‘I will say home quarantine is much more effective than institutional quarantine … there is a psychological aspect to this’

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May 29, 2020

Kerala has been a standout performer in the fight against Covid-19. The state’s health minister KK Shailaja, a high school physics teacher  turned politician, explains her administration’s strategy to Rajiv G:

Kerala has succeeded in combating the first two waves. Now, are you worried with the increase in cases?

It is a fact that we had flattened the curve in the first two phases. Now, the situation is different as lockdown restrictions are eased. We are getting people from different parts of the world and also from within the country. The biggest advantage till date was that we have been able to prevent cases through contacts due to strict quarantining of the people.

We know the situation might turn worse in the coming days and there will be a huge increase in the number of positive cases. What we are focussing on is to prevent community spread. For this we will have to get tough sometimes. That was the reason why we maintained certain strict measures while issuing advisories on quarantine. If we succeed in bringing down the cases through contacts then we can say we are safe.

But, we are prepared to face any situation. When we say we have put 84,258 people under observation it literally means that each of them is in our radar. Even if a single person flouts the norms, then our machinery will find out. I don’t think any state can monitor such a large number of people individually. You will not believe that we are ready now to treat 5,000 positive people. That is the planning we have done.

What is Kerala’s biggest strength in dealing with this situation?

The advantage of the state is its very strong primary healthcare system and the support we get from the local bodies. This is why Kerala stands apart from other states in the country. Can you imagine a strong workforce of nearly 10,000 people like Asha workers and our junior public health nurses manning the healthcare system at the grassroots? The details of all people who are under quarantine are at the fingertips.

We also have the support of a strong network of hospitals. Each district administration is working round the clock to assist the health department. Imagine the way our officials developed the route map of the patients who tested positive, to trace their contacts. This later became a model for the entire country.

There is not even a single incident reported in the state of people passing through entry points without coming in the radar of these officials.

However, I must say the biggest strength of the state is our people. They have become much (more) health literate now and have become health volunteers too. We get so many calls in a day alerting us that the neighbour under quarantine has stepped out of the house. The awareness level is so high among the people.

Haven’t there been differences with the Centre on home versus institutional quarantine?

I will say home quarantine [HQ] is much more effective than institutional quarantine [IQ]. The state has proved that through home quarantine we could bring down the cases and also prevent community spread. A sense of fear will be there for the person who is under HQ that he could infect his near and dear ones if he doesn’t take care. This considerably prevents the spreading. This was where we succeeded in the second phase.

There is practical difficulty in ensuring isolation at the IQ. Even the common facilities like toilets at IQ are risk factors. When there is a big flow of passengers from outside Kerala, we will not be able to ensure proper isolation there. That’s why we have been advocating HQ. There is also a psychological aspect to this. The person under HQ will have a sense of security; they will be having food from home. I will say HQ is the safest one. I heard even the Centre is now reconsidering the decision on IQ.

Kerala has been criticised for lagging other states in testing samples.

World over we have witnessed incidents of testing everyone and then running out of kits. There is no need for testing everyone if there is no reporting of more cases through contacts. Even ICMR and the Union health ministry are advocating testing only on priority groups or among high risk categories.

At present, we have tested nearly 51,000 samples from the suspected cases and nearly 7,000 samples from the high risk categories. Among the high risk categories we have got only four positive cases. This proves that there is no spread. Then why should we go for more testing and run out of kits? We have only RT-PCR kits. At present, we have stocked nearly 80,000 kits which will be in need in the coming days since we are getting more people from outside.

DISCLAIMER : Views expressed above are the author’s own.


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