Cabinet Secretary Rajiv Gauba on Friday chaired a meeting on the COVID-19 situation in the country in which it was pointed out that eleven states and Union Territories (UTs) were showing a surge in daily cases and they have not shown commensurate increase in enforcement of containment activities.These states and union territories have been categorised as “states of grave concern” on account of their high and rising daily COVID-19 cases and deaths. The situation was particularly “worrying” in Maharashtra.The high-level review meeting was attended by Chief Secretaries, DG Police and Health Secretaries of all states/UTs, with a focus on 11 states/UTs that have been reporting “very high rise” in daily cases and daily mortality because of COVID-19 in the last two weeks.”11 States/Union Territories (UTs) were categorised as “states of grave concern” on account of their high and rising daily case and higher daily deaths. These have contributed 90 per cent of COVID cases (as on March 31) and 90.5 per cent of deaths (as on March 31) in the last 14 days, and have crossed/or close to crossing their early reported peaks during last year. The situation was particularly worrying in Maharashtra,” said the Ministry of Health and Family Welfare (MohFW).”These states and UTs were advised to take up immediate and high effective measures to ensure containment of active cases and daily deaths through adherence to the standard clinical management protocol shared earlier with all states and UTs,” it added.The Union Health Secretary highlighted the current trajectory of COVID in the states/UTs, while Union Secretary (Information and Broadcasting) showcased ways of effective behavioural change communication to instill COVID appropriate behaviour among the populace.After a detailed and comprehensive review of the measures taken by the states/UTs, the Cabinet Secretary reiterated the necessity of meticulous and hard work regarding stringent enforcement of containment and surveillance measures, in conjunction with ramping up vaccination and strict enforcement of COVID appropriate behaviour.NITI Aayog Member (Health) Dr VK Paul emphasised on the need for states to follow a protocol for sharing clinical and epidemiological data for a more detailed study of a mutant strain of the virus for genome sequencing. The Union Home Secretary pointed out that the 11 states and UTs that are showing a surge in daily COVID cases have not shown commensurate increase in enforcement of containment activities. He urged the Chief Secretaries and DGs (Police) of the states/UTs for taking appropriate strict action in this regard.The states were also asked to examine Case Fatality Rate (CFR) hospital-wise, devise an appropriate strategy and mitigate concerns regarding late admission in hospitals and non-adherence to National Clinical Management Protocol. The need to formulate District Action Plans with a focus on mapping of cases, reviewing of ward/block wise indicators, 24×7 emergency operations centre, incident command system area specific rapid response team and timely sharing of information was stressed upon.The states were specifically asked to increase testing continuously to ensure that positivity comes down to 5 pc or less than 5 pc; Focus on ensuring RT-PCR tests comprise 70 pc of total tests; Reduce waiting time of test results with regular review with testing labs; Use Rapid Antigen Tests (RAT) as screening test in densely populated areas and where fresh clusters are emerging; All symptomatic RAT negatives to be mandatorily subjected to RT-PCR tests. Ensure effective and prompt isolation of those infected in institutional facilities (Covid Care Centres).”Ensure that patients isolated at home are to be monitored daily. Isolated infected persons to be transferred immediately to health facilities, if required; Ensure that 25 to 30 such close contacts to be traced for each infected person. Tracing of close contacts and their isolation to be done in 72 hours. Subsequent testing and follow up of all close contacts to be carried out. Setting up of containment zones/ micro containment zones to break the chain of transmission,” the officials told states and UTs.In order to minimise the daily fatalities, the states were advised on strengthening public and private healthcare resources.Taking note of the present situation due to the continuous deterioration of the COVID scenario over the fortnight, the Cabinet Secretary pointed out that the current COVID case growth rate of 6.8 per cent in March 2021 has surpassed the previous record of 5.5 per cent (June 2020). The country also reported 5.5 per cent growth rate in daily COVID deaths in this period. While the country was reporting about 97,000 daily new COVID cases at the peak of the pandemic in September 2020, the country has now reached the critical figure 81,000 daily new cases of COVID.Another worrisome aspect pointed out was that Tier 2 and Tier 3 cities along with peri-urban areas have recorded the recent high ruses in COVID cases; the spread of infection from these areas to the rural areas with weak health infrastructure would overwhelm the local administration was also highlighted.The Cabinet Secretary exhorted the Chief Secretaries to galvanize the state administration and to use all resources at their disposal to tackle the recent surge of COVID cases. The need to expand the efforts to departments other than the Health Department through a “Whole of Government” approach was re-stressed at the meeting. It was emphasised that the Centre continues to provide all resources and support to all states and UTs for public health measures and clinical management for fighting COVID-19.