As the number of COVID-19 cases steadily spikes in the country, Kerala has strengthened surveillance and monitoring in the fervent hope that containment of virus transmission is still possible if the State continues to screen and quarantine people aggressively as when the first three cases were reported in the State recently.
Public health experts, however, point out that the world has more or less accepted now that the containment of the virus is an illusion and that even while attempting containment aggressively, the State should have a Plan B which focusses on mitigation.
“We need not give up containment measures (intensive surveillance, identifying cases, quarantining people, etc). Mitigation would mean that we accept that the virus is unstoppable and that community spread is inevitable and hence do our best to mitigate its effect on people. We should be amping up infection control measures in hospitals, reviewing our capabilities and skills for providing critical care to people who might need it,” a public health specialist said.
Lack of symptoms
“There might not be any evidence of ongoing community transmission till we suddenly find patient clusters as it happened in the Washington State in the U.S. Cases went undetected because most of the people would have had very mild or non-specific symptoms,” he pointed out.
Kerala might have been successful with its aggressive surveillance, arduous contact tracing and quarantine strategies in the initial phase when the threat perception was narrowed to people or travellers with some link to China. That situation has changed drastically now and at a time when the nation is waking up to the possibility of domestic spread of COVID-19, more attention should be paid to imposing upon people the importance of social distancing, avoiding unnecessary public gatherings and religious congregations and avoiding unnecessary travel, both within and outside the country.
China measures
“We cannot adapt the draconian measures that China might have taken in an attempt to contain or limit the transmission but what we can do is focus on educating the public that simple preventive measures can go a long way in reducing transmission. Our advisories issued earlier to the general public still stand, but we need to reinforce the message on maintaining utmost respiratory hygiene, frequent hand-washing, avoiding unnecessary physical contact – touching one’s face, shaking hands and fist bumps, hugs, etc. – through an intense and very visual IEC (information, education, communication) campaign,” says R. Aravind, head of Infectious Diseases, Government Medical College Hospital, Thiruvananthapuram.
Senior health officials are also worried that there could be a mass exodus of Keralites from West Asia and that as the population profile changes, imposing and ensuring proper home quarantine measures could prove to be tricky. Officials are also worried that there could be mass demand for testing, which might not be easily met.
