of the call centre, each workstation should have the following items:

 Headset for hands-free answering;  Reference materials (including all standard MoHFW guidelines);  Item to be used to request assistance from the supervisor (Paper and pen/pencil, register etc)  All phone/computer banks are set up in close proximity to power, telephone, and data sockets/ports.

Mandates for Call Centre:

 Call centre will be operational 24*7  Documentation of all the activities happening in call centre  Daily consolidation report at 4.30 pm.  Establishing call centre with sufficient connectivity  To answer medical queries, logistics and administrative issues regarding health and health related problem  Daily maintenance of second and third level call referral.

The helpline shall be a single point contact for the following:

 Direct connection to district-level RIMS helpline  Information regarding current COVID-19 status/ figures in India, Jharkhand, and Ranchi

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 Information on preventive measures  Information regarding nearest laboratory testing facilities and prescribed procedure  Complaint regarding fake news/ rumours (call information to be forwarded to Media Management Cell)  Complaint regarding non-compliance with district orders or overarching principles mentioned in 1.1-1.7 in this document (call information to be forwarded to Human Resources, Troubleshooting, and Quarantine Management Team). Such complaints may concern black market for masks/ sanitisers (notified as essential commodity).  Mental health support – Direct connection to RINPAS helpline 2.23 Nodal officer - District Informatics Officer, Ranchi 2.24 Sub-teams –  Call Centre Management Team  Reporting and Documentation Team (for sending daily reports on call information to the Control Team and immediate reports within 30 mins to the teams mentioned above)

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2.3 PUBLIC AWARENESS AND MEDIA MANAGEMENT TEAM 2.31 Nodal officer - District Public Relations Officer, Ranchi 2.32 Description-

Generating societal awareness and social responsibility is the prime necessity for meaningful epidemic control. This team shall be responsible for sensitising and generating awareness among the public at large, and training professionals and frontline workers for COVID-19 preparedness, standard operating procedure, and treatment.

2.33 Sub-teams –  Public Awareness Team (DPM, NHM, Ranchi shall be one of the members) o The team shall create posters, banners, audio (IVRS, radio), video (including those from officers), SMS content on the basis of advisories and IEC/ BCC material authorised by the MoHFW or District Administration, Ranchi.

List of reference documents-

 Advisory on Social Distancing Measures  Guidelines on use of masks by public  Guidelines on home quarantine  Guidelines for Workplace  a, b – Reference IEC material  Guidelines for home-based care

Special focus shall be on:  social distancing  handwashing techniques  quarantine and home-based care  importance of working from home  importance of avoiding mass gatherings - especially on public festivals like Sarhul (27th March), Ram Navami (2nd April), Mahavir Jayanti (6th April), Good Friday (10th April), Ambedkar Jayanti(14th April)  use of masks/ sanitisers  need to isolate and take special care of vulnerable persons (including senior citizens; persons with HIV-AIDS, Tuberculosis, Diabetes, auto-immune diseases, cancer, and other immune-suppressive conditions; persons with cardiovascular disease or lung disease; persons undergoing treatment which includes immunosuppressant medication; pregnant women; etc.).  need to give paid leave to informal workers/ support staff

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 nearest testing centres and hospital facilities  other orders issued by the District Administration o Jingles/ catchy awareness campaigns on unhygienic habits observed locally - dangers of spitting in public places, indiscriminate dumping of used masks/ tissues. o Timed campaigns (e.g. timely reminders to wash hands), through public announcement systems including those used by religious places. o Major locations: Population-dense locations such as arterial roads & chowks (Main Road, Firayalal Chowk, Shahid Chowk, Sujata Chowk, Karamtoli Chowk, Kutchery Chowk; Bijupara Chowk, etc.); major markets in city area (Big Bazaar, Reliance, etc.); major malls and shopping complexes (Nucleus, JD Hi Street, Hari Om Tower, Panchvati Plaza, etc.); weekly/ daily/ open markets in urban and non-urban areas; banks; near places of worship; hospital OPDs, etc. o Advisories should be made in regional and tribal languages apart from and English o LED vans and screens should be used in prominent locations to display awareness content o Collaborations may be made with campus ambassadors, university students, etc. to spread the information, especially via different forms of social media. o No awareness creation mechanism should involve mass gatherings. o Awareness campaign should emphasise on social and healthcare support from the district, instead of spreading panic, fear, or hostility towards any person – especially suspect cases. o The content should be regularly updated on the basis of latest information from WHO.  Media Management Team (Headed by DPRO) o Collection of information regarding COVID-19, demand and supply of logistics, human resources etc. circulated in the media, validating the information collected from the media o All complaints from helpline regarding fake news and rumour mongering to be verified, and clarified on Administration’s press release/ social media 2.34 Daily reports should be sent from both sub-teams to the Control Team by 5 PM IST.

