COVID-19: Lone positive case in a day, but delayed confirmation of foreign returnees a worry

The last time Kerala had a single positive case reported in a day was on March 19, when the virus had only begun to slyly form chains of infection and when the total confirmed cases were only 27. Now, for the first time after the contagion began to drop in intensity by the end of March, only a single confirmed case was reported on Wednesday.

The lone man to test positive today is in Kannur, and he is a primary contact who got seeded by someone who had arrived from outside.

It was from April 12, when there were just two confirmed cases, the virus looked to have lost steam in Kerala. The next day, too, saw only three cases. But there was a sudden spike to eight on April 14, stoking fears of a slippage. However, Wednesday once again ushered Kerala very near to the entrance of the Promised Land of a virus-free Kerala.

Nonetheless, the recovery has not shown the kind of fertility seen during the last days when 36, 27 and 19 patients had shaken away the disease on certain days.

Only seven had recovered today; four in Kasaragod, two in Kozhikode and one in Kollam. Not a single person recovered today in Kannur, where there are 41 active cases. Yet Kerala has the highest recovery rate in the country. By now, 218 people had recovered in Kerala, which is nearly 57 per cent of the total confirmed cases of 387.

And the active cases have consistently gone down since April 6. From 266 active cases eight days ago, it has now fallen to 167.

Delayed infection of returnees

However, the recent phenomenon of foreign returnees turning positive 20 or more days after they had landed is troubling. Officially, it is stated that in certain cases the incubation period, or the time taken for symptoms to show, is longer than the 14 days laid down by the WHO, and therefore there is nothing to worry. It is also said foreign returnees are kept in strict quarantine and their chances of infecting others are virtually nil.

But this assurance will not hold water after a 35-year-old man, native of Edachery in Kozhikode, had turned positive on April 14. He had returned from Gulf on March 18 but he was tested only after April 11, 24 days after his return, when his father, a person with no travel history, had tested positive.

This is proof that the man was infective even without showing any symptoms. It was not just his father he had infected. A 19-year-old female in the same house had also tested positive on April 14.

Already 18 foreign returnees had tested positive long after they should have been declared positive. This indicates that virus carriers, without any prominent symptoms, still continue in their homes instead of being isolated in hospitals.

The Kozhikode case at least should persuade the government to mandatorily test foreign returnees after 14 days of quarantine even if asymptomatic.

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Kerala still has 97,000 people in quarantine and over 85 per cent of them have still not been tested. Many of them could be carriers and could be infecting others, especially close family members.

Rapid kits stuck in China

This makes rapid testing, which would check for antibodies in a wider section of population quickly and at a lower cost, all the more inevitable. Kerala has placed orders for nearly two lakh kits (1,99,990 kits) with two companies in China. “We are also finding it hard to get the kits internally as the producing states like Maharashtra needs them for their use,” a top official said.

Rajiv Gandhi Centre for Biotechnolgy has developed a cost-effective antibody kit but its second round of internal evaluation was completed only today (April 15). “We will submit the kit to the ICMR (Indian Council for Medical Research) tomorrow (April 16),” RGCB director Prof Radhakrishna Pillai said.

Local cancer care centres

The focus on COVID-19 has taken the attention from other serious illnesses, at least in the initial phases. However, the government has made consistent efforts, and have also persuaded privte hospitals, to take care of patients with other severe ailments. Telemedicine service, where major doctors in Kerala are available on call, has been a major relief.

Now, it has been decided to open 21 local cancer care centres in all the districts. This is to reduce the travel time of cancer patients, who mostly depend on the Regional Cancer Care Centre in Thiruvananthapuram. “Cancer patients have very fragile immunity and if they contract he virus it can suddenly turn worse,” the chief minister said.

Here are the local cancer care centres: Thiruvananthapuram General Hospital, Kollam General Hospital, Punalur Taluk Hospital, Kozhenchery General Hospital, Alappuzha General Hospital, Mavelikkara General Hospital, Pala General Hospital, Kottayam District Hospital, Thodupuzha General Hospital, Ernakulam General Hospital, Muvatupuzha General Hospital, Thrissur General Hospital, Palakkad District Hospital, Ottappalam Taluk Hospital, Tirur General Hospital, Nilambur District Hospital, Kozhikode Beach Hospital, Nalloornadu Tribal Hospital (Wayanad), Kannur District Hospital, Thalassery General Hospital, Kanhangad District Hospital.

This is the first such initiative in the country.

Lockdown relaxations

Chief Minister Pinarayi Vijayan said lockdown relaxations after April 20 would more or less stick to the guidelines issued by the Centre on Wednesday (April 15). “We have no fundamental difference with Centre on these guidelines,” he said.

However, the chief minister said the state would adapt certain conditions to suit Kerala's specific needs. He especially referred to the traditional industries and agriculture. “In the Centre's guidelines, they speak about jute workers while mentioning lockdown relaxation for the traditional sectors. But in our case, the relaxations will have to be for coir and beedi workers,” Pinarayi Vijayan said.

A decision on relaxations after April 20 will be taken at the Cabinet meeting to be held on April 16.

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