Kerala sets its sights on containing Wuhan coronavirus

At a hospital in Kochi, workers in protective gear dispose of garbage from an isolation ward for persons suspected of having the n-CoV infection, on February 4.

With Kerala reporting the first three confirmed cases of the Wuhan coronavirus infection in India, and with 93 persons under observation in government hospitals and 2,435 more under home quarantine in various districts, the State administration and the people are keeping their fingers crossed and hoping that tireless, sustained containment efforts will help check the deadly respiratory infection from spreading.

State Health Minister K.K. Shylaja said after a review meeting of the Corona Virus Rapid Response Team that 16 more persons had been admitted to government hospitals on February 5, taking the total number of people under observation in hospitals to 93. Samples from 223 persons suspected to have contacted the infection were sent for testing. Of the 196 results announced so far, 193 were negative. No fresh positive cases were reported in the past two days in the State.

According to information available with the government, 2,528 people have reached Kerala from regions known to be under the sway of the tentatively named ‘2019 novel Corona Virus’ (2019-nCoV). Of these, the largest numbers are in the districts of Malappuram (357), Kozhikode (316), Ernakulam (315), Thrissur (230), Kollam (213), Alappuzha (182), Thiruvananthapuram (189) and Kannur (162).

Following the World Health Organisation’s declaration that the 2019-nCoV outbreak is a Public Health Emergency of International Concern, Kerala, on February 3, declared the outbreak as a “State Calamity”. It emphasised the need for extreme alertness by the people and the State government machinery to follow the containment guidelines after three students of Wuhan University in China returned to their homes in the State with the infection.

Wuhan, where the virus is said to have originated, is a city of over 11 million people and a transportation hub in Hubei province in central China. The three students who returned from Wuhan are now in hospitals in Alappuzha, Thrissur and Kasaragod districts, and their condition has been described as “stable” or “satisfactory”. One of them, for instance, had reached Kerala in the last week of January, travelling first to Kolkata and taking domestic flights to Bangalore and Kochi, and then taking a train to his home in Kanhangad in Kerala’s northernmost district.

The State Health Department is finding its resources stretched to the limit, now that it has to trace every person who has come in contact with those who have returned from nCoV-affected areas. Even otherwise, there are reports of people who have returned from China recently refusing to heed the government’s health advisory, especially regarding reporting and testing themselves at the nearest government facility immediately on arrival and quarantining themselves at home for 28 days.

On February 4, health authorities were startled by the news of two people who returned from China and supposed to be in home quarantine leaving for Saudi Arabia. Some others were reported as insisting on attending weddings or revealing only after seeking treatment in private clinics that they had been to China recently.

In a State facing a severe financial crisis, categorising the infection as a State calamity also makes available additional financial resources for the containment effort, as the State Disaster Response Fund can now be used for it. The Health Minister has also called for immediate Central assistance to sustain Kerala’s focussed efforts to tackle the emergency.

Given the lack of clarity on the actual number of people who have returned to Kerala either from the worst-affected regions in China or from other countries that reported the infection, and the many others who have come in contact with them, Kerala needs to continue to be on high alert, the Health Minister said. However, there was no cause for concern as the State was fully geared to tackle the situation, she said.

Kerala perhaps accounts for the largest number of Indian students doing professional courses in China and their return home is as much a matter of relief for their families as it is a growing cause of public concern even as 2019-nCoV infection spreads to other parts of the world.

The Health Minister said the State Government’s priority was to provide necessary health care to those who had returned from Wuhan, ensuring that there were no deaths as a result of the infection and that the infection did not spread among the people.

Kerala won praise for effectively tackling a similar public health emergency following outbreaks of the deadly Nipah virus in the past two years, with early detection and prompt containment efforts focussing on the review of each case, tracing everyone who had come into contact with the infected person and putting them on observation, and setting up emergency quarantine and hospital facilities.

A similar back-to-the-basics approach for infection control was put in place immediately after the first positive case of the 2019-nCoV was identified. But the tasks involved, especially in contact tracing, creating awareness about the need for quarantining, and providing training to health care and hospital personnel may prove to be more difficult this time, even as other States have been asked to ‘replicate the Kerala model’ for containing the infection.

The respiratory virus is already known to have claimed the lives of 563 people in China and infected more than 24,000 people in at least 24 countries.