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2.4 PERIMETER SURVEILLANCE TEAM 2.41 Nodal officers – SDO, Ranchi and SDO, Bundu 2.42 Description- This team shall collect daily reports from the following:  , Ranchi – on the basis of self-declaration reports  Ranchi Railway station and Railway Station – on the basis of self-declaration at help desk  Buses at land transport checkpoints (at Hulhundu, , Nagri Flyover, Mesra, and Ratu) (The frequency of reports from land transport checkposts shall be varied on the basis of severity of the epidemic in Ranchi)  Any other checkpost created at the border or in the interior of Ranchi District  Teams may be constituted in similar lines as FST/ SST during elections, as and when required.

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2.5 MATERIAL AND FACILITY MANAGEMENT 2.51 Nodal Officers – NDC, Ranchi; Civil Surgeon, Ranchi; and District Engineer, Ranchi 2.52 Functions:  Procurement of thermal scanners, masks, sanitisers, medicated liquid soap for use at airport, railway stations, entry to government buildings, etc.  Procurement of PPE and medicated soaps/ sanitisers for healthcare/ frontline/ field/ paramedical/ sanitation/ security workers  Procurement of advanced life support ambulances as necessary  Procurement and civil works, as required, for isolation wards in Sadar Hospital, Bundu Subdivision Hospital, RIMS, and other identified locations (including ventilators, life support equipment, etc.)  Procurement for setting up of testing centres in Sadar Hospital/ Bundu Subdivision Hospital 2.53 Reports to be sent once in 3 days to Control Team List of reference documents-  Updated case definitions and contact categorisation  Guidelines on Clinical Management of COVID-19  Guidelines on setting up Isolation Wards  Checklist of items for preparedness of District Hospital Labs for Sample Collection from Suspected New Coronavirus Outbreak Cases  Specimen Collection, Packaging and Transport Guidelines  Advisory for Hospitals/ Clinics for management of suspect case  Guidelines for Screening Centres  Detailed Guidelines for Infection Prevention Control for Suspected Cases  Guidelines on Clinical Management of SARI in suspect/ confirmed cases  Guidelines on Ambulance Transfer  Personal Protective Equipment (PPE) - Medical device specifications (gown, shoe cover, face mask, gloves, disposable protective eye gear, body bag)  Biomedical Waste Management Guidelines for COVID-19 ward/ OPD  Discharge Policy  Patient proforma- a, b  Guidelines for disinfection of quarantine facilities  Guidelines on Dead Body Management

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2.6 HEALTHCARE TRAINING AND SURVEILLANCE TEAM 2.1 Nodal Officer- DRCHO, Ranchi 2.2 Sub-Teams (heads of sub-teams to be decided by nodal officer) –  Healthcare Training Team  Hospital Surveillance Team  Field Surveillance Team  Laboratory Surveillance Team  Sample Tracing Team  Private Hospital Surveillance Team  Transportation and Ambulance Management Team

Healthcare Training Team –

 No training should take place in mass gatherings with less than 3 feet distance between persons in the training area

 Training of doctors (especially those deputed to COVID-19 screening, isolation wards, and treatment centres), nurses, laboratory technicians, ambulance personnel on latest SoP (usage of personal protective equipment, testing, specimen collection and transport, ambulance use, biomedical waste management, isolation and quarantine, dead body management, etc.)

