Systems that were in place in the district to trace contacts of COVID-19 patients and enforce quarantine are beginning to crumble beneath the weight of a growing number of active cases.
Ward-level rapid response teams were formed to handle COVID-related exigencies earlier. The teams, comprising the local ASHA worker, Kudumbashree and anganwadi workers, local health officials and the councillor or panchayat member, were still keeping track of people in quarantine in the district, said Mathews Numpeli, district programme manager, National Health Mission. But it was no longer practical to trace and track all contacts and enter their details into the system. “We are relying on people being aware themselves,” said Dr. Numpeli.
A junior health inspector in Kadungalloor said secondary contacts were no longer being traced. “Primary contacts in the family or workspace are alerted and then asked to inform people they came in contact with,” he said. A junior health inspector in Eloor also said that if there were 18 to 20 positive cases in a single division in a day, it was no longer possible to identify and alert all contacts.
While the ward-level response teams would meet regularly earlier, those meetings rarely happen at present, said P.M. Harris, councillor representing Kaloor. Besides, some of the community-level health workers also ended up in quarantine routinely, making such meetings nearly impossible, he added.
A senior police officer who asked not to be named said the services of the police in the contact tracing process were currently marshalled only in some cases where the source of infection was unknown and a patient’s memory jogged using call records retrieved by the police. “With law and order problems, there is little time to trace contacts or enforce quarantine as we did earlier,” he said. The Ernakulam Rural Police had introduced an app, Happy@Home , in April to enforce quarantine norms. But, the app was barely in use any more and enforcing quarantine even among primary and secondary contacts was proving to be difficult considering the number of active cases in the district, he added.
A doctor part of the District Surveillance Unit for COVID-19, who also asked not to be named, said some of health workers at the field level were engaged in entering data onto three different software portals – the State government’s Healthmon and COVID Jagratha, and the district administration’s Coronasafe Network – and at least five spreadsheets that collated information from the local level on testing and details of patients. Besides tracing contacts and symptom surveillance, health workers in some places where data entry operators had not been appointed, also had to enter large volumes of data, he said. The system hinged on such data being made available on time even from private labs, to avoid a situation where the control room was not immediately aware of patients who tested positive and asked to be shifted, he added.
