Kerala CM Pinarayi Vijayan recently voiced concerns over three COVID-19 patients who flew into the state from Abu Dhabi on May 16, and withheld their health status from officials. They allegedly knew they were COVID-19 positive, landed in Thiruvananthapuram, and were tested only after health officials overheard their suspicion-inducing conversation while shifting them to quarantine centres. “It is a serious matter that these patients were able to board the flight. The state government will take it up with the centre which has to take it up with foreign governments,” Pinarayi said in his press meet on Monday.
Following the incident, TNM got in touch with Dr Amar Fettle, the state’s nodal officer for COVID-19, who said that in reality, the government had no control over the screening protocols of passengers in foreign airports, including passengers who were to fly into the state. He added that the only way to filter out cases is to thoroughly screen passengers once they land in Kerala’s airports and avoid any mix up.
“We cannot dictate COVID-19 screening processes undertaken in foreign airports as they are under the jurisdiction of a foreign government. Further, even if a person is tested negative at the source country, they can still contract the virus during travel as there is a fair bit of contact at the international airports and hours spent in proximity inside the flight,” Dr Amar added.
As per the Indian government's protocol for Indians stranded abroad, the Ministry of External Affairs (MEA) prepares a ship/flight based database of registered passengers including their basic details, residence and final destination. They will also collect information on whether an RT-PCR test has been taken and if so, the result of the test. A thermal screening will be done prior to boarding, and only asymptomatic passengers will be allowed to enter the aircraft.
Protocol followed after landing
“We allow self-declaration of passengers who land at Kerala’s airports. At the first checking point, passengers are allowed to declare to airport health authorities if they have a fever. Those who declare that and those are found to be running a temperature during checks are sent to a separate airport isolation bay,” Dr Amar told TNM.
At the next checkpoint, passengers who are cleared in the initial screening are then checked for other COVID-19 symptoms including cough, breathlessness etc. Here too, those who declare any symptoms or are found to have symptoms indicative of COVID-19 are segregated and sent to a separate division of the airport isolation bay.
“The rest of the passengers are then allowed to go through customs and pick up their baggage. They are then directly transported to institutional quarantine facilities in their respective destination districts,” he added.
Meanwhile, those in the isolation bay are directly shifted to dedicated COVID-19 hospitals for testing and into isolation wards, to avoid any mix up. Pregnant women, children below 10 and elderly persons are allowed to go for home quarantine.
Persons avoiding detection
Several patients who returned from foreign countries in India’s Vande Bharat repatriation mission were also found to be asymptomatic, proving to be a bigger challenge for the government which checks for symptoms before immediate testing of patients.
“Symptoms develop late in some people. Other passengers might pop a paracetamol or a cough syrup if they feel that they are coming down with a fever or cough or cold. This will suppress their symptoms for the next eight hours. It is, therefore, difficult to achieve 100% accuracy even while screening people,” Dr Amar said.
Kerala has reported 667 cases of the novel coronavirus, with 161 people currently under treatment in the state. As per the state’s current protocol, all international passengers who arrive in Kerala are to undergo institutional quarantine for seven days, after which they are mandatorily tested for the virus. If found negative for COVID-19, the passenger is allowed to home quarantine for an additional seven days. If tested positive, they are shifted to isolation wards in dedicated COVID-19 hospitals. The guidelines are applicable to all international returnees barring pregnant women, children below 10 and senior citizens.
After three Kollam patients testing positive, samples of 63 passengers who arrived in the same aircraft were taken for testing.
Influx of people will add to challenge
To add to the challenge, Kerala will also see an influx of passengers flying in from abroad in the coming days. Till June 2, 2020, the state is expected to receive 6,530 persons landing in the state from 20 nations.
“We have been informed that 38 flights carrying Indian nationals will enter the state from now until June 2,” Pinarayi said.
Eight flights from the United Arab Emirates (UAE), six from Oman, four from Saudi Arabia, three from Qatar and two from Kuwait and one flight each from Bahrain, Philippines, Malaysia, UK, USA, Australia, France, Indonesia, Armenia, Tajikistan, Ukraine, Ireland, Italy, Russian and Singapore will land in the state in the coming days.