Assessment of health system preparedness to deal with the second wave of COVID-19 in a remote tribal district Surguja, Chhattisgarh, India-April 2021

Abstract

Background: Present study was conducted to assess the preparedness of the Surguja district to curtail COVID-19.Methods: We conducted a cross-sectional observational study from May 2020 to March 2021 through records of 2 primary health centres areas selected by convenient sampling (farthest and nearest to district headquarters). Data on existing facilities and logistics was from district headquarters. Preparedness was assessed through checklist. Observations were presented as rates, ratios and proportions. Standard error of difference between two proportions was used as test of significance and p value≤0.05 was considered significant.Results: For Surguja district population of 925938 (65% rural), overall attack rate was 1.15%, case fatality rate was 0.96% (102/10636); there was 1 DCH, 9 DCHC, 6 CHCs, 25 PHCs, 3 upgraded PHCs, 197 subcentres, 12 CCC, 01 RT-PCR laboratory and 228 COVID vaccination centres. There were 1151 isolation beds; 300 with oxygen support (26%); ICU beds 134 (11.60%) with 34 ventilators. Cumulative 258229 tests; antigen 67.90%, test positivity rate 4.10% (urban 8.2%, rural 1.7%).\xa0 This urban-rural difference in test positivity rate was statistically significant (p<0.001). Health care workers, 94.81% (12722/13418) had received one dose of vaccine with 53.36% (6789/13418) both doses. Above 45 years eligible population; 66.68% (154254/231331) received one dose of vaccine.Conclusions: Surveillance and management of COVID-19 were as per GOI guidelines issued. However, to enhance response we recommended strict implementation of appropriate behaviour in community, establishment of containment zones/facilities for high risk population in urban area blocks and increasing laboratories with RT-PCR testing in appropriate proportions.