‘Prepare SOP to help districts exit lockdown’

Vellore

According to eminent virologist and former head of the department of virology at CMC, Vellore, Dr Jacob John, the Centre should have taken measures to control spread of virus much before announcing the lockdown.

“What should have been done is that the Centre should have appointed an expert, who then should have formed a think tank with all members reading up on virology and epidemiology studies related to COVID-19 and suggest measures to stem the tide. The government measure should have been undertaken by the third week of February as we had received information of the virus attack a week earlier,” he said.

He said the lockdown has failed, as the virus does not manifest simultaneously across the nation. “Its spatial and geographic manifestation differed, which is why the lockdown failed. What exacerbated matters was that instead of one entity handing out well thought out advice, we had the Union Health Minister, Indian Council of Medical Research (ICMR), National Centre for Disease Control (NCDC) and the Directorate General of Health Services (DGHS) all offering advices,” Dr John added.

In Chennai, 9,905 cases are from core city zones that are densely populated. Though Corporation Commissioner G Prakash claimed that the huge number of cases was due to the large number of tests conducted and population density, sources said the sample testing has reduced. “Initially, we were taking samples from family members, contacts and extended contacts of infected persons. But we have been directed to take samples of family members or contacts only if they show any symptoms,” said a sanitary inspector said.

“Protocols are being followed for the treatment, but more has to be done to prevent the spread of the infection rather than treating them. Testing needs to be scaled up so that more number of cases can be identified and be isolated to break the chain,” said a member of the expert committee.

Though the Health department guidelines says all those who come from outside the State should be tested, Directorate of Public Health and Preventive Medicine officials deny it. “If the Centre’s guidelines say people from other states should be tested, they will be tested. There is no mandatory testing for all those who travel from other states. Quarantine is different and has been recommended for all with inter-state and foreign country travel,” said Director of Public Health and Preventive Medicine Dr TS Selvavinayagam.

J Radhakrishnan, special nodal officer for COVID management for Chennai, said containment measures have brought about some success. According to him, Tiruvottiyur, Manali, Madhavaram, Sholinganallur, Alandur and Perungudi zones are showing a declining trend.

The challenge, he added, was the residual impact of the Koyambedu market cluster in Kodambakkam, Valasaravakkam and Anna Nagar zones, besides the slums in Royapuram, Tondiarpet, Thiru-Vi-Ka Nagar and pockets of Teynampet.

“We are trying to decongest worst-affected areas and are trying to do door-to-door testing along with the non-governmental organisations and Corporation officials to identify people with symptoms,” he said.

Doctors added that comorbidities have been a contributing factor to the complications and higher risk of getting infected. “We have been observing and identifying the co-morbid conditions in the death cases, and are following the guidelines that have been formed to treat the patient with comorbidities,” said Dr Hariharan, a member of the expert committee and chief of medicine at Government Stanley Medical College Hospital.

In Chennai, there were many challenges like population density, movement of people from other States and migrants, said Health Secretary.

After identifying the comorbid conditions by conducting death analysis of all the cases, the officials are doing a real-time mapping of the patients with comorbidities, she said. “We have formed a specific vertical team within the city to test and treat the patients with comorbidities to ensure that the mortality levels are low,” she added.

According to Dr Jacob John, mortality due to the infection could be reduced by undertaking IgG (immune-globulin) tests so that anyone who tests positive can be allowed to interact with the public though with some restrictions. Masks should be mandatory for all, he added.

“As the economy has to be restarted, the ideal would be for the Centre to form a standard operating procedure (SOP) and hand it out to all 736 districts, with district heads being given the authority, responsibility and accountability to convert the SOP to suit the needs of individual districts,” he added.

“This will mean district heads - aided by district level committees consisting of experts from various spheres – decide on how to implement SOP in schools, colleges, places of worship and industries and other areas where people congregate so that the economy and normal life are re-railed,” said Dr John.