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Nearly 10% of Health Care Facilities in Punjab Operate Without Required PPCB Permission

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Nearly 10% of healthcare facilities (HCFs) in Punjab are operating without the necessary permission from the Punjab Pollution Control Board (PPCB), as required under the Bio-Medical Waste Management Rules 2016. This raises concerns about the enforcement of these rules. The state has a total of 14,715 identified healthcare facilities, including government and private establishments, as well as veterinary hospitals and clinics. However, only 13,301 of these facilities have been granted the required authorization under the Bio-Medical Waste Management Rules 2016, leaving 1,414 healthcare facilities operating without approval. The PPCB shared these details in an interim report, which was sought by the Punjab State Human Rights Commission after it took suo motu cognizance of a TOI report highlighting healthcare facilities operating without the necessary authorization. Healthcare facilities that generate, collect, receive, store, transport, treat, dispose of, or handle bio-medical waste are required to obtain authorization from PPCB, as per Rule 10 of the Bio-Medical Waste Management Rules 2016. The rules also outline penalties for any violations related to the management of bio-medical waste. All 14,715 facilities collectively generate 24.65 tonnes per day (TPD) of bio-medical waste. Individual healthcare facilities conduct the segregation of this waste at the source. Following segregation, waste is collected and transported to designated common bio-medical waste treatment facilities (CBWTFs) for treatment and disposal. The pollution board monitors the process through 16 regional/field offices across the state. The board submitted that bio-medical waste generated by facilities not having authorization is being regularly collected, transported, treated, and disposed of by CBWTFs under separate agreements executed between CBWTFs and healthcare facilities. Six CBWTFs are operating in the state. Of these, five are authorized to collect, transport, treat, and dispose of bio-medical waste in accordance with the provisions of the Bio-Medical Waste Management Rules 2016. One facility has been authorized to collect and transport waste to four CBWTFs for treatment and disposal due to technical reasons, and a case regarding this matter is pending before the Punjab and Haryana High Court. The board informed that notices have been issued to all healthcare facilities that have failed to obtain authorization or renewal of authorization as required under the rules. The matter is also being taken up by the board with the Department of Health, Department of Animal Husbandry, and Department of Rural Development and Panchayats to issue directions to healthcare facilities under their jurisdictions to obtain authorization under Bio-Medical Waste Management Rules 2016. The pollution board claimed that it is “diligently” implementing bio-medical rules in the state and has adopted measures to ensure that healthcare facilities operating without authorization obtain the same. These measures include setting up helpdesks at regional offices of the board across the state to provide technical assistance to health facilities for submitting authorization applications on the online portal of the board. It also conducts training programs for state officers and occupiers of health facilities for better understanding and compliance with the rules. The commission has directed the PPCB and the Director of Health to file the final and action taken report before the next hearing on September 6.

India Emerges as Global Cancer Capital, Witnessing Alarming Surge in Cases, Reports Apollo Hospitals

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A recent study by Apollo Hospitals reveals concerning trends in non-communicable diseases (NCDs) across India, with cancer cases witnessing an unprecedented rise. The 4th edition of the Health of Nation Report, released on World Health Day 2024, designates India as the “cancer capital of the world.” The report highlights a surge in NCDs such as cancer, diabetes, hypertension, cardiovascular diseases, and mental health disorders, significantly impacting the nation’s health landscape. Disturbingly, one in three Indians is pre-diabetic, two in three are pre-hypertensive, and one in 10 suffers from depression. Key Insights: Cancer cases in India have surpassed global rates, with the country experiencing a surge in diagnoses, particularly among younger demographics. Despite the lower median age for cancer diagnosis, cancer screening rates in India remain alarmingly low. Breast cancer, cervix cancer, and ovarian cancer are prevalent among women, while lung cancer, mouth cancer, and prostate cancer are common among men. Report Findings: Obesity rates have doubled from 9 percent in 2016 to 20 percent in 2023, while hypertension cases have risen from 9 percent to 13 percent during the same period. A significant proportion of Indians are at risk for obstructive sleep apnea, highlighting the need for urgent health interventions. The report underscores the critical need for regular health screenings to monitor conditions like obesity and hypertension, thereby reducing the risk of cardiac-related ailments. Dr. Preetha Reddy, Vice Chairperson of Apollo Hospitals, advocates for collective efforts to combat NCDs through education and personalised preventive healthcare solutions. Dr. Madhu Sasidhar, President & CEO of Apollo Hospitals, emphasizes the importance of innovation in preventive healthcare and improved accessibility, leveraging technology for accurate diagnosis and patient-centric treatment methodologies. The findings of the report underscore the urgent need for unified action to address the growing epidemic of NCDs in India. Prioritising investments in health infrastructure, promoting preventive healthcare measures, and addressing health inequities are crucial steps towards sustainable development in the health sector.  

