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As of April 17, Madhya Pradesh has 1,120 confirmed cases of COVID-19 - the fifth-highest among all states in India.  The Government of Madhya Pradesh issued one of its initial COVID-19 related orders around January 28, 2020, advising healthcare workers to use appropriate protective gear when examining patients from Wuhan, China.   Since then, the government has taken several actions to contain the spread and impact of COVID-19.  In this blog, we look at key measures taken so far.

Figure 1: Day-wise COVID-19 cases in Madhya Pradesh

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Early stages: Focus on screening international travellers

On January 28, the state government issued directions to monitor international travellers from specified countries, test and maintain surveillance on those who are symptomatic.  A further order required district administrators to monitor and report on all passengers who arrived from China between December 31, 2019 and January 29, 2020.  While efforts were largely focused on screening and testing, the first quarantine restrictions for symptomatic travellers from China, entering India after January 15, were imposed on January 31.  Those leaving quarantine were subsequently kept under surveillance and their health conditions reported on for a period of 14 days.  By February 13, a constant presence of a medical team at the airport was required to test foreign passengers from an increasing list of countries and send daily reports.  

February and early March: Improving public health capacity, restricting social gatherings

The next steps from the government were aimed towards adapting the public health infrastructure to handle the evolving situation.  Following are some of the steps taken in this regard:

  • A helpline, with a dedicated call centre, was set up to inform citizens about COVID-19 and its prevention.
  • The regional directors of the Directorate of Health Services, Government of Madhya Pradesh, were instructed to ensure availability of N-95 masks and PPE kits in their region.
  • The Health Department issued guidelines to the Chief Medical and Health Officials in the State regarding the collection and transport of COVID-19 test samples.
  • Medical professionals in public hospitals were ordered to attend a national training.
  • An order was issued to improve arrangements for quarantine and isolation wards.
  • Leaves were cancelled for all employees/officers of the Health Department. 
  • To grant certain rights to establish effective control over outbreak affected areas and take swift actions, section 71 of the Madhya Pradesh Public Health Act, 1949 was invoked.  This section of the Act provides all Chief Medical and Health Officers and Civil Surgeon cum Chief Hospital Superintendents rights set out therein.  

As the number of cases in India increased through March, the MP government turned focus and issued orders directly concerning their citizens.   Several measures were undertaken to spread awareness about COVID-19 and implement social distancing.  

  • dedicated portal was created for COVID-19 related information.  
  • An order was issued to close several establishments including schools, colleges, cinema halls, gyms and swimming pools.  Biometric attendance was stopped at all government workplaces. 
  • On March 20, the government issued an order (effective till June 15) requiring suppliers of masks and sanitizers to: (i) maintain a fixed price and (ii) keep and present fortnightly, a record of purchase and sales of the essential items.  The order also prevented them from refusing to sell to any customer. 

March 21 Onwards

On March 21, MP reported four cases of COVID-19. On March 23, the government released the Madhya Pradesh Epidemic Diseases, COVID-19 Regulations 2020 to prevent the spread of COVID-19 in the state.  These regulations specify special administrative powers and protocol for hospitals (government and private) to follow while treating COVID-19 patients. These regulations are valid for one year. Over and above general instructions to maintain social distancing and personal hygiene, the government has undertaken specific measures to: (i) increase healthcare capacity, (ii) institute welfare protection for the economically vulnerable population, (iii) strengthen the administrative structure and data collection, and (iv) ensure supply of essential goods and services.  These measures include-

Healthcare measures

  • Preparation of hospitals for the treatment of COVID-19 including postponing elective surgeries, ensuring an adequate supply of PPE kits. 
  • On March 28, the Bhopal Memorial Hospital and Research Centre was designated as a state-level COVID-19 hospital.  This order was reversed on April 15. 
  • District collectors were empowered to appoint doctors and other healthcare workers as required in their districts in a fast-tracked manner.
  • Establishing a telemedicine unit in each of the 51 district hospitals
  • Facilitating the appointment of final year undergraduate nursing students as nurses
  • On March 29, the government launched the SAARTHAK app for daily monitoring and tracking of quarantined and corona positive patients
  • The government released a strategy document to contain COVID-19. This strategy places emphasis on identification of suspected cases, isolation, testing of high-risk contacts, and treatment (called the I. I. T. T. strategy)

Welfare measures

  • One-time financial assistance of Rs 1,000 will be provided to construction labourers
  • One-time financial assistance of Rs 2,000 will be provided to families of Sahariya, Baiga and Bharia tribes
  • Social security pensions for two months will be paid in advance to pensioners
  • People without eligibility slips under the National Food Security Scheme to be allowed to receive ration 

Administrative measures

  • Senior officials were designated to coordinate with various states to resolve issues regarding migrant labour.
  • District Crisis Management groups were formed to coordinate state-level policy and the local implementation machinery.

