Government of Himachal Pradesh

OFFICE OF THE DISTRICT MAGISTRATE-CUM-CHAIRMAN DISTRICT DISASTER MANAGEMENT AUTHORITY (DDMA) CHAMBA (H.P.)

No. CBA-Relief-3(36)-2020 28th November, 2020

ORDER

Whereas, the Chief Secretary-cum-Chairman, State Executive Committee (SEC), Himachal Pradesh has issued Orders vide No. Rev(DMC) (C) 20-2/2020- COVID 19 dated 28.11.2020 (Annexure – A) for extension of lockdown in Containment Zones and directions and guidelines for Surveillance, Containment and Caution of COVID-19 in areas outside Containment Zones which will remain in force till 15.12.2020 or further orders, whichever is earlier;

And whereas there has been an increase in the number of Covid-19 positive cases in the district which necessitates extension of lock down in Containment Zones and taking immediate measures to effectively prevent any further surge and take measures for Surveillance, Containment and Caution of COVID-19 in areas outside Containment Zones;

Now, therefore, I, D C Rana, IAS, District Magistrate cum Chairman DDMA Chamba, in exercise of the powers vested in me under Section 34 of the Disaster Management Act 2005 hereby order that the orders of the SEC dated 28.11.2020 shall be implemented in letter and spirit by all Departments and Officers with the following specific directions:

i. The movement of any person or persons in any public place such as temples, market, institutions, offices, common grounds and any other place of gathering shall be subject to the proper social distancing, use of face covers/masks, respiratory etiquettes and practice of frequent hand washing with soap/ alcohol- based hand sanitizers. There shall be no spitting in public places. Violators shall be penalised by the Police.

ii. All the stakeholder departments/Officers shall ensure that implementation of the District Covid-19 Action Plan (Annexure – B) circulated by the CMO Chamba

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vide his office letter No. 20174 dated 20.11.2020. Action taken report by all concerned Departments be sent to the District Emergency Operation Centre (DEOC) every Monday. iii. Asha workers, Health workers, Anganwari workers, Mahila Mandals/ Yuvak Mandals/ NGOs/ CBOs/ Members PRIs and ULBs will visit households/ institutions/ places where social/ academic/ political/ sports/ entertainment or other such gatherings or congregations are likely to be held in near future and will sensitize the organisers about the measures to be adopted for preventing COVID- 19 spread. The SDM shall be the Sub-Division Level Nodal Officer for this special awareness drive and will put in place measures to implement these directions w.r.t. his/her area of jurisdiction. Regular reporting of action taken to DEOC in this regard will be made. iv. The SDMs will meticulously plan and ensure notifying Containment Zones, as and when necessary, to check the spread of COVID-19 infections. Close watch on COVID-19 positive cases being reporting in their areas daily be kept and all preventive measure enforced. DEOC will compile information related to active Containment Zones and share this report every day.

v. The Labour Officer will ensure implementation of directions issued by SEC on 28.11.2020 w.r.t. Weekly ‘Closing Day’ for all the markets/shops on Sunday throughout the district and take action against the violations. Shops dealing with fruits, vegetables, milk & milk products and other daily essential goods/Pharmacies, etc. will be exempted from this requirement. vi. All the Sub Divisional Magistrates shall be the Responsible Officers for effective implementation of COVID-19 prevention guidelines issued by the SEC vide order dated 16.10.2020, and modified on vide order dated 28.11.2020, for organisation of social/ academic/ sports/ entertainment/ cultural/ religious/ political and other congregations and shall ensure monitoring thereof through Executive Magistrates under their respective control. Random checking of such events may be done to see whether compliance to SOPs/directions is being done. They shall also ensure that strict action is initiated against violators as per law. Prior intimation of all such gatherings shall be given to SDM of the area by the organisers of such events, who if need be, can order the event to be video graphed. The organizers shall be responsible to ensure compliance of directions and other SOPs issued by SEC from time to time.

