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Advisory for quarantine of migrant workers
Introduction Coronavirus disease 2019 (COVID-19) is an acute infectious respiratory disease caused by a newly discovered coronavirus (SARS-CoV-2). Most people infected with the COVID-19 virus experience mild to moderate respiratory illness and recover without requiring special treatment, the disease presentation is more likely to be severe in older people, and those with underlying medical problems like cardiovascular disease, diabetes, chronic respiratory disease, etc. Purpose of the advisory Migrant workers from peri-urban and rural parts of the country who migrate to large cities constitute a sizable segment of urban population across the country.
During outbreak of a communicable disease or social distancing measures as being undertaken for COVID-19 Pandemic, such populations tend to return back to their homes. In such a scenario, the resultant congregations of migrant workers in bus stations/State borders may make them susceptible to COVID-19 infection. Further such exposed individuals may later become infected and carry this infection to far flung rural localities. Also it would be difficult to track them and their contacts. Hence this advisory. Advisory 1. Advisory by Ministry of Home Affairs (MHA) The migrant workers will remain at their regular place of work/local residence within the city. They will not be evacuated either by their employer/landlord.
Action to this effect and to address other related issues will be taken by local administration as per advisories being issued by Ministry of Home Affairs. 2. Health actions at place of congregation of migrant workers As some of the migrant workers have already moved in groups and either reached their destination or are on their way, the health actions would be based on the locations where the migrant workers are currently located.
2.1 Migrant workers who are in the cities of their local residence 2.2 Migrant workers who are on their way and are yet to reach their destination city/village 2.3 Migrant workers who have reached their destination
2.1 Migrant workers who are still in the cities of their local residence Wherever a congregation of migrant workers has formed in bus stations/railway stations or any other place within the city of their local residence, the following actions would be taken: a) Names, local residential and permanent addresses and mobile numbers of the migrant workers shall be recorded.
b) District health administration will depute a team which would include District Surveillance Officer/his representative and public health personnel. Thermal screening of all such persons shall be done by this team.
c) Persons found to be suffering for fever shall be further interviewed by this team for (i) other symptoms suggestive of COVID-19, (ii) history suggestive of contact with a suspect/confirmed case of COVID-19. All such persons qualifying these criteria shall be referred to designated COVID-19 treatment hospital for isolation and testing.
d) Those who are not exhibiting any such symptoms would undergo a risk profiling.
e) Those who are above 60 years or have co-morbidities would be shifted to facility quarantine. Others would undergo home quarantine for 14 days.
f) IDSP will monitor those under home/facility quarantine.
2.2 Migrant workers who are on their way and are yet to reach their destination city/village
2.2.1 Setting/establishment of quarantine center
a) If there are no established quarantine centers in the vicinity, a quarantine center will be established that would conform to the norms as per the checklist communicated already to States.
b) Norms for the same can be referred to at https://ncdc.gov.in/WriteReadData/l892s/90542653311584546120.pdf
2.2.2 Health actions at the quarantine facility Following action would be taken up at the quarantine facility:
a) Names, local residential and permanent addresses and mobile numbers of the migrant workers shall be recorded.
b) District health administration will depute a team which would include District Surveillance Officer/his representative and public health personnel. Thermal screening of all such persons shall be done by this team.
c) Persons found to be suffering for fever shall be further interviewed by this team for
(i) other symptoms suggestive of COVID-19,
(ii) history suggestive of contact with a suspect/confirmed case of COVID-19. All such persons qualifying these criteria shall be referred to designated COVID-19 treatment hospital for isolation and testing.
2.2.2.1 Administrative actions at the quarantine facility a) A record of all migrant workers assigned to a particular quarantine facility shall be kept.
b) The contact number of administrator/or any subordinate officer will be displayed for the persons being quarantined to report their grievances.
c) Adequate manpower to attend to planning, operation, logistic and financial aspects of the quarantine center would be deployed. d) All basic amenities as per the checklist shall be provided at these centers (refer to 3b above).
e) All such persons shall be encouraged to remain in contact with their family members through phone to avoid anxiety and stress. Phone charging points shall be provided at these centers in adequate numbers.
f) Access control shall be enforced at the quarantine center. g) Total duration of quarantine shall be 14 days*.