Decline of COVID-19 Variant JN.1 as Emerging Subvariant Takes Hold

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The prevalence of the dominant COVID-19 variant, JN.1, is waning as an emerging subvariant gains ground, signaling a shift in the trajectory of the pandemic. JN.1, which surged in the U.S. late last year, has seen a significant decrease in its contribution to new COVID-19 infections. Estimates from the Centers for Disease Control and Prevention indicate that JN.1 accounted for 86% of new cases over the past two weeks, down from 90% at the beginning of March. This variant, closely related to BA.2.86, had previously driven infections during the fall and winter months. Now, JN.1 is ceding ground to a subvariant, JN.1.13, which has experienced a notable increase in recent weeks. From comprising nearly 2% of new cases last month, JN.1.13 has risen to nearly 11% over the past two weeks. Additionally, another descendant, JN.1.18, has witnessed a modest uptick, albeit to a lesser extent, representing less than 2% of new infections in the same timeframe. Despite the emergence of various subvariants, overall COVID-19 transmission is declining across most regions of the U.S. While respiratory illness levels remain elevated in many areas, key indicators for the virus are on a downward trend. Weekly hospitalizations due to COVID-19 have decreased by nearly 14% in the past week, marking the first time new admissions have fallen below 10,000 since July 2023. Furthermore, recent data released by the CDC indicates a rise in life expectancy in 2022, attributed in part to a decline in COVID-19 mortality. Although this increase marks a reversal from the pandemic’s earlier impacts, it represents only a partial recovery from the losses incurred during the pandemic’s peak.

Tamil Nadu Health Department Issues Advisory Amid Monkey Fever Surge in Karnataka

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The Tamil Nadu Public Health Department has raised concerns over the increasing cases of Monkey Fever (Kyasanur Forest Disease) in neighbouring Karnataka districts, prompting the issuance of an advisory to Tamil Nadu forest authorities and local bodies in bordering areas. As Monkey Fever cases surge in Karnataka, with two fatalities and 103 hospitalizations reported in Shivamogga, Uttara Kannada, and Chickmagaluru districts, the threat looms large over Tamil Nadu’s border villages. A joint study by the Indian Council for Medical Research (ICMR) and the National Institute of Virology (NIV) has confirmed the presence of the virus in Mysore and Hassan districts of Karnataka, adjacent to Tamil Nadu. To mitigate the risk, health and forest authorities have intensified surveillance along the Tamil Nadu-Karnataka border, particularly targeting forest personnel, anti-poaching watchers, and guards, who are at higher risk due to their proximity to wildlife habitats. The Mudumalai Tiger Reserve (MTR) in the Nilgiris, Tamil Nadu, shares borders with the Bandipur National Park in Karnataka, where about 200 field staff operate daily, potentially exposing themselves to the virus carried by monkeys, rodents, and shrews. With the approaching dry season and forest fires, which can exacerbate the spread of ticks carrying the virus, the coming months pose heightened risks for field staff. Although vaccination against Monkey Fever was administered to forest personnel in the Nilgiris until 2020, the practice was disrupted by the COVID-19 pandemic. Monkey Fever typically manifests symptoms like chills, fever, headache, severe muscle pain, vomiting, gastrointestinal issues, and bleeding. While there’s no specific treatment, early hospitalization and supportive therapy are crucial for managing the disease.

India Witnesses Third COVID-19 Wave, Officials Confirm JN.1 Variant Impact

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As India grapples with the ongoing challenges posed by the COVID-19 pandemic, official sources have confirmed the emergence of the JN.1 variant. However, reassuringly, the available data suggests that this variant is not causing an exponential rise in new cases, nor is it associated with a surge in hospitalizations and mortality rates. India has experienced three distinct waves of COVID-19, with the most significant impact observed during the Delta wave in April-June 2021. At its peak, the country reported a staggering 4,14,188 (4.14 lakh) new cases and 3,915 deaths on May 7, 2021. The latest data indicates that the JN.1 variant is not leading to a scenario similar to the Delta wave peak. This information comes as a relief amid concerns about the potential impact of new variants on the country’s healthcare system. Since the onset of the pandemic in early 2020, India has witnessed more than 4.50 crore people contracting the virus, with over 5.30 lakh fatalities recorded over the course of about four years. This underscores the persisting challenges and the need for ongoing efforts to combat the spread of the virus and mitigate its impact on public health. As the situation continues to evolve, health authorities are closely monitoring the spread and characteristics of the JN.1 variant. The confirmation that the variant is not currently associated with a severe increase in cases provides valuable insights for public health strategies.

