Early Action Plan, Coordination Helped Contain Coronavirus: Shailaja Teacher

As the fear over novel coronavirus (nCoV) – officially named as COVID-19 by World Health Organisation – intensifies across the world, Kerala, a state in South India, has been able to contain the spread of this virus with an early action plan and dedicated teamwork. Ensuring awareness across all sections of the society and using all the possible machineries, the state has been successfully tackling the only reported cases of the virus in the country.

While the state’s health system and its vigilance is being appreciated widely, the health department—led by KK Shailaja Teacher—has been busy dealing with the quarantined people. On February 7, Kerala had withdrawn the State Calamity status issued over the coronavirus as they were successful in arresting the spread of virus, after testing three positive samples in the initial phase. As of February 11, as many as 3,447 people are still under watch. Of these total, 3,420 are quarantined at home and 27 in various hospitals across the state.

To understand how the Left Democratic Front government ensured its urgent and comprehensive response in dealing with the looming threat, NewsClick spoke to Shailaja Teacher via email.

Excerpts of the interview are given below:

How is the Kerala government fighting the novel coronavirus? What steps are being taken to deal with the anxiety among the people following the outbreak?

Since the outbreak of the novel coronavirus in Wuhan, China, the Kerala State Health Department had begun taking preventive measures and preparing to fight against it on a war footing.

Three cases of coronavirus were tested positive on January 30, February 2 and 3. Because of the new virus, it has no vaccine or precision medicine. However, the best treatment is through specialised targetting and allied treatment including ventilator. Isolation treatment has been set up for this. It also strengthened safety standards for preventing disease outbreaks within hospitals.

Since January 18, the Department of Health has strengthened its preventive measures at various levels. In the wake of the coronavirus spreading in China, the state's health department has issued an alert. Monitoring of airports in Kerala has been strengthened. Those who have returned from China are advised to contact the respective District Medical Officer. It was decided to take special care of them if they displayed any symptoms. He also directed health department officials to take stringent measures to prevent the spread of the disease.

State control room and district control rooms have been set up. Day-long meetings are coordinated by the Health Secretary. The Minister of Health has also attended key meetings. Coronavirus OP and Isolation Wards have been prepared in medical colleges and major general or district hospitals in the district. The use of disinfectants has been intensified in all hospitals. KMSCL (Kerala Medical Services Corporation Ltd) was entrusted with the provision of personal protective equipment and medicines such as masks, gloves and safety shields.

Surveillance at airports and seaports has been tightened, primarily to detect people with coronavirus. They are screened by Airport/Sea Port Health Officers. If they see any symptoms, they are sent to the hospital where the isolation wards have been set up. When the first case was confirmed, the Chief Minister was informed immediately and the following actions were coordinated with his instruction. The department declared a disaster in the state. The people were alert even though they were frightened as well. People from China were willing to self-monitor and collaborate with the Department of Health. A Mental Health Program was also organised to address concerns of home and hospital residents and their relatives.

The Department of Health has released a set of guidelines and therapeutic standards approved by the World Health Organisation for strengthening the novel coronavirus resistance. Increased surveillance has been arranged by dividing the monitored people into individual family health centres with the help of local bodies.

How prepared is Kerala’s public health system to deal with the coronavirus?

The Department of Health is set to tackle the novel corona virus with the experience of surviving the Nipah virus. As soon as the World Health Organisation was warned of this, the state government began to take precautions and prepare for a war with the virus. The battle lines were then drawn up and guidelines for disease prevention were issued. Preventive measures have been taken in connection with the epidemic division of the central government. As soon as the news came from China, the State Level Rapid Task Force convened a meeting to prepare districts for disease surveillance, laboratory monitoring, treatment guidelines, training guidelines and awareness campaigns.

The Department of Health is spearheading a wide range of initiatives across the state to tackle the novel coronavirus. Private hospitals have also been alerted. Strict action is being taken against false propaganda. Everyone should take extreme precautions to avoid spreading the novel coronavirus to others. We survived the Nipah, the floods (in 2018) and the Okhi (cyclone) through collective action. The battle against novel coronavirus is being waged with the same confidence.

How did the upgrading of the Virology Institute in Alappuzha help the functioning of the health department this time? How about the contributions of the Institute of Advanced Virology, Thiruvananthapuram?

There has been a demand for an efficient virology lab in Kerala since the Nipah virus outbreak in the state. Following this, the Virology Lab at Alappuzha was strengthened. The Institute of Advanced Virology Lab at Thiruvananthapuram is also functioning now. Tests against the new type of novel coronavirus could be run only with the permission of the Centre. With the approval of the Centre, the results were very fast. The Institute of Advanced Virology Lab at Thiruvananthapuram is fully equipped and able to detect and prevent such infections very quickly.

In a bid to generate a people-friendly health delivery system in the state, the government had introduced AARDRAM Mission. How is such a mission crucial for an efficient public health system?

As part of the AARDRAM mission, hospitals from primary care centres to medical colleges were strengthened and made patient-friendly. It helps to diagnose and treat diseases at the primary level.

Several natural calamities including floods in two consecutive years and epidemics like Nipah and corona have been inflicted on the state recently. How has the mission helped in dealing with the sudden outbreaks of the diseases?

The new year is about being more cautious than the previous years. So, the Department of Health has been proactively undertaking a number of activities. Earlier too, it had launched Health Awareness 2018 in the state as part of the wetland mission to effectively combat the epidemic. Annual Action Plan 2018 and 2019 had been implemented in a timely and energetic manner throughout the year. The Department of Health and local governance have been actively involved with other departments, agencies and mass movements.

Two seasons of Nipah, then corona, why has Kerala witnessed such outbreaks within a short interval?

Kerala is a very densely populated state. So it is very likely that the epidemic is due to several reasons. This can only be avoided through careful preventive action. Take the case of the coronavirus. There are many Malayalees studying and working in China. Therefore, the preparations were based on the possibility that someone with the novel coronavirus would come from China. The Department of Health has taken the initiative to save the lives of those who come from China, their relatives and the public.

Besides the current virus outbreak, the state has continuously been dealing with many patients of dengue fever, leptospirosis, among other infections. What factors contribute to their contraction?

Due to climatic changes, changes in the topography and lifestyle of Kerala, various epidemics are spreading in different parts. If not taken care of, there is a risk of increased deaths. Diseases such as chikungunya, dengue, H1N1, leptospirosis, smallpox, malaria, jaundice and diphtheria can all lead to death if not taken care of. In the meantime, though rare, Nipah, coronavirus and West Nile Fever have also attacked us. Each of these require significant intervention from the state health department to counter. Environmental clean up is also done with due diligence to eliminate pathogenic microorganisms at the source.