Supply of essential goods and services

  • On April 8, the government implemented the Essential Services Management Act,1979. The Act among other things, prohibits anyone employed in essential services to refuse to work.
  • E-pass procurement facility was started to ensure smooth inter-district and across states flow of essential goods & services.  

For more information on the spread of COVID-19 and the central and state government response to the pandemic, please see here.

As of April 26, Rajasthan has 2,083 confirmed cases of COVID-19 (fifth highest in the country), of which 493 have recovered and 33 have died.  On March 18, the Rajasthan government had declared a state-wide curfew till March 31, to check the spread of the disease.  A nation-wide lockdown has also been in place since March 25 and is currently, extended up to May 3.  The state has announced several policy decisions to prevent the spread of the virus and provide relief for those affected by it.  This blog summarises the key policy measures taken by the Government of Rajasthan in response to the COVID-19 pandemic.

Early measures for containment

Between late January and early February, Rajasthan Government’s measures were aimed towards identification, screening and testing, and constant monitoring of passenger arrivals from China.  Instructions were also issued to district health officials for various prevention, treatment, & control related activities, such as (i) mandatory 28-day home isolation for all travellers from China, (ii) running awareness campaigns, and (iii) ensuring adequate supplies of Personal Protection Equipments (PPEs).  Some of the other measures, taken prior to the state-wide lockdown, are summarised below:

Administrative measures

  • The government announced the formation of Rapid Response Teams (RRTs), at the medical college-level and at district-level on March 3 and 5, respectively.

  • The District Collector was appointed as the Nodal Officer for all COVID-19 containment activities.  Control Rooms were to be opened at all Sub-divisional offices.  The concerned officers were also directed to strengthen information dissemination mechanisms and tackle the menace of fake news.

  • Directives were issued on March 11 to rural health workers/officials to report for duty on Gazetted holidays.  Further, government departments were shut down between March 22 and March 31.  Only essential departments such as Health Services were allowed to function on a rotation basis at 50% capacity and special / emergency leaves were permitted. 

Travel and Movement

Health Measures

  • Advisories regarding prevention and control measures were issued to: (i) District Collectors, regarding sample collection and transportation, hotels, and preparedness of hospitals, (ii) Police department, to stop using breath analysers, (iii) Private hospitals, regarding preparedness and monitoring activities, and (iv) Temple trusts, to disinfect their premises with chemicals. 

  • The government issued Standard Operating Procedures for conducting mock drills in emergency response handling of COVID-19 cases.  Training and capacity building measures were also initiated for (i) Railways, Army personnel etc and (ii) ASHA workers, through video conferencing. 

  • A model micro-plan for containing local transmission of COVID was released.  Key features of the plan include: (i) identification and mapping of affected areas, (ii) activities for prevention control, surveillance, and contact tracing, (iii) human resource management, including roles and responsibilities, (iv) various infrastructural and logistical support, such as hospitals, labs etc, and (v) communication and data management.

  • Resource Management: Private hospitals and medical colleges were instructed to reserve 25 % of beds for COVID-19 patients.  They were also instructed to utilise faculty from the departments of Preventive and Social Medicine to conduct health education and awareness activities. 

  • Over 6000 Students of nursing schools were employed in assisting the health department to conduct screening activities being conducted at public places, railways stations, bus stands etc.

  • Further, the government issued guidelines to ensure the rational use of PPEs.

Welfare Measures

During the lockdown

State-wide curfew announced on March 18 has been followed by a nation-wide lockdown between March 25 and May 3. However, certain relaxations have been recommended by the state government from April 21 onwards.  Some of the key measures undertaken during the lockdown period are: 

Administrative Measures

  • Advisory groups and task forces were set up on – (i) COVID-19 prevention, (ii) Health and Economy, and (iii) Higher education.  These groups will provide advice on the way forward for (i) prevention and containment activities, (ii) post-lockdown strategies and strategies to revive the economy, and (iii) to address the challenges facing the higher education sector respectively. 

