On March 15, in a circular that listed a number of guidelines and restrictions for the people of Tamil Nadu to avoid contracting the coronavirus, the state government also advised the public against travelling, even within the country. The government had earlier asked residents to avoid non-essential international travel and crowded public places within their own cities and towns.
While this advice places further restrictions on residents, experts agree that it is necessary to avoid an unmanageable burden on the public health system.
Speaking to TNM, Dr Vijayalakshmi, a senior consultant on Infectious diseases from Kauvery hospital says, "So far, the state is receiving a lot of patients who actually travel at the national level and come back with respiratory problems. The existing guidelines do not allow for them to be tested for the virus as they do not have a travel history of going abroad. However they could have still contracted it from someone else who has been in contact with a carrier of the virus in other states."
The doctor says that private hospitals are notifying the government when such cases come to their notice and instructing the patients to stay under home quarantine.
"So far, the suspected cases in Tamil Nadu are from upper class, upper middle class and middle class," says Dr. Vijayalakshmi. "In such cases home quarantine is suitable. But if people from underprivileged backgrounds begin contracting it, they will not have the adequate infrastructure, a separate room, ability to skip work or work from home, to quarantine themselves. If this spreads to the poor, it will become extremely difficult to handle. Avoiding travel is a way to protect them as well," she adds.
The lack of a spot test for influenza in the country also proves problematic, as it cannot be immediately ruled out, the doctor says.
Dr Sylvia Karpagam, a public health researcher, says that there are two issues as far as travelling even within the country is concerned. The first of course is the risk of you contracting the virus and the second is the possibility that you spread it to others when in an asymptomatic phase.
"The community spread of the virus has already started, so we need to increase precaution now to avoid further damage," she says. "Initially the government tried to isolate people coming from abroad with the virus, but when it spreads beyond these patients, they have to take the next step. They discourage travel as much as possible because when we get the infection, we take it back to our community. If I go home and I am in contact with elderly people I become an agent which spreads the virus," she adds.
The researcher points out that most state governments are unprepared for such public health issues.
"Preparation for public health must start before and not during an outbreak . We need to send out regular messages and keep people informed about necessary hygiene measures. Tracking down people after they get the virus is not always possible. Even if the government tells you not to travel, finally the decision is in the hands of the people," she adds.
Director of Public Health in Tamil Nadu, Dr K Kolandasamy also points out that despite advice given to the general public, travel has been a sore spot.
"Even elderly people, who know that they are at risk if they contract the virus, call me asking if they can go to a public event or travel to meet children in another state or in another part of the state. This is despite having no urgent need to do so. We are constantly telling them to avoid any such plans," he says. "We have been constantly saying - non-essential travel must be avoided. Whether it is to a mall in the next street or a wedding in the neighbouring state."