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Bhilwara’s “ruthless containment” model – editorials


Bhilwara emerged as one of the hotspots for India’s early coronavirus disease (Covid-19). With the infection spreading from a hospital, 27 people tested positive. But, for the past week, the Rajasthan district has not reported a positive case. To be sure, cases could come up again. But this change is a remarkable story, and is now being considered as a possible model to be replicated in other parts of the country.

The Rajasthan government focused on a comprehensive approach. The first step was to close the district on March 20, five days before the national closure was announced. This eventually extended to a strict curfew, where even the essentials were delivered to homes. The next step was the identification of sensitive areas and the aggressive screening of those with a travel history, contact with those who had traveled, and vulnerable groups such as health workers. Those with symptoms were tested; and they, and their close contacts, were isolated and quarantined in both public and private facilities. There was then a focus on offering treatment to positive cases. This has now been followed up with careful monitoring.

There is an underlying logic to this entire process. Make sure there is no movement, preventing others from entering and spreading the infection further, and possible positive cases from moving and infecting others. Once the disease is contained in a specific group, check who can have an infection. Keep such cases away from others, to prevent them from spreading. Eventually, lack of mobility, and lack of contact with positive cases, will decrease the infection rate. There are three clear lessons from this model. Go local, and as deep as possible within specific geographies. Ensure the deployment of adequate human resources to evaluate and test and increase the health infrastructure to isolate. And limit movement as long as possible. It is difficult to expand this at the national level, especially if there is a sudden increase. But managers across the country should adopt this model to their specific circumstances.

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