Home quarantine is not an easy job for any healthcare provider. It means convincing the suspected patient to stay isolated from family and friends for a period of time. Counselling has to be comprehensive, patients’ have to ensure they sanitise all objects they touch, use separate toilets, sneeze and cough in the right manner, use separate food utensils and stay at least 3 feet away from another human being. It’s a transfer of trust, from health service staff to the possibly infected, each believing in the other’s advice and subsequent actions.
The fact that Kerala, which declared a state emergency on February 3 after three people tested positive for novel Coronavirus (nCoV), successfully home-quarantined 3,420 people and is keeping 27 people under observation in isolation wards across the state (as on February 10), largely with the help of health workers and district administrations, is a measure of the faith residents have in the state’s healthcare system.
The state emergency health response model was activated as soon as the virus outbreak turned into an epidemic in Wuhan, China, in January 2020. Knowing that it had students and others who had returned to Kerala during the Chinese New Year holidays, the state feared a repeat of the Nipah outbreak in 2018, in which 17 people, including the nurse who treated the first patient, died. It was the first time Kerala had handled an epidemic of unknown nature, but its containment and the state response was commended even by the World Health Organization (WHO).
This time around, things were different. Public education and engagement, along with prompt preventive action, worked in the state’s favour. At a high-level meeting chaired by health minister K.K. Shailaja on January 25, it was decided to locate all returnees from the affected Chinese regions and screen them. Some 123 healthcare teams were set up to home/ facility quarantine the returnees and offer them counselling. We took all precautions to contain the spread of the virus and appealed to people in the high-risk category to remain at home for 28 days to complete the incubation period, the minister told INDIA TODAY.
Meanwhile, isolation wards with 40 beds were set up in 21 major hospitals across the state and a helpline activated in every district. The health department updated the database of home-quarantined persons and people in isolation wards and monitored their progress every day. The state screened all suspected cases and sent samples for testing to the National Virology Institute (NVI), Pune. Later, the NVI set up a testing lab in Alappuzha to speed up the process.
Since there was no medicine to treat nCoV, our priority was prevention through high-level surveillance, home quarantine and isolation wards across the state, says Dr Rajan Khobragade, principal secretary, health department.
The first nCoV positive case of a medical professional who had returned from Wuhan on January 24 via Kolkata was reported on January 30 from Thrissur. The second case was reported from Alappuzha and the third from Kasargod district. After the third case, the government notified the outbreak as a state disaster. Most people obliged and understood the risks involved if they interacted with the general public. Even marriages were postponed, says a senior medical officer in Thrissur.
The state has now called off the emergency with no fresh cases reported. The health department sent 380 samples to the NVI for testing; 344 tested negative. The remaining results are awaited. We will continue our vigil for a few more weeks. The first person who tested nCoV positive was found to be negative in the second test. The two other positive persons are also recovering, says minister Shailaja.