 Training of frontline workers on identification and reporting of suspected cases (symptoms, timelines, vulnerable groups – elderly, pregnant women, etc.)

 Focused training on healthcare personnel working with patients with tuberculosis, HIV- AIDS, cancer, sickle cell anaemia, and other immunosuppressive conditions – identification and reporting of symptomatic persons.

 Training should focus on ways to make people, especially suspect cases, feel comfortable and supported by the district machinery, In case a person declares experiencing or is found to display symptoms of COVID-19, they should be made to feel welcome to approach relevant authorities for prompt testing and further information/ treatment. While precautionary and protective measures should be adopted in line with relevant advisories, such persons should, at all times and by all persons, be treated with respect and consideration. If such person is found to be non-compliant with instructions from the CPCR machinery even after adequate counselling and warning, the Administration may exercise appropriate powers under the

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Indian Penal Code, 1860 (Section 188 - Disobedience to an order lawfully promulgated by a public servant) or any other appropriate legal provision, in a fair and proportionate manner.

 All workers to be provided with PPE as per mandated technical specifications, and trained on proper usage/ techniques

List of reference documents-

 Updated case definitions and contact categorisation  Guidelines on Clinical Management of COVID-19  Guidelines on setting up Isolation Wards  Checklist of items for preparedness of District Hospital Labs for Sample Collection from Suspected New Coronavirus Outbreak Cases  Specimen Collection, Packaging and Transport Guidelines  Advisory for Hospitals/ Clinics for management of suspect case  Guidelines for Screening Centres  Detailed Guidelines for Infection Prevention Control for Suspected Cases  Guidelines on Clinical Management of SARI in suspect/ confirmed cases  Guidelines on Ambulance Transfer  Personal Protective Equipment (PPE) - Medical device specifications (gown, shoe cover, face mask, gloves, disposable protective eye gear, body bag)  Biomedical Waste Management Guidelines for COVID-19 ward/ OPD  Discharge Policy  Patient proforma- a, b  Guidelines for disinfection of quarantine facilities  Guidelines on Dead Body Management

Members-  DSWO, Ranchi  CDPOs  DPM, NHM, Ranchi  DPC, NHM, Ranchi  DQAC, NHM Ranchi  Other members as necessary

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Hospital Surveillance Team-  The condition of the Symptomatic patients admitted at isolation wards of hospitals will be closely scrutinized and reports will be updated to surveillance team  Analysis of the reports

Field surveillance Team -  Those patients discharged from hospitals will be monitored by field workers in their corresponding PHC area.  Those asymptomatic travellers/contacts in home isolation will also be monitored for 14 days by field workers and reports will be sent to the sub-team head.

Lab Surveillance Team-  The nodal officers entrusted for sample collection will inform to the lab surveillance team before sample collection  Sample requisition forms will be scrutinized before sending to National Institute of Virology Pune/VDRL lab network.  Liaison with districts and sample collection point

Sample Tracing Team-  The team should keep a watch on sample sent to each lab from all districts and answer all queries regarding the sending of samples in coordination with the PH lab.  The team should hand hold the district in transportation of samples, filling formats, collecting reports and intimate the authorities regarding the status of results  Monitor sample collection and facilitate  All sample test results to be reported to the nodal officer for Healthcare Training and Surveillance Team on a daily basis

Private Hospital Surveillance Team- Team should compile the data regarding the general public visiting private and suspect and identify any missed out contacts of contacts reaching the facilities.

Transportation and ambulance management team-

The teams should compile the data regarding the availability spacing, training of drivers of ambulances and vehicles carrying patients from home isolation to the hospital isolation facilities and back it should be ensured that there should be continuous availability of vehicles 24 x 7 in the district.