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vii. In gathering where dhams/community kitchen or professional catering is to be arranged, the Sub Divisional Magistrates on receipt of information as per point No. vi supra shall coordinate with BMO concerned to ensure testing of manpower deployed for the organisation of such dham, community kitchen or professional catering for COVID-19 not earlier than 96 hours before the event through RAT/RT-PCR. Weekly report of testing done in this regard will be shared with DEOC on every Monday and the latter will share consolidated information with the DM. viii. The Sub Divisional Magistrates will identify Volunteers Groups, Disaster Youth Volunteers, NGOs CBOs or Inter Agency Groups Member volunteers who shall visit market places and encourage people to follow COVID guidelines like use of masks/face cover, cough etiquette, hand hygiene and social distancing. Police will be asked to challan the violators who fail to heed the advice of these volunteers.

ix. Police department shall ensure regular challans of violators at its own level too and share the information with DEOC at least once a week i.e. every Monday.

x. People without face cover/masks will not be allowed to board public transport such as buses and taxis and provided any services/goods in public offices or private establishments/shops. The Police will regularly check these commercial establishments and stage/contract carriages. The shopkeepers and transport/taxi operators shall be liable for violation in addition to the individual concerned.

xi. All the Heads of Offices/Institutions (Health, etc.) especially those with large public dealings, shall take step to reduce overcrowding in their establishments, maintain social distancing, and reduce footfall in offices. Use of online platforms and token/permits system will be encouraged to provide services and reduce queues in offices/institutions. Preference will be given to hold review meetings through web-based systems. Initiatives taken/good practices adopted in this respect and success stories shall be shared with DEOC fortnightly.

xii. All the project proponents, industrialists, contractors, orchardists, agriculturists, etc. will ensure that their workers maintain social distancing and take preventive measures to reduce spread COVID-19 in workplace and residential settings. They shall submit a report of good practices adopted by them to DEOC fortnightly. xiii. All the office bearers of Panchayati Raj Institutions (PRIS) and Urban Local Bodies (ULBs) shall ensure implementation of directives with respect to number of persons allowed to participate in indoor or outdoor in their respective

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jurisdictions. Violation of directive in this regard shall be brought to the notice of the District Administration forthwith.

District Magistrate Chamba, District Chamba.

Endst. No. As above Dated 28th November, 2020

Copy is forwarded to the following for information and further necessary action:

1. The Chief Secretary cum Chairman SEC, Government of Himachal Pradesh. 2. The ACS(Revenue) to the Government of Himachal Pradesh. 3. The ACS (Home) to the Government of Himachal Pradesh. 4. Secretary (Health) to the Government of HP. 5. The Divisional Commissioner, Shimla Division, Kangra at Dharmshala. 6. The District & Sessions Judge, Chamba (H.P.) 7. The Superintendent of Police, District Chamba. 8. The Sub-Divisional Magistrates in District Chamba. 9. All the Tehsildars/ Naib-Tehsildars in District Chamba. 10. The DIO Chamba with request to upload the order on official website of the District Administration. 11. All HoDs, District Chamba.

District Magistrate Chamba District Chamba.

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Annexure – B

District Action Plan for COVID -19 Management and Strategy to Restrict/ Arrest the spread of COVID-19 in District Chamba, HP (As circulated by CMO Chamba to all HODs in Chamba vide his office letter No. 20174 dated 20.11.2020)

1. Background

Corona virus disease 2019 (COVID-19) - is a contagious respiratory disease caused by severe acute respiratory syndrome Corona virus 2 (SARS-CoV- 2).Common symptoms include fever, cough, fatigue, breathing difficulties, and loss of smell and taste. First identified in Wuhan, China, it is currently an ongoing pandemic and affected more than 200 countries in the world. Real time PCR(RT-PCR) is the gold standard test for diagnosing COVID 19. First case of COVID 19 in Chamba was identified & diagnosed on 06-04-2020 WITH 4 Cases in block Tissa. 2. Current scenario related to COVID 19 in District Chamba, HP (till 13- 11-2020)

2.1 Overall Detail on COVID 19 in Chamba district, HP (As on 13.11.2020)

Total Sample 36811 Testing Rate 70.92/1000 Pop. Collection Total Positives 1461 Positivity Rate 3.97 % Active Cases 256 Person 2 Migrated Recovered 1271 Recovery Rate 87 % Deaths 19 + 2 NON- Death Rate 1.5 % COVID Deaths

2.2 Detail of Clinical/ Hospitals (DCH, DCHC and DCCC) capacity (in beds) & Patients under Institutional/ Home Isolation (till 13-11-2020) of Active Cases:-

Sr. Location Patients (In No.’s) Capacity (In Beds) No.

