On March 31, Kanyakumari reported five cases of COVID-19, and District Collector Prashant M Wadnere braced himself for a possible cluster of cases, he recalled. What followed was rigorous contact tracing, aggressive testing and seamless coordination between agencies to make sure the situation was kept under control, he said.
Kanyakumari district, on April 28, was lauded for reporting zero new COVID-19 cases for 14 days. The last case reported in the district was April 14, which took the tally of the total positive cases in Kanyakumari to 16. Other districts in the state have managed this distinction as well, including Theni, Nilgiris, Erode and Ranipet.
The first five cases in Kanyakumari were reported on March 31 and as of April 28, 10 patients have been discharged on recovery. Of the remaining six patients, none are in critical condition. As Kanyakumari has effectively managed to flatten the curve, TNM spoke to Prashant M Wadnere, the District Collector, about the work that took place behind the scenes.
It has been 14 days since the last positive case was reported from your district. What has the journey between March 31 and today been like for you?
It has been a tough journey. It is not easy to pause people’s normal lives. From the residents’ perspective, it has been difficult. From the administration's perspective, it was a stressful time because we were dealing with the unknown. We did not know exactly how the virus would behave.
Of the five cases reported on March 31, four were attendees of the Tablighi Jamaat event in Delhi. Were you worried about a possible cluster breakout around this group in your district?
We knew that new cases may arise from the event in the district once we started to see infected patients. It was only a matter of time. We were only concerned with how many cases would be reported in Kanyakumari. Hence we put a team of 25 officials, led by a sub-collector, to conduct contact tracing as and when more details arose.
Once we got the list of attendees of the event, we realised that apart from the four men who had already tested positive, other attendees had not yet returned to Kanyakumari. They were all in Delhi. We were fortunate because these men reached Kanyakumari on March 22, but due to the Janata Curfew and the subsequent lockdown, their movements were restricted. Hence contact tracing became easier for us. We identified 30 high risk contacts of these four patients and tested them all.
The fifth case was a man who worked in Chennai airport. He had moved around quite a bit after he reached Kanyakumari — he had attended an engagement function, quarrelled with his family and stayed at someone else’s house. So tracing his contacts was a little more challenging.
We had a total of 223 contacts — high risk and low risk — of these first five patients in the district. We tested all 46 high-risk contacts. Nine people turned out to be positive for COVID-19. Next, we tested the remaining of the 223 contacts, of which two persons turned out to be positive. So all 16 cases reported so far are contacts of the first five patients.
The curfew and the immediate lockdown also helped in curtailing a possible wider spread.
What other measures did the district administration adopt to ensure a larger breakout didn’t occur in the district?
We had a list of who all had traveled from foreign countries, around 4700 people. All of them were quarantined at their houses.
Since the five index patients were all from different localities, we set up five containment zones. The combined population of these containment zones was around 37,000 people and we conducted house-to-house surveillance in these zones, where our workers did daily checks for Influenza-like symptoms (Influenza-like illnesses, also known as ILI).
In the second week of April, we also conducted district-wide surveillance, in which we mobilised around 2,000 personnel from various departments and surveyed all the houses in the district. We found 163 ILI patients whose samples were collected and tested. All returned negative. On April 28, we started the second phase of the ILI survey and 11 ILI samples have been sent for testing. The results are yet to be received.
What about crowded places like the markets and the essential service providers?
We have also tested some proxy cases. Kanyakumari has two major markets — one in Nagercoil and one in Karungal. We shifted the Nagercoil market to a bus stand as it was more spacious. We tested all the vegetable sellers, roughly 311 in number, from both these markets and 75% of the results have returned negative. The remaining results are yet to be received.
We have also tested 232 policemen who are posted in crowded places like markets, checkposts etc., and the results of all have returned negative. We aim to follow up this routine every 14 days to ensure there is no community spread.
Kanyakumari also has a lot of tourists and migrant workers who might have gotten stranded in the district. How did you deal with that?
By March 15, the district-level administration took a call to vacate all lodges and hotels and close for tourism. We acted quite early because we did not want anyone to get stranded here. People were quite disappointed by this, but I am sure they are thanking us now since they did not get stuck here during lockdown.
With relation to migrant workers, a majority of them are from other districts of Tamil Nadu and a few from Kerala. The first thing was to tell them to stay where they were. We have around 9,000 migrant workers in the district engaged in work like fishing, brick kilns and a few other independent labour forms, like selling food items. With the help of our ground staff, we urged them all to shelter in place and told them that necessary goods, like food and water, would reach them.
Running a relief camp is a huge logistical exercise. People have to be dislodged from their comfort zones and put in a large, unfamiliar place with many others. We thought this would increase the risk of the disease spreading and decided instead that individuals should stay in place. We also learnt that about 141 persons did not have a place to stay, and arranged a shelter for them. We had two days to arrange all this.
Due to proper communication and good coordination, we didn’t have migrants walking to their homes from here. The state government’s distribution of rations and cash also helped them survive wherever they were, since they were given money (and not bank transfers) to buy vegetables or other emergency items. That helped us do our work more efficiently.
What next for the district?
It is too early to declare a victory. We are hoping for the best, but are preparing for the worst as well.
The World Health Organisation (WHO) and our own central governments have a set protocol around COVID management. The government of Tamil Nadu also has its protocol based on the state’s needs and wants. This is not a district-specific thing, the way I see it, because there is always a chance of people from other districts coming here once travel opens.
We will see what the state government decides and then take steps based on that.