What’s UP’s Vaccine Strategy & How Did It Manage COVID Crisis?

Uttar Pradesh Cabinet Minister Sidharth Nath Singh elucidates the measures the state govt took to fight COVID.

Image of UP Cabinet Minister Sidharth Nath Singh, who is the author of this piece, used for representational purposes.

(Photo: Erum Gour / The Quint)

Uttar Pradesh has a population of approximately 24 crores, the highest in any Indian state. Its population is exceeded by only four countries in the world and is more than that of many European countries combined.

The state implemented a coordinated strategy to tackle COVID. It is important to note that the state tests above 1.5 lakh samples a day — more than 2.83 crore samples have been tested so far. The state has been able to keep the positivity rate below 5 percent throughout the pandemic. In fact at present, the death rate due to COVID has come down to 1.3 while the recovery rate has shot up to close to 90 percent.

Uttar Pradesh has thus far, carried out the most number of vaccinations in any state, with more than 6.43 lakh health and frontline workers being vaccinated (11 percent of the total population to be vaccinated). Further, the state has opened 1,607 testing centres across its length and breadth.

To achieve this Herculean feat, the state’s multi-pronged strategy is also based on boosting overall health infrastructure, aggressive testing, contact tracing, surveillance and isolation, while rigorously adhering to public health guidance and the last being vaccination . The state implemented a large range of non-pharmaceutical interventions to control the spread of the virus and although, these measured differed in their level of stringency (ie, the severity of the measures), they proved their worth.

The combination of immediate risk assessment driven by science, with the decisive actions of the government at an apt time, helped us contain the spread of COVID-19.

It was our response to the COVID-19 pandemic — which has been lauded globally — which gave business leaders the most confidence for future investment in the state (so far investment proposals worth Rs 57,000 have been received).

UP’s COVID-19 Plan

• Robust Health Infrastructure: The government’s deft handling of the COVID-19 situation exemplifies an efficient health administration amidst an unprecedented challenge. Even when no cases had been reported, the state began implementing its pandemic containment plan in earnest in February 2020, which included preparing hospitals for an influx of patients while further instituting border-control policies to delay the pandemic’s arrival. Doing this early on with only over a few thousand cases globally at the time allowed them to basically stop the influx and prevent the community transmission. The Uttar Pradesh government initiated training for the medical staff to sensitise them about COVID-19, its prevention protocol, treatment flow chart and other logistics. The government’s strategy was multi-pronged comprising the containment of the virus, treatment of infected persons, ramping up testing, and providing employment to the returnee migrants.

• Team-11: Chief Minister Yogi Adityanath decided to set up a Team-11 comprising teams of senior officers of various departments to review and coordinate the measures taken by the government in the management of COVID-19 on a daily basis. Each officer was given a specific task to be carried out by him in coordination with other officers. As a pro-active protective measure, the CM had sealed the inter-state and international borders of the state even before the country-wide lockdown was imposed. In order to mobilise the required funds to supplement health services, the UP government created the ‘COVID Care Fund’.
• Emphasis on Testing: Initially, Uttar Pradesh did not have sufficient testing facilities. The state had only one testing lab and the testing capacity was just 60 on 22 March. It was all about how you muster and marshal your available resources. Because of inadequate testing and contact-tracing capabilities in March, the state made a dramatic and critical switch in strategy: a stringent lockdown. It gave the government time to ramp up their healthcare system. As a result, we currently have over 234 labs in UP including 131 government labs which conduct testing of about 1.75 lakh samples every day. The state government made expeditious purchases of vital equipments like PPE kits, High Flow Nasal Canula (HFNC), ventilators, oxygen cylinders to provide ICU care. The training to doctors and paramedics, which had started early in March itself, was also intensified. Uttar Pradesh recently became the first state to achieve the landmark of testing 2.5 crore samples for COVID-19. Initially, medical equipment like thermometers, pulse oximeters and PPE kits were being procured from outside the state but now they are being manufactured within the state under the aegis of the MSME department, which is further helping in lowering costs and generating employment.

Contact-Tracing Efficacy

An aggressive contact tracing strategy using rapid response teams and ensuring testing for almost every identified close contact(s) of COVID positive patient in the state became a defining tool in the whole pandemic management process.