1. DCH, Chamba 15 15 2. DCHC, Dalhousie 18 50 3. DCCC, at DIET Saru, 5 90 Chamba 4. DCCC, at Tribal NIL 70 Bhawan at Balu 5. DCCC, at Jawahar NIL 144 Navodya Vidyalaya 6. Home Isolation 197 NA 7. Other DCHs (at 7 Tanda, D/Shala & IGMC 8. Migrated 2 NA Total 244 369

• A total of 45 Patients under Institutional isolation, 197 under Home Isolation and 2 are migrated out of state

2.3 Detail of COVID 19 Deaths in district Chamba, HP till 13-11-2020

Sr. No. Place of Death of COVID 19 Patients No.’s of Cases 1. DCH 13 2. DCHC NIL 3. DCCC NIL 4. Home/ Home Isolation 2 5. In Transit (during referrals) 5 6. Migrated Out (of State) 1 G.Total 21

3. Issues at Hand a) Laxity in following COVID-19 appropriate behavior. b) Rapid spread of COVID-19 in the district c) Mortality during shifting of patients to Tanda/ Dharamshala/ IGMC, Shimla. d) Late detection of positive cases. e) Low testing Facilities/ Rate.

f) Ramping up facilities to cope up the approaching winters. g) Providing more facilities to COVI-19 patients at DCH, DCHCs and DCCCs. h) Protection of Vulnerable Population (Persons with co- morbidities and age>60 years). i) Shortage of Manpower. j) Clinical/ Hospital management issues. k) Observation of SOPs issued by various authorities

4. Objectives of the Action Plan

a) To contain the spread, cycle of transmission of COVID-19 b) To popularize COVID19 appropriate behaviour c) To decrease the mortality and complications (long term morbidity) due to COVID 19. d) Improving clinical management of COVID-19 patients

5. Components of COVID 19 Action Plan for the District

Issues Responsible/Nodal Department

a.) Mapping of the vulnerable population –People with age more • Health Department, CMO than 60 years, with co-morbidities Chamba. like diabetes, cancers, hypertension and stroke will be mapped on priority. Active case finding will be done by ASHAs/ Health Worker’s tentatively from 17-11-2020 onwards (or as per dates conveyed by state authorities) to identify any flu like symptomatic persons and send them for COVID 19 testing.

3 b.) To strengthen the IEC in the district

• Miking to be done on regular intervals in district at crowded • CMO Chamba locations such as Bazaars, Bus stand and Banks will be specifically targeted

• Walking Nukkad Natak’s to be organized by DPRO, Chamba at • DPRO Chamba with public places under technical and technical support of CMO financial assistance by Health Deptt, Chamba. Chamba.

• Distribution of Pamphlets

distributed during the ACF and • CMO Chamba extensive IEC to be done by ASHAs

with focus on Do’s & Don’ts to

prevent the spread of COVID 19.

• Digital IEC – Launch of digital IEC to

share IEC with all the key • CMO Chamba, the Stakeholder’s. They will share it to main coordinator. at least with 10 other persons each Supported by PO and with all the PRIs, UCBs, DRDA, BDOs, EOs, Educational institution and DDHE and DDEE, PO, Anganwadi centers. ICDS.

• All the departments to increase

IEC by displaying the Do’s and • All Departments/ Don’ts for COVID-19 by digital IEC, Organisation in banners and posters during any Chamba functions in their area at the

entrance.

• The LPG distribution vehicles will • DFSC Chamba regularly use loudspeakers to spread awareness about containment of COVID 19 while distributing LPG.