Health Minister Mandaviya Chairs High-Level Meeting on Preparedness for COVID-19 Variant JN.1 in India

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In response to the emergence of the COVID-19 variant JN.1 in India, Health Minister Mansukh Mandaviya convened a virtual high-level meeting on Wednesday to evaluate the current status and preparedness for the evolving situation. The meeting was attended by MoS (Health) Prof SP Singh Baghel, Health Minister of Uttarakhand Dr. Dhan Singh Rawat, ICMR DG Dr. Rajeev Bahl, Member (Health) NITI Aayog Dr. V K Paul, and former WHO Scientist Dr. Soumya Swaminathan. As India grapples with a surge in fresh COVID-19 cases, the meeting aimed to foster a collaborative “Whole of Government” approach in close coordination among various states. The attendees discussed the importance of vigilance without causing panic and emphasized the need for comprehensive preparedness measures. Minister Mandaviya stressed the significance of unity and collaboration, stating, “It is time to work together in a ‘Whole of Government’ approach, through closely working with each other. We need to be on the alert, but there is no need to panic.” He urged the implementation of mock drills for hospital preparedness, increased surveillance, and effective communication with the public. Notably, he proposed conducting mock drills in all hospitals every three months to enhance readiness. Acknowledging the gravity of the situation, the Health Minister assured full support from the Central Government to the states. The meeting addressed the necessity of proactive measures, given the reported death of an individual in Karnataka’s Bengaluru on Wednesday, who was not only affected by COVID-19 but also had co-morbidities. The gathering highlighted the collaborative efforts of state health ministers and key health officials, aiming to ensure a coordinated and efficient response to the challenges posed by the emerging COVID-19 variant. As India remains vigilant against the evolving scenario, the commitment to preparedness, regular mock drills, and enhanced communication strategies underscores the nation’s determination to combat the pandemic effectively. The proactive approach advocated by Health Minister Mandaviya aligns with the evolving dynamics of the pandemic, emphasizing the need for continuous preparedness and a united effort in the face of emerging variants.

Polio Remains a Public Health Emergency of International Concern: WHO

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The World Health Organization (WHO) has issued a report stating that the risk of the poliovirus spreading internationally remains a significant concern for public health. Currently, there are no travel restrictions in place for Pakistan. The potential for the international transmission of Wild Poliovirus type 1 (WPV1) in Pakistan, Afghanistan, and Africa is influenced by various factors. One of the reasons for polio transmission in Pakistan is the ongoing spread of the virus from eastern Afghanistan across the border. Additionally, there is a worrisome number of unvaccinated children in southern Afghanistan, posing a continuous risk of WPV1 reintroduction in that region. The report highlights suboptimal immunization coverage during vaccination campaigns in southeastern Africa, specifically in Malawi, Mozambique, Zambia, and Zimbabwe, which may lead to insufficient population immunity to stop transmission. In Pakistan, a new WPV1 case was reported in Khyber Pakhtunkhwa province on February 20, 2023. Furthermore, environmental surveillance has detected three positive samples in 2023, two in Punjab and one in KP, with two of them linked to viruses circulating in Afghanistan. In Afghanistan, no new cases have been reported in 2023, with the last case occurring on August 29, 2022. However, there have been 18 positive environmental samples in 2023, all from the eastern region, with three from Kunar and 15 from Nangarhar. Regarding the WPV1 outbreak in southern Africa, there have been no new cases reported since August 10, 2022, in Mozambique. To mitigate the risk of polio spread, the WHO committee recommends that all residents and long-term visitors (staying more than four weeks) of all ages should receive a dose of either bivalent oral poliovirus vaccine (bOPV) or inactivated poliovirus vaccine (IPV) between four weeks and 12 months before international travel. Travelers should also obtain an International Certificate of Vaccination or Prophylaxis as proof of vaccination. The committee emphasizes the need to restrict international travel for residents lacking appropriate polio vaccination documentation at the point of departure, regardless of the mode of transportation.