“Karimnagar was the first place where lockdown and containment were put in place. I salute the officials there who managed to ensure zero fresh cases over the last few days, without a single death. We are 100% successful in Karimnagar and it has emerged as a role model in the country. We have learnt lessons from that and we are quite successful.”
This was one of the first things that Telangana Chief Minister K Chandrasekhar Rao (KCR) said as he addressed reporters in Hyderabad on Tuesday.
Karimnagar shot into the limelight in March after a group of religious preachers from Indonesia belonging to the Tablighi Jamaat congregation tested positive for coronavirus. After attending the event in Delhi, the group took a train, along with three Indians, from Delhi to Ramagundam and travelled to Karimnagar, where they stayed for two days. Nine of the Indonesian nationals and one of the Indians tested positive for the virus.
March 17 was a crucial day in the pages of Karimnagar’s battle against the disease because the fifth COVID-19 case was registered in the state with one of the Indonesians testing positive. From then, the state saw a steady spike in the spread, raising concerns.
In a span of 50 days, over 540 samples were tested and over 130 persons were placed in isolation at the District Hospital in Karimnagar while over 835 were placed in home quarantine.
The district also became a bedrock to the communal spin to the COVID-19 spread in the state as well as in the country, but has had no positive case for the last 20 days. The last positive case was recorded on April 15. So far 18 patients have been discharged after treatment at Gandhi Hospital in Hyderabad.
Today the district has only a single active case with a flattened curve.
Karimnagar Collector Shashanka K spoke to TNM about the containment measures and strategies that the authorities followed in the 50-day long battle in the district.
There are no fresh cases in the last 14 days in the district, which was once called a ‘hotspot’ for the virus. What helped?
There are three factors. Since the beginning, we had support and guidance from the state starting from the Chief Minister to the Health Minister and the Civil Supplies Minister. Second factor was that it was a team effort with a focused approach. District administration, police, Health department and the Municipal Corporation worked together, there was no scope for miscommunication.
Thirdly, continuous dialogue with elders, community leaders, and religious and public representatives helped. We had a lot of support from the community, with many coming forward voluntarily, which is an advantage.
What were the crucial areas in the district?
Against 19 cases, we had eight containment zones in the district – four in Karimnagar city and another four in Huzurabad. The spread was limited to urban areas, specifically these pockets.
We were firm and methodical when we did the containment because ours was the first containment zone in the state.
Was there any difficulty in doing the contact tracing for the Indonesian patients, monitoring them or bringing them to quarantine?
It was new for everyone, for us and for the community. We were also learning as we worked. The first case (Indonesian) tested positive on the afternoon of March 17. On the same day, by evening, we started contact tracing and identified around 73 primary contacts in two to three days. Later, 19 people were identified as attendees of the Tablighi Jamaat Delhi event.
Members of the Health department’s Integrated Disease Surveillance Programme (IDSP) were roped in and they worked closely with the police, revenue and municipal departments to map out who moved closely with whom.
If we put up the same rules for everyone, people will comply. That is what my limited experience as an officer has taught me. Firm containment in 600 meters around the epicentre which covered 3,600 households also helped to prevent the virus’ spread, since 70% of the primary contacts were from that area.
We also took up a special sanitisation drive, and 50 medical teams were roped in to do a rapid fever survey to check if anyone had influenza-like symptoms. Thousands were screened.
How was the crucial zone contained?
There is no point if people come out even after we declare it a containment zone. If we want to keep people home, the first thing we have to do is to ensure that essentials are delivered to their homes.
Municipal Corporation staff were roped in with due bodysuits/PPEs, they delivered vegetables free of cost. Milk points and kirana (grocery) points were opened later, from where municipal staff did home delivery as per phone orders. COVID-19 awareness campaigns were carried out both in Telugu and Urdu.
Seventy-three people who came in contact with the Indonesian patients were placed in quarantine and tested twice in 28 days – first in 5-14 days and second time in 14-28 days – leading to diagnosing two cases.
We had a 250-bedded quarantine facility in the district headquarters. Wherever there was a case, we declared it a containment zone and followed the same Standard Operating Procedure (SOP) with Micro Containment Planning (MCP).
MCP clearly classifies and indicates who should do what in line with World Health Organisation (WHO) guidelines, which has been adopted by the Union Health and Family Welfare ministry and the state government. Call centres were set up to address all sort of queries pertaining to COVID-19 concerns and to engage with the people.
While the present SOP and modalities are being hailed, is the district administration considering reviving containment measures such as extending the number of quarantine days?
We go by the severity of the scenario on the ground. As on date, we have tested 542 samples and seen 19 positive cases, our last case was on April 15. If we come across more positive cases in the near future we may consider it, but it depends on the state guidelines. The state has ordered a 28-day quarantine and that’s what we are following as of now.