On Wednesday, Telangana recorded eight new coronavirus patients. However, it is P-5 who has become a cause of worry for the state.
The religious preacher from Indonesia, part of a group of 10, was travelling across Karimnagar for at least three days before he tested positive. While seven others in the group have also since tested positive, it is tracing P-5’s direct and secondary contacts that has become a tedious task. It does not help that the state government is not forthcoming about information related to P-5, or for that matter the three other active cases before him.
While health minister Eatala Rajender did hold a press conference on March 17, his first since March 12 when there was just one active patient, he was still a bit stingy with information. In the five days between the two press conferences, there were just statements from his office or the CM’s office to figure out what was happening. From March 12, the office of the director of Public Health has been displaying a print-out outside, stating visitors would not be allowed till March 19. To everyone’s surprise, the media too was not allowed.
During the march 17 press conference, the minister said flow charts showing movement of patients before they were tested positive were unnecessary. Even as the Director of Public Health, Dr. G Srinivas Rao, waved the charts at the reporters, indicating that all protocols were being followed, the minister said: “We have all the information, and need not tell you everything. People will get panicky.” Further, Dr Rao said the patient could have visited hundreds of locations, the minister added, “We are on the job and we are serious about it.”
As a reaction to journalists telling him before the press conference that there was a lack of information, the minister started the conference assuring media that medical bulletins will henceforth be regular. However, a day later, the minister refused to give the number of primary and secondary contacts of the Indonesian national. Answering repeated questions, he said: “The patient has travelled by train from Delhi to Ramagundem in Telangana via Bhopal and stayed in Karimnagar district for two days. The bogey he travelled in and fellow passengers have been identified. We have shared the information with other states too. We will inform you when we have full information.”
One reason for this lack of information could be traced back to the state’s first Covid-19 case on March 2. There was widespread panic and even a lockdown in the area after it was known that the patient was a resident of Mahendra Hills near Secunderabad.
On the positive side, today morning, the official handle of the minister for health tweeted out saying the government has set up chfw.telangana.gov/homeCorona.do, a one-stop portal for all information related to Covid-19 from preventive measures to helplines.
Stressed how information dissemination is ‘absolutely critical’, former Union Health Secretary K Sujatha Rao told indianexpress.com that there has been a measure of carelessness in Telangana. “This is not just about the epidemiology of the virus… where is it circulating, among whom, how virulent is it among different age groups, and what are the modes of transmission… there is a need for people to know about how many tests have been conducted, the details of who is positive and what action is taken.”
She said some of the unnecessary tension that prevailed in the state could have been avoided. “For example, there was no information on what action was taken to sanitise and isolate individuals that came in contact with the patient who came from Karnataka and went back and eventually died. This has created some unnecessary tension… such situations should be avoided.”
While highlighting that not sharing information about the patient’s history of local travel is the government’s conscious choice, Dr. Ramana Dhara, professor at Indian Institute of Public Health (IIPH-Hyderabad) and adjunct professor at Atlanta’s Emory University, said it was the failure of the government to intervene and reassure the public that led to panic in Mahendra Hills. “The Mahendra Hills case is one of social stigma, just like the Chinese were stigmatised. The best way to counter this is for the health officials to provide accurate scientific information that the virus is not airborne and that measures like home quarantine, social distancing will effectively contain the transmission,” the professor said.
Former vice-chairman of the National Disaster Management Authority (NDMA) Dr. Marri Shashidhar Reddy, however, feels the number of cases confirmed as positive in Telangana could be misleading. He pointed out that a lot of people were being turned away after checking their travel history, despite showing flu-like symptoms. According to him, doing so would negate the efforts put in reaching out to all those persons traveling into the country. “Do not go just by the travel history and turn away people to save on the kits. The kits do need to be used judiciously but we cannot take such huge risks,” he said.
Telangana does have the capacity to test 450 samples a day in five different labs, but the samples tested currently per day are much lesser. Echoing similar views as Dr. Reddy’s, Dr Ramana too said
unless you test, you don’t detect positive cases. “The debate if India has moved from stage 2 to stage 3 transmission can only be put to rest if you test widely. If you don’t test, you don’t find cases.
Coronavirus illness will mimic flu-like illness. So testing capacity has to be drastically increased. Everyone meeting the government of India criteria like travel history, history of contact with the positive case, etc should be tested,” he asserted.
Commenting on the Kerala model of aggressively dealing with the virus, Dr Ramana said a widespread epidemic like Covid-19 requires such an aggressive approach. He pointed out that the number of cases in Italy had started rising unexpectedly and should be a lesson for all. Agreeing with Dr Ramana, Dr Reddy said Italy did the mistake of taking Covid-19 lightly. “It was a very unfortunate, irresponsible and regrettable statement from Chief Minister K Chandrashekhar Rao when he asked people to not worry and take paracetamol. One of the reasons for the spread of the virus in Italy is that initially, they started doing self-medication by taking Brufen. Do not spread panic but do not say such things as well,” Dr Reddy added.
According to him, the state government should explain the local travel history of patients. “We learn from the experiences of others. If a Covid-19 positive has traveled to X place before detection and isolation, let the information out so that someone who sees that and had also visited the place at that time, could be careful and isolate himself at home,” he added.
Admitting that transparency is the key, Dr Ramana said it is an information vacuum that leads to a situation where conspiracy theories and treatment discoveries start spreading. In Telangana, three persons were arrested by Bhongir police on March 16 for spreading fake news and another similar case is registered elsewhere too. “The best way to counter this is by providing good scientific information,” said Dr. Ramana.
The president of the Telangana chapter of Indian Medical Association, Dr. E Vijayendra Reddy, while maintaining that transparency is important, said the government is in a fix. “It is very important that no panic is created. The government must do justice to its people and also take care of the patients,” he stated. However, hinting that the government is doing a good job, he said what is more important than discussions is that all precautions are taken sincerely and the State is prepared for any eventualities.
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