  • Services of retiring medical and paramedical professionals retiring between March and August have been extended till September 2020. 

Essential Goods and Services

  • A Drug Supply Control Room was set up at the Rajasthan Pharmacy Council.  This is to ensure uninterrupted supply of medicines during the lockdown and will also assist in facilitating home delivery of medicines.

  • The government permitted Fair Price Shops to sell products such as masalas, sanitisers, and hygiene products, in addition to food grains.

  • Village service cooperatives were declared as secondary markets to facilitate farmers to sell their produce near their own fields/villages during the lockdown. 

  • A Whatsapp helpline was also set up for complaints regarding hoarding, black marketing, and overpricing.

Travel and Movement

  • Once lockdown was in place, the government issued instructions to identify, screen, and categorise people from other states who have travelled to Rajasthan.  They were to be categorised into: (i) people displaying symptoms to be put in isolation wards, (ii) people over 60 years of age with symptoms and co-morbidities to be put in quarantine centres, and (iii) asymptomatic people to be home quarantined.

  • On March 28, the government announced the availability of buses to transport people during the lockdown.  Further, stranded students in Kota were allowed to return to their respective states. 

  • On April 2, a portal and a helpline were launched to help stranded foreign tourists and NRIs.

  • On April 11, an e-pass facility was launched for movement of people and vehicles. 

Health Measures

  • To identify COVID-19 patients, district officials were instructed to monitor people with ARI/URI/Pneumonia or other breathing difficulties coming into hospital OPDs.  Pharmacists were also instructed to not issue medicines for cold/cough without prescriptions. 

  • A mobile app – Raj COVID Info – was developed by the government for tracking of quarantined people.  Quarantined persons are required to send their selfie clicks at regular intervals, failing which a notification would be sent by the app.  The app also provides a lot of information on COVID-19, such as the number of cases, and press releases by the government.

  • Due to the lockdown, people had restricted access to hospitals and treatment.  Thus, instructions were issued to utilise Mobile Medical Vans for treatment/screening and also as mobile OPDs

  • On April 20, a detailed action plan for prevention and control of COVID-19 was released.  The report recommended: (i) preparation of a containment plan, (ii) formation of RRTs, (iii) testing protocols, (iv) setting up of control room and helpline, (v) designated quarantine centres and COVID-19 hospitals, (vi) roles and responsibilities, and (vii) other logistics. 

Welfare Measures

  • The government issued instructions to make medicines available free of cost to senior citizens and other patients with chronic illnesses through the Chief Minister’s Free Medicine Scheme.  

  • Rs 60 crore was allotted to Panchayati Raj Institutions to purchase PPEs and for other prevention activities. 

  • A one-time cash transfer of Rs 1000 to over 15 lakh construction workers was announced.  Similar cash transfer of Rs 1000 was announced for poor people who were deprived of livelihood during the lockdown, particularly those people with no social security benefits.  Eligible families would be selected through the Aadhaar database.  Further, an additional cash transfer of Rs 1500 to needy eligible families from different categories was announced.

  • The state also announced an aid of Rs 50 lakh to the families of frontline workers who lose their lives due to COVID-19.

  • To maintain social distancing, the government will conduct a door-to-door distribution of ration to select beneficiaries in rural areas of the state.  The government also announced the distribution of free wheat for April, May, and June, under the National Food Security Act, 2013.  Ration will also be distributed to stranded migrant families from Pakistan, living in the state.

  • The government announced free tractor & farming equipment on rent in tie-up with farming equipment manufacturers to assist economically weak small & marginal farmers.

Other Measures

  • Education: Project SMILE was launched to connect students and teachers online during the lockdown.  Study material would be sent through specially formed Whatsapp groups.  For each subject, 30-40 minute content videos have been prepared by the Education Department.

  • Industry:  On April 18, new guidelines were issued for industries and enterprises to resume operations from April 20 onwards.  Industries located in rural areas or export units / SEZs in municipal areas where accommodation facilities for workers are present, are allowed to function.  Factories have been permitted to increase the working hours from 8 hours to 12 hours per day, to reduce the requirement of workers in factories.  This exemption has been allowed for the next three months for factories operating at 60% to 65% of manpower capacity.

For more information on the spread of COVID-19 and the central and state government response to the pandemic, please see here.