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2.7 HUMAN RESOURCES, TROUBLESHOOTING AND QUARANTINE PLANNING TEAM

2.71 Nodal Officer- Deputy Development Commissioner, Ranchi 2.72 Functions-  Manage deputation and recruitment for CPCR machinery  Investigate and address complaints coming through helpline  Communicate with training and awareness cell for timely training of newly recruited/ deputed personnel  Receive reports from single-window helpline team, Healthcare Training and Surveillance Team, block/ CHC-level helplines, or any other source, regarding high-risk persons who need to be quarantined.  Weekly meetings to be held at block level and reported to district level (coordination with block development officers and circle officers)  Control room to be set up with calling and internet facilities to track high-risk person/ quarantine data from across the district.  The nodal officer/ any other person authorised by the nodal officer shall issue signed letter to person requiring quarantine or isolation/ treatment.

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2.8 DISTRICT LEVEL CONTROL ROOM-  Shall be set up under the control of DIO, Ranchi  Shall consist of – o Persons working in the single-window helpline team o Persons deputed for collecting and monitoring data from panchayat/ block/ ward/ RMC level regarding high-risk, suspected, or confirmed cases of COVID-19 for quarantine/ isolation o Persons deputed for collecting and monitoring data from perimeter surveillance team/ healthcare training and surveillance teams  Should be set up in a space that allows at least 3 feet interpersonal distance  All furniture, machines, and equipment to be sanitised daily  Handwashing facilities and instructions to be provided at entry/ exit gates  Thermal scanning facilities must be present at the entrance.

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PERIMETER MEASURES To be monitored by Perimeter Surveillance Team

3.1 Airport:

 In-flight announcements  Distribution and collection of self-declaration forms 30 minutes before arrival  Thermal scanning and testing of passengers by paramedical staff  Reporting format to be followed, but apart from the countries mentioned in the enclosure, travel in the last 14 days to countries and Indian states where COVID-19 positive cases have been identified (as per daily situational report from WHO), should also be recorded.  If found to have travelled to places with positive COVID-19 cases and to be having symptoms of COVID-19, passenger should be separated and directed to the Airport Health Officer.  Sanitisation of seats, window panes, overhead luggage compartments, trays, vents, vents, etc. after every flight  Banners and hoardings in the waiting area and arrival area  Separate passenger queues for the elderly and pregnant women.

List of reference documents-  Guidance Document for COVID-19 Surveillance  Sample in-flight announcement  Guidelines for sequence of activities at airport arrival gates  Self-reporting form  Airport reporting format  Alert for all travellers/ crew members

3.2 Railway stations:

 Banners, hoardings, regular announcements  Availability of medicated liquid soap and water at all washbasins in the station  Thermal scanning at exit points  Help Desk set up for self-declaration

3.3 Road Transport:

 Checkpoints – thermal scanning, assistance for self-declaration  Sanitisation of bus seats, windows, and vents after arrival at Khadgada and Ratu bus stands

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MEASURES FOR PUBLIC PLACES/ COMMUNITY To be monitored by SDO, Ranchi and SDO, Bundu/ RMC/ District Transport Officer/ LDM 4.1 Workplaces-  Employers, especially for workplaces with multiple persons using the same space, should enforce work from home policies for any work for which physical presence or travel is unnecessary.  For work necessitating physical presence or travel, strict sanitisation, handwashing, and symptom-screening measures should be adopted. The physical layout of the workplace should be such that a 3 foot distance can be maintained between persons sharing space.

4.2 Taxi and auto associations, vehicle showrooms-  Daily sanitisation of vehicles  Sanitisation of test-drive vehicles after every drive  Awareness creation among all drivers

4.3 Resident Welfare Associations-

 Posters and awareness creation within complex  Regular sanitisation of elevators, staircases, etc.

4.4 Relevant civil society associations/ religious associations-

 Section 144, CrPC to be imposed in the district in the places and to the extent mentioned in specific orders.  Refrain from celebrations/ meetings that entail mass meetings or gatherings (Public holidays – Sarhul (27th March), Ram Navami (2nd April), Mahavir Jayanti (6th April), Good Friday (10th April), Ambedkar Jayanti (14th April).  Refrain from mass protests in exercise of right to peaceful assembly/ right to freedom of speech and expression (Haj House, educational institutions, etc.) until 16th April, 2020.  Refrain from social gatherings/ weddings/ meetings/ workshops with 50 or more people and where 3-foot interpersonal distance cannot be maintained.

