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Health Minister K K Shailaja: ‘Was accused of creating panic… time has proved Kerala is on right track’

Kerala Health Minister K K Shailaja speaks to Shaju Philip on how the state managed to flatten the COVID-19 curve and why it is too early to rest.

Written by Shaju Philip |
Updated: April 25, 2020 4:56:30 pm
K K Shailaja, kerala health minister, kerala coronavirus, kerala coronavirus cases, kerala coronavirus success, kerala covid-19 deaths, pinarayi vijayan State health minister KK Shailaja congratulated the entire staff of the Kottayam Medical College for providing the best treatment to the couple.

Kerala Health Minister K K Shailaja speaks to The Indian Express on how the state managed to flatten the COVID-19 curve and why it is too early to rest. Excerpts:

Is the COVID-19 threat over for Kerala?

We don’t think the COVID-19 problem can be solved within a month. At present, our caseload has come down and there is good recovery. Another relief is that there was no community spread as a major chunk of the cases were people from Gulf countries and their primary contacts. At the same time, we haven’t reached a shore of comfort. Cases are going up in neighbouring states. In this scenario, Kerala cannot remain as a safe island. We have to continue our present vigilance and standard operating procedure. I have told our medical teams that we cannot rest considering the huge work before us. I have told them we may have to fight for the next four or five months.

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What is the challenge ahead?

The return of expatriates would be a big challenge for Kerala. We are really distressed by the poignant experiences shared by people from the Gulf. In many bachelors’ camps, ordinary workers were telling me that they have symptoms but were not getting tested. We are ready to bring them back on a priority basis. Also, there are Keralites in other states, especially students presently held up in hostels. They also want to come back after the lockdown. Quarantining all these people would be an unprecedented challenge. We have to ensure enough stock of testing kits when there is a huge inflow of people into the state. Right now, we are handling less than 150 cases, but our planning is for tens of thousands.

How are you preparing for that stage?

We will have a strong screening system in the airport, stricter than the one before lockdown. More teams would be deployed to ensure that not a single person is left out of screening at airports. The symptomatic would be shifted to hospitals and the asymptomatic would go to their homes or common quarantine centres. Earlier, we had provided good facilities at quarantine centres. But in the next stage, when the number of people go up, we may not be able to ensure such facilities to everyone. We would have to convert auditoriums and educational institutions into quarantine centres. We had planned very well but the task is not so simple… Also, my job is to impart enthusiasm to the health workers and medical teams. Because medical teams have been working continuously for the last three months in batches.

How did Kerala manage to flatten the curve?

Our planning and preparedness are the most important factors behind our success. We had planned in advance. In early January, when I heard that a virus had been spotted in Wuhan, a high-level meeting of the health department was held. I could easily sense the danger because there are students from Kerala in Wuhan and some medical students had even approached me in the past for internships. I told the officials that the students usually return during February-March and hence we should be careful. After the 2018 Nipah outbreak in Kerala, reports of virus spotting anywhere in the world is a matter of concern for the state. On January 24, we initiated an action plan, which was taken down to all districts. That worked well and we handled very well all the three positive cases from Wuhan without any of their contacts getting infected.

Kerala coronavirus, coronavirus in Kerala, Kerala Covid-19, Kerala coronavirus Covid-19 curve, Kerala healthcare Coronavirus, Coronavirus Kerala news, Kerala covid-19 news People outside a mobile showroom in Kochi on Sunday. (PTI)

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How did you address the post-Wuhan scenario?

There was an impression that the virus attack was over. As no fresh cases were detected or reported anywhere in India, many advised me to lower the vigilance. But, we maintained a team at the airport for screening passengers although universal screening was not in place then. We got in touch with airlines to announce the screening at Kochi. Some even accused me of creating panic among people through such actions. The Opposition asked me to learn from America and follow that country’s mitigation method… If we had withdrawn that vigilance, the COVID-19 war fronts in Kerala would have multiplied. Only one family escaped our airport screening. We never remained complacent even when cases were not reported. We had trained doctors and other health staff and asked them to remain vigilant if persons with respiratory diseases turn up. When we strictly screened and quarantined people, I was blamed for over-action. But time has proved that Kerala is on the right track and is following the right SOP of screening, quarantining, isolating, tracing and treatment.

Is the threat of community spread over?

At present, there is no community spread. But, we cannot say the danger is over. Now our concern is about growing numbers in the Tamil Nadu districts bordering Kerala. Despite strong monitoring at the inter-state areas, several people from the affected Tamil Nadu districts are sneaking into Kerala. If virus carriers reach Kerala in this manner and go unnoticed, we would be facing the risk of community spread.

coronavirus kerala, kerala lockdown, kerala police drone footage, kerala covid 19 cases, kerala govt novel coronavirus, coronavirus india, coronavirus news, latest news DGP Lokanath Behera operating a drone in state capital Thiruvananthapuram to keep an eye on lockdown violators.

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What about the danger of sudden spurt in cases from unexpected quarters?

So far, we do not see any such chance as we have already quarantined all persons with travel history and continue to test all symptomatic persons. We have already done pool testing, random testing and surveillance testing. Also, pneumonia cases have been tested, but no community spread has been reported so far. Only a few primary contacts of persons from abroad have tested positive. So far, no secondary contacts have tested positive.

Kerala has 16 labs with a total capacity to test around 2000, but only 500-700 tests are being held daily. Why?

We have scientifically planned testing. There are two reasons. If we test someone before he/she develops symptoms, there is no guarantee that such a person would not emerge as a positive case. Sometimes, the incubation period is long and goes beyond 14 days. Secondly, we have to use test kits judiciously. At the time of a pandemic, there is a scarcity of test kits as the entire world is demanding those kits. If we test thousands of asymptomatic persons, in case of an emergency situation demanding testing of hundreds of symptomatic persons, we may run short of testing kits. That would lead to a big crisis and things would go out of control. In many countries, that situation had emerged. Hence, we cannot leave people to fate.

What about the antibody test Kerala planned for one lakh people?

The antibody test is not fully reliable and would create a pseudo-confidence. However, we have not abandoned the antibody test plan. We had ordered kits from a Chinese firm. But, they did not supply at the last moment. Now, we have placed orders with another firm. ICMR had supplied 12,480 kits but when validation was done, some positive cases became negative. We have stopped use of it following ICMR directive.

Read| Behind containment in Kerala: robust healthcare system, effective strategies

Everyone is speaking about the Kerala model of combating COVID-19, what is that model?

We have a people-centred programme in which everyone is a participant. At the outset, we prepared our own protocol and standard operating procedure, which have been followed meticulously. Our state is cash-strapped, but with people’s support, we could bring changes in the health sector. Over the last four years, we could strengthen the network of primary health centres/family health centres with modern facilities and make them people-friendly through the AARDRAM Mission. We have seen MPs, MLAs, local bodies and even rich laymen financially supporting infrastructure facilities at government hospitals.

What has the health sector in Kerala learnt during the COVID-19 fight?

The biggest lesson is that people should be taught about responsible health behaviour. They should be made aware about proper health behaviour at the time of an epidemic. We will come out with an action plan towards that. Also, infection control methods and training would be strengthened in all hospitals. We are planning to stop unhealthy practices of visitors turning up at hospitals in large numbers. Our 62 hospitals have already got certification from National Quality Assurance Standards in the last four years. More hospitals would work towards that.

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