New challenges continue to emerge for Tamil Nadu, which has recorded 12,448 cases of COVID-19 so far. With the lockdown having been extended yet again, there are 11 more days to go. In an email interview, Prabhdeep Kaur, Scientist E/Deputy Director, Indian Council of Medical Research - National Institute of Epidemiology, who is on the panel of public health experts advising the government, specifies the areas that need to be focused on, testing requirements, and the way forward for the State.
With the lockdown having been extended till May 31, what should be the areas of focus for the next two weeks?
Geographically, the focus should be on a few districts and zones of Chennai with a high infection burden. Strategically, focused testing, tracing, isolation and quarantine will be critical in reducing the spread of the disease. The third important factor is the careful management of mild cases. Asymptomatic or mild COVID-19-positive cases could either be hospitalised at a COVID Care Centre or opt for home isolation. While the former is absolutely necessary for individuals from densely populated neighbourhoods, for the rest, the latter may suffice. Also, close contacts who have tested negative should remain in quarantine for 14 days. The feasibility of home quarantine as against facility quarantine can be assessed depending on the locality.
What is your assessment of the measures taken by the Tamil Nadu government during the 54 days of lockdown?
Tamil Nadu performs the highest number of tests per day, thanks to the ramping-up of capacity in recent weeks. Contact tracing has also been implemented well. Good hospital infrastructure has enabled quality care. However, social distancing measures were not fully implemented, and there was poor compliance from the community in places like the Koyambedu market. There were challenges in the implementation of containment strategies in highly congested areas.
The panel of experts has been stressing the need for more testing. Are the current testing figures, ranging from 10,000 to 14,000, including repeat samples, adequate for days to come?
The testing requirement depends on the size of an outbreak in a given district. As we lift the lockdown, there will be more transmission, and testing requirements will definitely increase. All those who need to be tested as per the ICMR’s guidelines should be tested, if there are adequate resources. Our estimates suggest that given the current situation, Chennai requires around 100 tests per lakh population. There will also be additional testing requirements for travellers from other States.
In your view, what are the things that should be avoided, and what should be enforced in the coming weeks?
We should avoid sharing misinformation, and visits to public places should be limited to essential needs. The elderly and people with co-morbidities should stay at home to the extent possible. Lastly, stay away from social gatherings. We must continue to enforce compliance with norms like the wearing of masks at workplaces/public places and the use of floor markings in shops to maintain social distancing.
In the last few days, many returnees from other States/countries have tested positive for COVID-19 in Tamil Nadu. What kind of a strategy is required to handle this inflow, since more people are expected to arrive in the days to come?
This is an area of concern, as the districts that are currently free of infection may get a wave of cases due to the influx of infected people from other areas. All travellers with symptoms should be tested, and those without symptoms should be quarantined.
At the community level, what do you, as a public health expert, expect from the people?
People should adapt themselves to the new normal. The working population should maintain distance from the elderly and those with co-morbidities. Active participation of communities by way of compliance with the norms on wearing masks and practising social distancing at workplaces and public places will tremendously augment the governmental efforts. People with fever and cough should stay at home and seek the advice of a doctor.