4.5 Gyms, swimming pools, clubs, malls, sports/ educational coaching/ tuition centres, all educational institutions (private schools/ colleges/ universities), etc.:

 To remain closed until 16th April, 2020, until further notice

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4.6 Restaurants and hotels  No in-dining/ seating of 50 people or more  Sanitisation of utensils, furniture, kitchen equipment  Training to all staff to follow proper handwashing and hygiene techniques  Proper waste management  Posters/ banners and facilities for handwashing  Self-declaration forms in hotels (form)

4.7 Shops:

 All shops, except those selling essential commodities, medicines, and groceries, shall remain shut till 16th April, 2020, until further notice

4.8 Parks, tourist places, etc.

 Gated/ ticketed public places and tourist places like gated parks, museums, etc. shall remain closed till 16th April, 2020, until further notice. 4.9 Ranchi Municipal Corporation (RMC) -  Daily sanitisation of bus stops, toilets, roadside public utilities, etc.

4.10 Delivery personnel (food delivery, courier delivery, milk and newspaper delivery, etc.), shop workers, taxi/ public transport drivers, workers in religious places, etc.-  Should be provided with masks, sanitisers, handwashing facilities, and appropriate PPE (along with training and usage policies)  No-touch delivery policies to be enforced as far as possible

4.11 Banks –  Separate queues for the elderly and pregnant women  Posters and banners for awareness  Help-desk with option for self-declaring symptoms (to be informed to helpline)

4.12 Salons/ road side hair-cutting places- shall enforce strict sanitisation policies for furniture, tools, and other equipment. PPE should be provided to the workers.

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MEASURES FOR PUBLIC PLACES (Government facilities) To be monitored by relevant departmental officers at the district level 5.1 Government buildings/offices (Collectorate, Vikas Bhawan, Project Bhawan, Secretariat, courts etc.)  Awareness posters/ banners  Thermal scanners and sanitisers at point of entry  Reporting of suspect/ self-declared cases to call centre  Each room to have restricted number of people inside at a given time; token/ card system may be used.  Biometric attendance has been stalled as per order. (order). Biometric mechanisms to be stalled in PDS shops.  Mass gatherings for meetings/ workshops/ trainings to be stalled until further notice. 5.2 Government schools/ colleges/ universities  To remain closed as per state orders  Money allocated to each child enrolled in a government school for mid-day meal to be transferred to the child’s account at the beginning of each week 5.3 Residential shelter homes, orphanages, remand/ observation homes, etc. shall continue functioning but contact with outsiders shall be minimised. Any visitor/ staff should be made to follow a strict handwashing policy at the time of entry and exit, and made to maintain a 3 foot distance with the residents at all times. 5.4 Flu corners to be set up as per state orders, and other measures to be adopted as per directions. 5.5 Anganwadi Centres  To remain closed until 16th April, 2020  Money allocated to each child for mid-day meal to be transferred to the child’s guardian’s account at the beginning of each week/ MDM to be distributed house-to-house by sevikas with proper PPE and sanitation facilities.  AWC to open only on designated VHSND (Village Health, Sanitation, and Nutrition Day) for routine immunisation and antenatal care. Handwashing facility with medicated liquid soap to be made available for mandatory handwashing before entering during VHSND.  Awareness generation on COVID-19 to be ensured on each VHSND. List of reference documents-  Office memorandum on preventive measures  Office memorandum on mass gatherings

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OTHER PREVENTIVE MEASURES To be monitored by relevant departmental officers at the district level/ RMC