• All the Petrol Pumps will display IEC (banners/hoardings) on COVD 19 appropriate behaviour. • DFSC

• Implementation of SOPs issued under DM Act by SEC • All SDMs and • Implementation of SOPs issued by Magistrates and Education Department Police • DDHE and DDEE, DPO • Implementation of SOPs issued by Health and Family Welfare Department • CMO Chamba

• Implementation of SOPs issued by LAC • DLO Chamba • Implementation of SOPs issued for work places • All Head of Offices in • Reduce crowing in social functions Chamba like marriages, etc. • CMO and DPO ICDS through Asha and Anganwadi workers c.) To increase the testing for COVID- • Principal Pt. 19 JLNGMC, • Targeting schools/educational Chamba & institutions/ market District places/offices/banks and to revise

the target for RT-PCR tests to about Administration, 400 samples/ day. Chamba • RTPCR Laboratory should be made functionalize 24x7. • As apprised by Principal Pt. JLNGMC Chamba there is requirement of 3 LTs and 1 Microbiologist to functionalize the same. District Administration may provide the manpower for the next three months as adhoc measure on outsourcing basis. In the meantime, the Principal Medical College will take up the matter with Govt. to provide adequate staff to College so that RT PCR testing can run 24 x 7 in the district and adequate testing can be done.

d.) Supervision & Monitoring of • CMO, Chamba, SDMs, BMOs Institutional & home isolated and DEOC to keep an active COVID Patients surveillance on all the home • To ensure patients under DCH/ isolated COVID 19 patients on DCHC/ DCCC should be examined by daily basis and maintain the MOs on duty at least 2 times/ day record. All to share report with (Morning & evening time) with DEOC who will compile the proper record of vitals/ parameters same and share with DC on as per guidelines. daily basis. • All the patients under home isolation should be provided with Pulse oximeter and necessary medicines. • Three tier monitoring mechanism for person under home isolation will be done through daily audio/ video calls to the patients by BMOs, SDMs, CMO Office and DEOC would check

the same on daily basis randomly to check whether the patients are getting due advice and care. In the event of any deficiency immediate remedial action would be taken. e.) Violation for not following COVID • Police department, 19 appropriate behavior Chamba – To send • People for not following appropriate report of Challans done behavior for COVID 19 (Not wearing to DEOC, Chamba Masks at public places) should be regularly at least once a challaned and to be tested for COVID- week. 19. • Action for violation for SEC orders f.) Management at Clinical/ Hospitals (DCH/ DCHC/ DCCC)

• To ensure all clinical/ Hospitals • Action taken by All the (DCH/ DCHC/ DCCC) must install Nodal Officer’s, DCH, a board at the entrance & ward DCHCs, DCCCs. displaying Name of Nodal Officer with Mobile No. and Duty Roaster of Health Staff.

• In view of upcoming winter • Action taken by All the season, all the DCH, DCHCs and Nodal Officer’s, DCH, DCCC to ensure heating DCHCs, DCCCs in arrangements and Food warmers coordination with for admitted patients. District Administration

• Ensuring proper care of patients • Action taken by All the admitted in DCH, DCHC and Nodal Officer’s, DCH, DCCCs, e.g. regular visit to COVID DCHCs, DCCCs in 10 ward by senior doctors, coordination with nursing care of patients, good District Administration

sanitary conditions in wards and washrooms, hot meals, etc.

• Sr.MS/ Principal Pt. • Installation of Oxygen Manifold JLNGMC, Chamba to system and oxygen Plant to be initiate the process of installed and to ensure adequate installation of oxygen availability of additional oxygen manifold system and cylinders and functional Oxygen plant at DCH, Ventilators at DCH, Chamba. Chamba, CPWD Department will give the estimate for Oxygen manifold system and HP

PWD will give the estimate for oxygen plant and float the tender at the earliest.

g.) Creation of Isolation Ward for COVID 19 patients in tribal areas of Chamba i.e. at Bharmour & Pangi.

• To create space to hold • CMO, Chamba & BMO COVID 19 patients at the Bharmour & Pangi. above two locations during extreme winters/ Snowfall

persists from Nov-April, Special isolation wards will be created at Bharmour and Pangi to keep COVID 19

patients required for hospitalization.

• CMO, Chamba

h.) Strengthening of Ambulance Services – Utilizing all available ambulances in the district. • CMO, Chamba, SDMs i.) Strengthening of CCCs – and all the Nodal Preparing them to handle patient Officer’s of CCCs load.

6. MONITORING AND EVALUATION

Implementation of Action Plan will be reviewed by the Deputy Commissioner Chamba with all stakeholder departments regularly. Chief Medical Officer Chamba shall be the Nodal Officer for implementation othe the Action Plan.

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