As COVID-19 challenges the capacity and efficiency of the State’s health system, the success of all containment and subsequent mitigation efforts will depend on how compliant the public are to adapting behavioural changes which will minimise transmission of the virus in the community.
Though Kerala is preparing itself for the long haul to battle SARS CoV-2, inadvertent lapses in surveillance and the inability of the system to convince people on the merits of home quarantine/self-isolation to counter virus transmission are bringing forth new challenges daily. Public health professionals are worried that the State may lose grip on the window of opportunity for the containment of COVID-19, given the strain the health system infrastructure is being put to. In the past three days, Kerala has added on an average 1,500 to 2,000 people daily to its surveillance network.
“We have been investing heavily in human resources, time and effort in the surveillance and the subsequent contact tracing exercise, which is indeed a crucial part of the containment activity. But every time some systemic lapses happen or people wilfully try to escape surveillance and quarantine, it puts an additional burden on the system, which is already under much strain,” a senior Health official pointed out.
Practical public health should account for the vagaries in human behaviour which might trump the system’s best laid-out plans. Health officials are disappointed that despite their massive IEC efforts — every person coming in to the designated corona clinics for screening is sent back with printed literature on dos and don’ts — home quarantine/self-isolation efforts have been failing miserably.
More efforts
Failed home quarantine (if people have been freely mingling with family/friends or moving about freely in society, instead of isolating oneself in self-contained rooms) means more people having to be isolated in hospitals and more efforts at contact tracing in the community.
“At this rate, we will soon need more hospital beds, human resources and materials. The COVID-19 isolation wards are being run alongside the regular hospital work and the health-care staff are quite overworked. Caring for patients for hours in sweltering heat, wearing the full protective gear, is quite taxing,” a senior doctor at the Government Medical College Hospital (MCH) said.
All available government hospital beds in both modern medicine and AYUSH systems would be utilised.
Vulnerable sections
If this outbreak gets out of hand, the health-care requirements of the vulnerable sections — the elderly, dialysis patients and those with chronic conditions like cancer — would also go for a toss.
“At this point, we estimate that we may just have a short window of opportunity — two to three weeks at the most — for the containment of the virus. As of now, we are able to trace every reported positive case back to the point of contact. As of now, we have no documented evidence of community spread. It is human behaviour which will determine the course of COVID-19 outbreak in Kerala in the coming days,” a senior Health official said.