Last Tuesday, when a 38-year-old woman tested positive for COVID-19 in Dakshina Kannada, it became clearer to authorities that many cases in three districts in the coastal belt of Karnataka were linked to one hospital - First Neuro Hospital, a dedicated neurosciences health centre located in Padil in Mangaluru.
15 cases in Dakshina Kannada district are directly linked to the hospital. 29 more cases in Bhatkal in Uttara Kannada are also linked to the same hospital.
First Neuro’s 200-member staff have been quarantined in the hospital’s premises for the past three weeks. But the district administration in Dakshina Kannada is yet to pinpoint the source of the virus despite testing more than 800 people in connection with this cluster.
They are still investigating the source of the transmission, whether it started from patients who received treatment in the hospital in the last two months or if they had come into contact with someone who has the virus.
“The source of the infection is still inconclusive. We are looking at whether the source is from Bantwal where the first two deaths were reported in the same family. But we are also looking at other sources since First Neuro Hospital takes in patients from many places including Uttara Kannada, Udupi and Kasargod in Kerala,” Dakshina Kannada Deputy Commissioner Sindhu Rupesh told TNM.
Three members working in First Neuro have tested positive for the virus, according to the DC.
A six-member committee led by Dr. Ramachandra Bairy, Dakshina Kannada District Health Officer, is currently examining the hospital’s link to the cases emerging in the district. In addition, a group of experts from the RGICD are also examining the cases but have made no breakthrough on P-0 in this cluster.
First Neuro Hospital being sealed off in April
First Neuro patient from Bantwal tests positive
Speaking to TNM, Dr. Rajesh Shetty, the Managing Director of First Neuro Hospital says that a 75-year-old woman from Bantwal in Dakshina Kannada district, was admitted in the hospital on March 8. This patient did not report with symptoms of coronavirus and was receiving treatment for other ailments.
She was shifted to the ICU of the hospital on March 18 and was shifted to a ward when her condition improved on April 1. A day later on April 2, her daughter-in-law, a 50-year-old woman, visited her in the hospital for the first time since she was shifted out of the ICU. “The woman was asymptomatic when she visited the hospital so we did not know at the time about any link to the coronavirus,” says Dr. Rajesh Shetty.
More than two weeks later on April 18, the daughter-in-law was admitted at the Wenlock District Hospital in Mangaluru after she was diagnosed with Severe Acute Respiratory Infection (SARI).
A day later on April 19, she died at the hospital. Following her death, her test results showed that she was COVID-19 positive.
“It was only around this time we realised that the woman who died had visited our hospital. The police told us that there has been a death and the patient was related to one of the patients admitted here,” adds Dr. Rajesh.
Soon after, the mother-in-law who was being treated at First Neuro Hospital was shifted to Wenlock District Hospital on April 22 and succumbed a day later. She too tested positive for COVID-19.
Dr. Rajesh says that the hospital was sealed off and the staff were quarantined inside soon after the death was reported. He also says that the hospital has shared information with the district administration from February 1 about the out-patient department and in-patient department patients at the hospital. "We take in patients from Kerala, Udupi and Uttara Kannada like many hospitals in Mangaluru and we have shared the information with district authorities," Dr. Rajesh says.
Following the death of the 75-year-old woman, the district administration scrambled to compile the details of the patients who have visited First Neuro Hospital in April. “As soon as the second death was reported, we collated the information of IPD patients from April 1 to April 23. This information was shared with neighboring districts on April 27. The data about OPD patients was shared on May 5 since we took some time to collate it. There was no delay in this process,” Dr. Ramachandra Bairy, Dakshina Kannada DHO told TNM.
Cases in Uttara Kannada linked to First Neuro
On April 20, a family of three from Bhatkal in Uttara Kannada district including a couple and their five-month old baby visited First Neuro Hospital. The trio had travelled with permission from authorities and had spent the day in the hospital from 9 am to 3 pm and returned to their residence in Uttara Kannada on the same day. Two weeks later on May 5, the family tested positive for COVID-19, prompting district officials in Uttara Kannada to examine whether cases emerging in their district had a link to First Neuro Hospital.
“We suspected that this hospital could be the source and we asked the Dakshina Kannada district administration to provide a list of patients from our district to visit First Neuro Hospital in April. 10 people from Uttara Kannada visited the hospital in April and they were tested for COVID-19,” says Uttara Kannada Deputy Commissioner Harish Kumar. Of the ten patients, three tested positive
Officials point out that when the family of three from Uttara Kannada district visited First Neuro Hospital on April 20, the 75-year-old woman from Bantwal who later tested positive for the virus was at the hospital. She was shifted out of the hospital to the designated COVID-19 hospital only two days later on April 22 and she succumbed on April 23.
However, district officials in Dakshina Kannada say that despite indications that the hospital could be linked to the spread of COVID-19 cases in their district and in Uttara Kannada, they are yet to conclusively trace the source of the spread. “It could be through the cases that came through Bantwal but it could also be through the cases that spread in Uttara Kannada. Since the hospital takes many patients from Kasargod in Kerala, the source could be from there too,” says Dakshina Kannada DC Sindhu Rupesh.
Dakshina Kannada DC Sindhu Rupesh also says that the source could be from a patient from Kasargod, Kerala visiting the hospital. “We have shared information with Kasargod district too about the patients who visited this hospital. We are yet to hear whether their test reports have returned negative,” says Sindhu Rupesh.
“We can see it from a different perspective also.The patients from Uttara Kannada who visited First Neuro Hospital could have been infected from a different source in Uttara Kannada itself. There was another person in their family who earlier tested positive for the virus,” says Dr. Ramachandra Bairy, Dakshina Kannada DHO told TNM. However, this claim is not corroborated by district officials in Uttara Kannada.
In addition, the district administration of Dakshina Kannada is not counting the cases that emerged from Bantwal among the cases linked to First Neuro Hospital and are waiting for clarity on the source of the virus before establishing the link. "If we count the cases from Bantwal, then the number of cases linked to this hospital will be more. We want to pinpoint the source of this spread but more importantly, we want to contain it,” Sindhu Rupesh adds.