Thousands of surveillance teams were formed to conduct surveys of the houses, acquaintances and contacts of the patients. In fact, an unprecedented surveillance effort to identify Influenza Like Illness(ILI)/ Severe Acute Respiratory Infection (SARI) patients, via multiple house-to-house visits by frontline workers, was floated. It helped them get early testing and reference for early treatment.

The state teams till now have covered more than 18 crore people out of the 24 crore (approx) population of the state.

Ramping Up the Capacity of COVID Hospitals

The state announced exclusive COVID hospitals to deal with the overwhelming number of cases. The state now has a total of 674 COVID hospitals including 571 Level One COVID Hospitals, 77 Level Two COVID hospitals and 26 Level Three such hospitals. The total availability of beds in these hospitals has been increased to 1.57 lakh.

As of now, all 75 districts of the state have at least one or more Level-2 COVID hospitals with provision for ICU beds.

Further, each district hospital in Uttar Pradesh is to get a post-COVID care unit for those patients suffering from post-COVID complications like breathlessness, mental and physical ailments.

It was due to clear command lines and uncluttered instructions which helped build up a strong health ecosystem which could deal with a public health emergency of such mammoth proportions with relative ease.

Role of Technology

As an added facility for COVID patients, a unique portal — UPCovid19tracks — was developed in record time.

This functioned as a one-stop-shop for information, helping in the tracking of every patient longitudinally by all stakeholders — the state government, testing labs, hospitals etc, providing real time information on the basis of which responses could be adjusted dynamically.

The UP government decided to set up an Integrated Control and Command Centre (ICCC) at the office of the Relief Commissioner at the state headquarters for effective monitoring. Similar ICCCs were also established at every district headquarter to be manned by the concerned District Magistrate and Chief Medical Officer (CMO).

Also, continuous engagement with COVID patients was maintained through the CM’s helpline; all patients were personally called to enquire about their wellbeing and any issues faced at the hospital level.

Apart from these, the streamlined ambulance services, introduction of online OPD services, tele-medicine and tele-consultation facilities were the other logistics employed by the government during Covid management.

The state government also ensured the supply chain of oxygen was maintained and a new oxygen plant was also inaugurated in Modi Nagar, Ghaziabad during the pandemic.

Ensuring Safety & Welfare of Migrants

The influx of about 45 lakh migrants and their rehabilitation had been one of the hardest tasks to be carried out by any government. The Yogi government's decision to hire trains to bring the migrants home was yet another step in the right direction. As many as 1660 trains were run to bring in migrants from various parts of the country. The government ensured basics like food and water to returning migrants. Community kitchens were opened up, which catered to migrant labourers and the destitute. About 6.75 crore food packets were distributed to them during the lockdown period.

The returnee migrants, who were sent to home quarantine, after proper medical check-ups, were given ration kits with 30-day rations. Every migrant who had returned was also given a sustenance allowance of Rs 1,000 each, along with the ration kit.

In addition, about 53 lakh construction labourers, street vendors, carriage pullers and daily wagers from the rural areas were also given Rs 1,000 each through the Direct Benefit Transfer (DBT) system. Efforts were made to persuade employers to pay wages during the lockdown period. More than 5 million employees thus received wages, which totalled over Rs 2000 crore.

The government undertook skill mapping to provide appropriate jobs to the migrants. Of which, about 27.28 lakh migrants were given jobs in 11 lakh industries comprising both small and medium-sized businesses. Besides, migrants were provided employment under the Mahatma Gandhi National Rural Employment Guarantee Act (MGNREGA) scheme.

Reviving the Economy

Over 8 lakh MSME units have been made functional where over 51 lakh labourers are employed. Rs 10744 crore worth loans have been distributed among 4.35 lakh industrial units under the Atmanirbhar Yojana. A labour employment commission was also set up for the social and economic security of labourers.

In addition, over 8.53 lakh new units were started and a loan worth over Rs 29428 crore was distributed through collaborations with banks in the state, and over 27 lakh jobs were created.

(Sidharth Nath Singh is a Cabinet Minister in the Government of Uttar Pradesh, holding the portfolios of MSME, Investment & Export, Textile, Khadi & Gram Udyog. He is one of the official spokespersons of the Bharatiya Janata Party govt. He tweets @SidharthNSingh. This is an opinion piece, and the views expressed are the author’s own. The Quint neither endorses nor is responsible for them.)