Reworking strategy

Kerala’s effective early strategies helped contain the spread of COVID, but its pressing concern today is preventing community spread.

Published : Jun 17, 2020 18:31 IST

Passengers  arriving from Jeddah by an Air India flight at Kochi International Airport on June 10.

Passengers arriving from Jeddah by an Air India flight at Kochi International Airport on June 10.

Streets are filling up fast, footfalls are rising in offices and supermarkets, and the influx of expatriates is slowly overwhelming health and quarantine facilities as Kerala turns its attention to its most pressing concern today: foiling chances of a community spread of COVID-19.

“Being prepared” has been the State’s most effective strategy from the very beginning, with the requirements of “tracing, quarantining, testing, isolating and treating”. And people adhered to the government’s advisories with remarkable eagerness.

However, the government realises that even the most well-planned containment strategies could fail if the fatigued official machinery becomes slack or people fail to adhere to prevention and control measures.

With the rising demand for liberal entry requirements and quarantine norms for incoming expatriates and a change of attitude among the public regarding containment norms, there is concern about three issues:

One is about the role people without symptoms (who account for over 60 per cent of all those who have tested positive in Kerala) might play in a possible COVID-19 spread; two, about the number of health workers getting infected in the State or being forced to go into quarantine; and three, the possibility of a spread through unknown contacts.

For instance, in Thrissur, one of the worst affected districts, several persons were infected through contacts on June 12. They included four sanitation workers in the civic corporation, four headload workers at the warehouse, one ambulance driver and a remand prisoner.

On June 14, in Kattakkada panchayat in Thiruvananthapuram district, a public health worker tested positive, but despite the district administration’s efforts to find out the source of the infection, no epidemiological link, such as confirmed travel history or contact with known COVID positive cases, could be established.

More than 500 contacts of the patient, spread over six wards of the panchayats, have been traced. All the wards were declared containment zones and the contacts were asked to undergo home quarantine.

The above instances are only indicative. Such cases are being reported in many parts of the State every day.

Until June 16, the State had recorded 2,543 confirmed cases, 1,348 (53.03 per cent of the positive cases) active cases, 1,174 recovered cases (46.17 per cent), and 20 deaths (0.79 per cent). Seven of the 14 districts had over a 100 active cases. They are Malappuram (192), Thrissur (138), Palakkad (155), Kasargod (115), Kannur (110), Alappuzha (107), and Pattanamthitta (104). The highest number of 772 positive cases were recorded in May, but in the first 16 days of June, 577 new cases were detected. The daily spike in the number of cases began after May 18, when the fourth phase of the lockdown began with the easing of restrictions.

The highest daily increase in positive cases was on June 5, when 111 people tested positive. At the same time, the rate of recovery of COVID patients was also increasing. Over 65 per cent of those who died (until June 16) had imported the infection from outside Kerala, 15 per cent had contracted the disease through contacts, and 20 per cent had no travel or contact history. All the 20 persons who died, including a seven-month-old child, had comorbidities. As on June 16, of the 2,543 cases in Kerala, 2,148 (77.93) were those who had travelled from other places into the State and 395 (22.07 per cent) had got the infection from contacts.

Meanwhile, even as the third phase of the Vande Bharat mission to bring expatriate Indians back home began on June 11, as many as 40,653 persons had already registered from other countries. In all, 5,59, 125 persons from other States and abroad had registered in the NORKA ROOTS website for returning to Kerala.

Moreover, Kerala is expecting more than 300 chartered flights to bring 50,000 to one lakh passengers from abroad in the coming days.

COVID Care Centres have been established in all districts with a view to accommodating people who need institutional quarantine facilities. The quarantine status as on June 15 was 1,20,727, with 1,18,704 persons undergoing home quarantine and 2,023 in hospitals.

From June 12, with the increase in the number of Keralites coming from other places testing positive in the State, the governments began allowing them to stay at home, too, if they had facilities there, provided they gave an affidavit agreeing to quarantine regulations.

This need not be a cause for worry, the government said, because Kerala had already proved the effectiveness of home quarantine in its containment efforts, with over 2.5 lakh people staying in home quarantine at one juncture.

In recent weeks, Kerala has allowed inter-district travel, and reopened restaurants and cafes and places of worship on a limited scale. But Sunday curfew continues.

Meanwhile, nearly 4.5 lakh children from State government-run schools and those in CBSE (Central Board of Secondary Education) schools are being offered classes online or through the popular VICTERS television channel. There are, however, complaints of exclusion because of the digital divide, including lack of Internet connectivity or access to devices, and about the handicap of classroom interactions.

Digital initiatives on education

But despite these initial hiccups, the State Education Department’s remarkable effort in reaching digital facilities to nearly 2.5 lakh students who did not have them, providing food at home to anganwadi students, and distributing TV sets and, in some cases digital devices, to underprivileged students with the help of volunteers, are some of the model initiatives in recent months.

With only a few months remaining for the local body elections, the opposition has been trying to pick holes in the State’s COVID containment efforts by highlighting instances where it has been caught on the wrong foot.

The latest instance is the vexed issue of the need to facilitate return of Keralites from other States or abroad, when such an influx is already leading to an increase in infections in the State.

The opposition United Democratic Front and the State unit of the BJP are taunting the ruling Left Democratic Front (LDF) government on this issue, obviously seeking political mileage. This, after the State toyed with the idea of insisting that Keralites who are planning to return by chartered flights should carry with them certificates received within 48 hours showing that they have tested negative for COVID-19.

In the context of concerns over physical distancing in flights among fellow travellers, the idea seemed a prudent one. But opposition leaders described it as “impractical” if not “inhuman”, as in many countries, especially those in the Gulf region, obtaining such certificates was a herculean and costly task and could dash the hopes of those wishing to return home. The case of the returning expatriates is, therefore, a politically sensitive issue in Kerala, which has a huge expatriate population.

Health Minister K.K. Shailaja, however, said that the need for a COVID-negative certificate for those returning by chartered flights was only a suggestion made by the State as a precautionary measure for the safety of passengers travelling in these flights. It was for the Centre to take a final decision on it, she said.

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