6.1 Masks and sanitisers to be made available at subsidised rates in Sadar Hospital (powers under DMA 2005, Essential Commodities Act, 1955) (Reference documents-order on power to procure masks, sanitisers in exercise of DMA 2005, and notification of masks and sanitisers as essential commodities;norms of assistance from the State Disaster Response Fund, https://www.mohfw.gov.in/pdf/disastermanagmentact.pdf) 6.2 Complaints regarding black market of hygiene supplies to be forwarded from single-window call centre 6.3 Handwashing facilities (water and medicated liquid soap) in all public toilets and government buildings on each floor along with instructions on handwashing on the wall. 6.4 Handwashing facilities (water and medicated liquid soap) in all old age homes, prisons, orphanages, remand/ observation homes, shelters; IEC material on handwashing on the wall. All directions from the state government, etc. shall be strictly adhered to. 6.5 Places housing residents in gated/ restricted facilities, like old age homes, prisons, observation homes, etc. should have strict policies for visitors, staff members, and any outsider. Apart from stringent handwashing policies at the time of entry and exit, they should maintain appropriate distance at all times with residents. Appropriate distancing/ sanitising policies shall be maintained for any items (ration, material, etc.) entering the premises. 6.6 In slum areas or other densely populated areas in the district, the Administration shall endeavour to start mass kitchens with home delivery mechanisms to surrounding households. ADM (SOR), RMC, and other departments shall collaboratively operationalise this mechanism. Existing dal bhaat kendras/ SHG canteens may be used for this purpose. In no circumstance should the workers involved be working without appropriate protective gear or sanitation facilities. Delivery of nutrition-dense food packets or cooked meals should be supplied to old age homes, in case of food shortage or lack of in-house cooking facilities. 6.7 All sanitation workers (working under RMC, in all government offices), security personnel, and all persons engaged in the CPCR machinery (especially those who have to interact with the community for fulfilling their responsibilities) shall be provided with facilities and training regarding PPE, handwashing, and sanitisation of equipment/ utensils/ items of use, etc.

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TESTING AND SCREENING FACILITIES To be monitored by Civil Surgeon and DRCHO, Ranchi

7.1 Currently, only MGM Medical College is the only functioning ICMR-approved laboratory for testing samples; whereas the RIMS laboratory is to be developed soon for the same. In light of this inadequacy, request for the following shall be sent simultaneously to the appropriate higher authority by the Civil Surgeon Office for –  Procurement of laboratory equipment  Authorisation as testing/ screening facilities (Bundu Subdivision Hospital, new building) 7.2 Apart from this, the following should be procured as per direction and approved technical specifications in sufficient quantity at appropriate health facilities:  All hospital equipment as per checklist  Ventilator/ respiratory support system  Equipment for sample collection and transport  Mobility support for specimen  Advanced life support ambulances for patients  PPE for healthcare workers and frontline workers  Thermal scanners, sanitisers, masks  Supplies required for biomedical waste management 7.3 Recruitment of medical and paramedical staff including lab technicians, counsellors, etc. shall be done immediately. The Administration may exercise its power to depute personnel from private health facilities, or utilise private health facilities, for this purpose, in accordance with central/ state government directions. A holistic procurement and recruitment plan should be submitted by the Material and Facility Management Team to the Control Team on or before March 21, 2020.

List of reference documents-  Strategy of COVID19 testing in India  Note on Laboratory preparedness in India  Guidance Document for State Nodal & Testing VDRLs  Contact person at RIMS, Ranchi  List of State Nodal VDRLs  Guidelines from MD, NHM, Jharkhand for testing facilities, status of VTM kits (APPENDIX – 2)  Guidelines from MD, NHM, Jharkhand for procurement for testing facilities(APPENDIX – 3)

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ISOLATION AND TREATMENT FACILITIES To be monitored by Civil Surgeon and DRCHO, Ranchi

8.1 Development of one floor of new building of Sadar Hospital as isolation ward 8.2 Development of appropriate space in Bundu Subdivision Hospital as isolation ward 8.3 Procurement of appropriate beds, protective material, ventilators for the wards 8.4 Acquisition of Khelgaon hostel for development of isolation ward (by virtue of power under DMA, 2005) 8.5 Recruitment/ Deputation and training of healthcare personnel specifically for this purpose, as required. 8.6 Procurement of advanced life support ambulance(s) 8.7 The Administration may exercise its power to depute personnel from private health facilities, or utilise private health facilities, for this purpose, in accordance with central/ state government directions. 8.8 A holistic procurement and recruitment plan should be submitted by the Material and Facility Management Team to the Control Team on or before March 21, 2020.