2.2.2.2 Technical actions at the quarantine facility
a) All quarantined persons will undergo daily medical examination for appearance of symptoms suggestive of COVID-19.
b) The migrant workers will be provided triple layer medical mask and sensitized on
(i) How to use and dispose off mask.
(ii) Washing hands frequently.
(iii) Following respiratory etiquettes (coughing/sneezing into tissue/handkerchief/flexed elbow).
(iv) Maintaining at least 1 meter distance from each other.
(v) To report on symptoms of fever/cough/breathing difficulty.
c) Those during the course of their stay are found to be symptomatic for COVID-19 shall be referred to designated COVID-19 hospital for isolation and testing. They will be managed as per guidelines on management of COVID-19 cases (available at https://www.mohfw.gov.in/pdf/GuidelinesonClinicalManagementofCOVID1912020. pdf) and discharged as per discharge policy (available at: https://www.mohfw.gov.in/pdf/Corona%20Discharge-Policy.pdf) and brought to quarantine center. d) If the person tests positive, all his close contacts shall be segregated and tested as per ICMR testing guidelines. (Available at: https://icmr.nic.in/sites/default/files/upload_documents/2020-03- 20_covid19_test_v3.pdf)
e) Special care shall be taken with regards to vulnerable groups including children, pregnant women, elderlies and those with co-morbidities.
f) In addition to medical care for COVID-19, routine healthcare needs (particularly provision for reproductive care, treatment of Non communicable diseases etc.) shall be attended to. For such purpose a medical team from the nearest hospital will visit/camp at quarantine facility.
g) A psycho-social team would visit all such facilities to address psycho-social issues if any.
h) An ambulance will remain stationed at the quarantine center to attend to any medical emergencies and referral of suspect patients.
i) To create awareness among people being quarantined, IEC material will be displayed at multiple prominent locations at quarantine centers. This shall also be addressed by interpersonal communication.
j) Clean beddings and fresh linen will be provided to the quarantined persons
k) All frequently touched surfaces will be disinfected twice a day with 1% sodium hypochlorite solution. Floors will be mopped daily with household cleaning agent and 1% sodium hypochlorite solution. For detailed information Guidelines on disinfection of common public places are available at: https://www.mohfw.gov.in/pdf/Guidelinesondisinfectionofcommonpublicplacesinclud ingoffices.pdf
l) All waste shall be segregated and disposed off as per bio-medical waste management rules 2016. The agency providing bio-medical waste disposal at the nearest hospital will be tasked for waste disposal.
m) Prior to their final discharge from the quarantine facility, a record shall be created of their names, mobile numbers, places likely to visit in next 14 days. A state wise list shall be prepared based on places they are likely to visit in next 14 days and communicated to respective State and district IDSP units for further follow up.
2.3 Migrant workers who have reached their destination Migrant workers who have reached their destination will be identified by the district administration and IDSP will follow them up at their residence.
a) District health administration will depute a team which would include District Surveillance Officer/his representative and public health personnel.
b) Such persons shall be contacted by IDSP teams and interviewed about place of local residence
c) Those found to be suffering for fever shall be further interviewed by this team for (i) other symptoms suggestive of COVID-19, (ii) history suggestive of contact with a suspect/confirmed case of COVID-19. All such persons qualifying these criteria shall be referred to designated COVID-19 treatment hospital for isolation and testing.
d) Those who are not exhibiting any such symptoms would undergo a risk profiling.
e) Those who are above 60 years or have co-morbidities would be shifted to facility quarantine. Others would undergo home quarantine for 14 days.
f) IDSP will monitor those under home/facility quarantine. * In facility quarantine, quarantine period shall be extended if a positive case is detected during the 14 days of quarantine. This extension of quarantine shall be applicable for all who were in close contact with the positive case and will be effective for 14 days since last close contact with the positive case, subject to the fact that there had been no intermingling with the person tested positive and his close contacts with other quarantined population. (Otherwise the extension of quarantine period shall be applicable to all quarantined persons).
