COVID-19: Kerala needs to revisit approach

Kerala had comparatively less community transmission of the novel coronavirus disease (COVID-19) during the first wave of the pandemic and midway into the second wave, as evidenced by its low sero-prevalence. The eventual case surge was inevitable with the entry of the delta variant of the virus in a state with high population density.

Kerala adopted globally well-established pandemic control measures according to guidelines of the Indian Council of Medical Research and the Union government. Criticism by outsiders should not fog insights of the government.

The state, however, should alter its testing strategy by ditching rapid antigen tests for the more reliable RT-PCR (reverse transcription–polymerase chain reaction) tests. The reliance on antigen tests has meant that a number of infected people have remained undetected (false negatives) and that they have in turn infected others. The state also needs to procure more testing equipment before it can make the transition.

There is a need to carefully divide the staff and resources for case contact tracing and testing, and vaccination. We have to now entrust junior public health nurses, health supervisors, staff nurses and limited doctors with vaccination drives, and employ healthcare workers like accredited social health activists, field supervisors and doctors to focus on screening symptomatic patients, sample collection, contact tracing and active surveillance. The practice of telephonic follow-ups has to be revived along with active case contact tracing and testing.

Another way to reduce the spread of infection and death is by vigilant monitoring of patients in care to ensure patients are shifted to the hospital before complications arise.  In 2020, the state set up the first-level treatment centres in all districts to quarantine suspected patients. These centres need to be revived.

The state has to finally increase preparedness for case surge which may happen at any time due to the emergence of mutant variants. There is a need to mobilise extra intensive care units and COVID-19 hospital staff from peripheral institutions and private sector and put them on the ‘reserve list’. 

Investments should also be made to set up floating assembly of equipment like ventilators, suction and infusion pumps, which can be moved to any hospital in any district within 24 hours, in case of an emergency.

Views expressed are the author’s own and don’t necessarily reflect those of Down To Earth.

Kollannur is a Kochi-based public health expert. The story first appeared in print in the October 1-15, 2021 issue of DownToEarth.