List of reference documents  Guidelines for Quarantine Facilities  Guidelines on setting up Isolation Wards  District-wise list of Monitoring Officials for COVID-19 in Jharkhand, and checklists for isolation ward and quarantine ward(APPENDIX – 4)

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REGULATIONS FOR PRIVATE HOSPITALS/ LABORATORIES To be monitored by Civil Surgeon and DRCHO, Ranchi

9.1 Compliance with reporting guidelines(Guidelines for private hospitals, Reporting format for private laboratories to be followed stringently) 9.2 If any person with immunosuppressive condition identified with COVID-19 symptoms or admitted for breathing support, immediate reporting (within 60 mins) to civil surgeon office apart from daily report. 9.3 Guidelines for notifying COVID-19 affected persons by Private Institutions-

In the wake of the prevailing COVID-19 situation and in order to strengthen the containment measures, it is of utmost importance that each and every case (suspects/confirmed) of COVID-19 is isolated and provided appropriate treatment and their contacts are traced at the earliest to break the chain of transmission. It is important that support and cooperation of private sector is enlisted, in this regard.

Therefore, it shall be mandatory for all hospitals (Government and Private), Medical officers in Government health institutions and registered Private Medical Practitioners including AYUSH Practitioners, to notify such person(s) with COVID-19 affected person to concerned district surveillance unit.

All practitioners shall also get the self-declaration forms, who, within their knowledge, are having travel history of COVID-19 affected countries/ states as per the extant guidelines and are falling under the case definition of COVID-19 (Suspect/ Confirmed Case).

In case the person has any such history in the last 14 days and is symptomatic as per case definition of COVID-19, the person must be isolated in the hospital and will be tested for COVID-19 as per protocol. Information of all such cases should be given to the State helpline number (104) and also to national helpline 1075. Email may also be sent at [email protected].

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SPECIAL MEASURES FOR VULNERABLE GROUPS To be monitored by relevant departmental officers at the district level

10.1 Frontline workers, workers in UPHCs/ Atal clinics, HSCs, and PHCs to be specially trained (in small groups) to identify vulnerable persons with COVID-19 symptoms and inform helpline. 10.2 Awareness sessions for all sanitation workers (in ward/ panchayat offices), mine workers (in their workplace), factory workers (in their workplace), daily wage earners (at nodal points of daily travel). Handwashing/ bathing facilities, masks, sanitisers to be provided (in addition to existing labour law and human rights mandates) 10.3 Persons admitted in ICU/ CCU in govt./ private health institution to receive special focus. 10.4 Any person who is elderly, pregnant, or has/ had TB/ HIV-AIDS/ any immunosuppressive condition; and is symptomatic of COVID-19; should be tested on priority. 10.5 Old age homes to be focused on for awareness regarding symptoms and reporting via helpline. 10.6 Healthcare professionals and frontline workers, who are symptomatic of COVID-19, especially those who have come in contact with suspected/ confirmed cases of COVID-19, shall self-report for further procedure. 10.7 Any person who has been advised to go on quarantine or isolation shall be given a signed letter from the assigned health facilities/ committees (Control Team/ Human Resources, Troubleshooting and Quarantine Planning Team/ person or entity authorised by either team). On the basis of such letter, their absence from work shall be considered to be paid leave. This applies to wage-earning, salaried, and fee-earning employment. The Superintendent of Labour along with the DMO, ADSS, Industries Department, should ensure compliance and awareness (to both employers and employees).

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APPENDIX

 Jharkhand State Epidemic Disease (COVID-19) Regulations, 2020 (in exercise of powers of the Jharkhand state government under Epidemic Diseases Act, 1897) (APPENDIX-1)  Guidelines from MD, NHM, Jharkhand for testing facilities, status of VTM kits as on 17.03.2020(APPENDIX – 2)  Guidelines from MD, NHM, Jharkhand for procurement for testing facilities (APPENDIX –3)  District-wise list of Monitoring Officials for COVID-19 in Jharkhand, and checklists for isolation ward and quarantine ward (APPENDIX – 4)

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