Global lessons for Kerala in corona fight

KOCHI: Spreading its tentacles swiftly across the globe, the COVID-19 pandemic has, in little more than two months, reached the far corners of the world. All of humankind, irrespective of race or religion, is at risk as a modern healthcare system is struggling to face the challenge. While Kerala has so far been able to limit the damage, thanks to coordinated efforts of the state administration and healthcare sector, lessons learnt from all over the world hold the key to keeping the virus in check. 

According to experts, one of the major factors affecting the efforts to control the pandemic is the lack of complete clarity about the disease. “While the outbreak and spread of the pandemic, from the first cases in Wuhan in December 2019, are being studied in detail, neither the best researchers nor the most detailed mathematical or statistical models can predict with certainty what the future holds in store. While the infection rate was earlier predicted to be less than 1%, this has seen an upward trend over the past few weeks. Fatality rate, initially estimated at 1.4%, has now gone up to 3.4%. While children and young adults seemed to be in the less-affected zone earlier, we now clearly know that this is not true,” said Rajeev Sadanandan, former additional chief secretary (Health).“An important takeaway from humankind’s experience with the virus so far is that those regions which implemented basic public healthcare measures were able to control the disease. Singapore, Taiwan, and Thailand are examples.

Those countries that chose to downplay the threat, including Italy, US and Spain, are facing the consequences of their inaction now,” he said. Declaring the outbreak a pandemic, Tedros Adhanom Ghebreyesus, head of the World Health Organisation, sought focus on five ‘P’s : Prevention, Preparedness, Public health, Political leadership, and People. While Kerala has its Nipah experience to help it deal with coronavirus, health experts feel it cannot let its guard down. They say the next couple of weeks are crucial in the state’s fight against the virus, and it cannot afford to let the situation go out of control. What is happening in Italy, some other European countries and the US should make health authorities in Kerala wiser, they say.

While the countries like South Korea, Hong Kong and Singapore proactively implemented social distancing on a massive scale, quarantined infected areas, cancelled big events and closed schools and offices to slow down the spread, in Europe and the US, these were done only after the cases started being reported. According to Dr Anup Warrier, infections and disease control specialist, social distancing and screening of people entering the state, from not just the designated “high-risk” countries, but from others as well, is the key to containing the spread of the virus. “People need to motivate themselves to isolate themselves from society.  The next two to three weeks are very crucial for the state. Travel restrictions or other measures put in place by governments cannot prevent people from interacting with each other unless they decide to keep themselves and others safe,” said Dr Anup. 

According to Rajeev Sadanandan, the likelihood of an uncontrolled outbreak in Kerala is very less, and the state is adequately geared-up to tackle the virus. “We are prepared for the worst. If need be, we have excellent facilities in private hospitals that can be made use of. Well-maintained primary health centres across the state can be converted to isolation zones,” he said, adding that in case the virus spins out of control, older citizens will be at high risk. However, according to Dr Anup, a full-blown outbreak, though unlikely, would be difficult to handle. “Make-shift arrangements will be required to be set up. A shortage of infrastructure and trained critical care staff will affect treatment efforts. ICU management, including even providing proper cylinder-based gas for the ICUs, will be a difficult prospect. Since most hospitals in Kerala are not built with proper isolation wards, setting up more would be difficult,” said Dr Anup.