As the Covid-19 cases are now spreading to new areas in the different parts of the country, secretary in the health ministry said the cases are likely to be scattered, and now the primary aim is to control the outbreak, especially in new locations.

The letter to states and UTs, by the secretary in the health ministry, Rajesh Bhushan, stressed the need for operationalizing the ambulance transport system with oxygen facility and quick response mechanism.

Considering the concern of potential spreaders of coronavirus infection to a large number of people by grocery shops, vegetable, and other vendors, the Union health ministry has advised all the states and UTs to take up testing of those to ensure early detection of cases which can lead to a reduction in mortality rate and increase the spread of the coronavirus.

He also made a point of the refusal rate of ambulances must be brought down and it should be monitored on a daily basis.

“The focus at the same time should be to save lives at all cost,” he said.

“While we have so far done better than many other countries in this respect, our aim should be to further reduce mortality and ensure that it does not cross the 1 percent mark,” Bhushan said in the letter, addressed to additional chief secretaries, principal secretaries, and secretaries (health).

Bhushan stressed on enhanced surveillance for influenza-like illness (ILI)/severe acute respiratory illness (SARI) as their symptoms are mostly the same as Covid-19.

Once a positive case is identified, a prompt contact-tracing should be undertaken and at least 80 percent of the contacts must be identified and quarantined within 72 hours, he said.

“There can be potential hotspots for the spread of infection like industrial clusters with the closed work environment, people coming from high prevalence areas, other high-density areas such as slums, prisons, old age homes, etc.

“In addition, grocery shops, vegetable, and other vendors, etc. can be potential spreaders of infection to a large number of people. Testing in such areas and of such people should be taken up proactively as per ICMR guidelines,” said Bhushan.

In the letter, Bhushan also said that a regular house-to-house search must be done periodically to identify those who are at high-risk, that is the elderly, people with comorbidities and pregnant women among others.