Kerala has so far been successful in containing the transmission of the coronavirus. The number of infected patients has seen a steady decrease while the number of those getting discharged from hospitals has seen a steady increase.
The strategy that the state followed so far was to track people who have been exposed to the virus and their contacts. Those who were asymptomatic were quarantined while those who were symptomatic were isolated and tested. From this, those who tested positive were treated. But the state is set for a shift in the testing strategy.
The state will begin aggressively testing those who have symptoms of pneumonia (especially community acquired pneumonia) and healthcare workers, including those who are asymptomatic. Community acquired pneumonia (CAP) refers to pneumonia that is contracted outside of a hospital environment. The most common symptoms of pneumonia include cough, fever, and breathing difficulties.
Already, Kerala has ramped up tests. On Thursday, 925 samples were collected for testing. This is the highest number collected in a day in the state, ever since March.
Those who are asymptomatic for COVID-19 need to be tested so that they don’t accidentally infect others, especially healthcare workers who are working in the frontlines of the battle against the pandemic. Many of them do not have adequate Personal Protection Equipment (PPE).
“This was the mistake made in Delhi. By the time they began testing their healthcare workers, community transmission must have already started. What the government of Kerala is set to do is to test healthcare workers and also start checking for community acquired pneumonia," a source in the Health department explained.
The state is also gearing up to deal with the influx of Non Resident Keralites (NRK) and restrict the surge in the number of cases as well as community transmission.
State Finance Minister Thomas Isaac told CNBC TV channel that a minimum of 1,00,000 people would fly into Kerala after the lockdown is lifted.
“The current strategy won't work then and has to be revised. Even those who are asymptomatic can transmit the infection to others. The infection can spread to any random person. It's not that they spread the virus to the first or second person with whom they come in contact. Also, the first or second person could be asymptomatic but it could be the fifth person who becomes symptomatic,” the source added.
However, according to Dr Amar Fettle, state nodal officer for COVID-19, the next strategy will depend on the prevalence and incidence of coronavirus.
“Everything depends on prevalence and incidence. At one point in time, both the prevalence and incidence were high in the state. Now, both have been reduced. The strategy would be either relaxed or tightened depending on the situation that emerges. It’s dynamic and we, at this point, can’t make any kind of prediction because the strategy will vary depending on prevalence and incidence,” Dr Amar told TNM.
Prevalence refers to existing cases while incidence refers to new cases.
The strategy, the source in the Health Department further says, for people coming back from the Gulf is very clear: “We have to quarantine them for the scientifically described period, shift them to the medical board if they are tested positive, and if negative, put them under surveillance for the entire quarantine period.”
“If the affluent among the Gulf returnees don’t prefer to live in the government care centers, they can be shifted to hotels at their own expense for infection prevention. This would provide business for hotels and the pressure on the state would be less. Some of them can also resort to private hospitals if they can afford it. This would again reduce the pressure on the state,” said former Health Secretary Rajeev Sadanandan.
"Of course, the state is obliged to look after those who can’t afford either because their remittances have backed our economy. The state will be able to manage the situation well is what I believe,” he added.
The state has identified over 2.5 lakh rooms in various districts which are to be converted into care centres for the NRKs who are set to return.
“Yes, in that phase, too, stringent isolation and testing using both antibody and antigen is the solution. They will be released only when we're assured that there won’t be any transmission through them. We have all the strategies with us - containment, testing, home quarantine and home isolation and lockdown. How we mix it up depends on the situation evolving in the state as well as in the neighbouring districts,” Dr Amar said.
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