Updated: April 20, 2020 9:29:19 am
Coronavirus (COVID-19): On Sunday, Goa Health Minister Vishwajit Rane tweeted that all patients who tested positive for COVID-19 in the state have recovered and “active number of cases in Goa now stands at 0”. The state had reported seven positive cases.
Chief Minister Pramod Sawant told the media, “I thank all doctors and nursing staff across Goa for continuously putting efforts for the recovery of seven patients. This also doesn’t mean anything is relaxed. The lockdown still continues.”
As of now, test results of 46 samples are awaited and 10 people are in isolation.
From an absolute disadvantage of not having a testing facility in the state, and with no trained microbiologist for RNA extraction, the state’s preparedness, officials say “started with an absolute disadvantage”. The biggest fear, the state administration admits, came from travellers and tourists, both foreign and domestic, with the tourism season still underway. Further, with eight entry points on road — connecting it to Maharashtra and Karnataka, both states with Covid-19 cases as early as March 9, the fear loomed large.
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The process has been a “learning curve”, say government officials as they now prepare for the next “major influx”, of over 8,000 stranded seafarers in Indian ports and foreign vessels in deep sea who have appealed for repatriation to home state, Goa. The Chief Minister Pramod Sawant is being assisted by a chief Secretary led State Executive Committee which is now preparing towards economic revival and planning the next wave of entrants to Goa, including reports coming from Belgaum of increasing number of Covid-19 cases.
With all quarantine now institutionalised with 35,000 hotel rooms ready, the state is also gearing towards preparing paid quarantine facilities, 10,000 additional hotel rooms with less than Rs 5,000 tariff have been identified and are being verified. By this month, it also hopes the orders fill for 300 operational ventilators.
Goa went into lockdown on March 22 and reported its first three cases of Covid-19 positive on March 25: two were from north Goa, and one from south Goa. The last case was reported on April 3, 2020. Of the seven, all male, six were returning from countries abroad, five of them seafarers, and only one having been infected through close proximity.
Unlike other states which had a relief period between March 22 and March 24 – the two initial lockdown dates, Goa has been on lockdown since 7 am, Sunday, March 22. While it put Goa on the national news with people struggling to get food and essentials, health officials want to believe it helped in containing the transmission. “It helped that our first cases came detected under lockdown,” says a government employee part of the Covid-19 response strategy. Till date, 28,538 cases of violations have been reported under lockdown with 804 arrests made.
Goa began collecting swabs from international passengers from January 28, two days before India reported its first infection. Since then, 780 swabs have been collected and tested with only seven turning positive.
In what now looks like an “advantage”, was a crucial decision taken; Instead of relying only on the airport’s Port Officer for Health, the bureaucracy pushed Directorate of Health Services (DHS) to install their own health kiosk with trained teams in three shifts. “It may look like a tiny detail but this integration helped. Unlike other states which started in March, the state government was working alongside airport authorities from day one with DHS teams,” said a senior official from the health department.
The second “crucial backbone” to the state’s quarantine exercise was the strict scrutiny and methodological filing of Self Declaration Forms. “Believe us, this was a life saver” says an airport official. “We relied heavily on the data here and pulled them routinely when we would probe manifestos from airlines which showed positive cases and use the network of Talatis, Mamlatdars and sarpanch to contact trace them. “One field in the form can go wrong, but not all fields. We always found the passenger. Plus, we ensured we took contact details at the airport if anyone showed flu-like symptoms for us to reach them in future,” adds an officer. Initially screening was only listed countries including China and six others, but soon the list grew. All the five flights manifestos were used alongside declaration forms and social media announcements to get to all the “three rows ahead and three row behind suspect passengers”. Home quarantine was made strict from day one with those quarantined getting a phone call twice a day checking on their health, and with notice put on homes later towards March when some complaints started to come. Till date, 1794 have been home quarantined with 202 facility quarantined. Being a tourist state, Goa Tourism Development Corporation’s remote locations helped tremendously for institutional quarantines, officers agree. “The other big contributor is Travel and Tourism Association of Goa whose members informed about tourists at their hotels who showed symptoms. They were visited and their medical and travel history separately checked,” said a health officer.
Chicalim Cottage Hospital, the closest hospital near the airport, became ground zero in initial days with the thrust on travel history combined with flu like symptoms. Contact tracing of the seven positive cases has put around 80 persons from family too in quarantine, and who later tested negative.
To the criticism that the tests were not scaled and still continue to be less, health officials say they “did not go for random testing and decided to focus only those where travel history matched symptoms or respiratory complaints. We had our limitations and we tried to work around them,” adds a health officer. In select cases the national network of ‘Epidemologist’s Integrated Disease Surveillance Team Data’ also flagged cases where a traveler tested positive in another state having traveled from Goa with contact tracing extending in Goa too.
Till the lockdown, swabs were sent as per protocol using a private courier to Pune NIV. Each test took hours and results days. Soon Chief Minister Pramod Sawant’s office liasoned with the Indian Navy through the office of MoS, Defence, Shripad Naik to get Doneirs to fly microbiologists to NIV for training. Today Goa has 4,000 test kits and three trained teams operating the RT-PCR or reverse transcriptase polymerase chain reaction test, with a capacity of 80 tests a day. IT’s an increase from 30 a day since March 29, when the laboratory state’s laboratory started at state run Goa Medical College.
“The first three swabs tested positive in NIV, Pune, but then we conducted the same tests in Goa, and they gave the same results. This validated our confidence that the training had been learnt,” adds a health officer. By April, a south Goa based firm got the ICMR approval towards Truenat Beta CoV test, with the technology now allotted at the Flu OPDs of the state district hospitals, four at north Goa, one in south Goa’s new hospital at Margao where the flu OPD is expected to begin this month. On Saturday, Goa also received 4,000 rapid tests kits which it now plans to use towards SARI and ILI symptom patients, based on a data collection drive the state opted. “We decided to go for Bhilwara Model. Of the 4.4 lakh households surveyed in three days, 40,000 households have showed SARI or ILI symptom patients or patients with other serious fields and now again we are probing the data to zero on who needs to be called for testing,” adds an official.
Among the advantages, officials say “we never depended on the Centre or ICMR for PPE and other safety gears and started creating an inventory ourselves from January. Today we feel safe when we see other states struggling. The other huge advantage is Goan entrepreneurs who are assisting us. The second level testing is being developed in Verna, south Goa. Even our orders for Viral Transmission Medium is sourced from a firm within the state. We get it within six hours of placing the order, this is huge in Covid response,” adds a DHS official. In his gratitude the Health Minister tweeted, “My deepest gratitude to our warriors, the excellent team of dotors headed by Dr Edwin Gomes at ESI Hospital, for working tirelessly to counter the menace of this deadly virus”. Most patients interviewed have spoken with high praise on Dr Gomes and his team of resident doctors and nurses. The other crucial aspect of the fight is the state’s decision to keep testing the Frontline staff continuously. “There are 50 of them in direct contact at GMC and ESI and they have been continuously tested. We are putting our first efforts in ensuring they remain negative,” said a senior official.
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