The multi-disciplinary team deputed by the Centre to study Kerala’s COVID situation has pinpointed inadequacies in the home care and isolation of COVID-positive patients, poor contact tracing efforts and lack of active surveillance to be the primary reasons for the rise in cases in the State over the past one month.
They also reported that the ABCD classification based on test positivity rate (TPR ) had had limited impact on disease transmission.
One observation of the team was that there was no active disease surveillance in the community and that case detection was mostly by testing those reporting in hospitals with influenza-like illnesses.
They also pointed out that contact tracing was “abysmally low”, with no more than two contacts per case being traced. In districts such as Malappuram and Kozhikode, where the family size is huge and joint families are the norm, transmission was spreading within families leading to a high TPR.
It was noted that 85% to 90% of those who tested positive for COVID are in home isolation and that there seemed to be low acceptance of isolation facilities created by the government. But home isolation did not seem to be working well and quarantine norms were being violated, leading to increased transmission within homes and formation of case clusters.
Recommendations
The Central team has recommended better and close monitoring of patients in home isolation as many home care patients were being admitted in hospitals in symptomatic phase. The State needed to have adequate infrastructure as well as a monitoring framework for the same.
“Deeper analysis needs to be undertaken regarding the number of deaths in home isolation as well as the number of people referred in serious condition to hospitals,” the report said.
It has also been recommended that the State improve contact tracing by including not just household contacts, but those in workplaces and close community contacts too.
The field-level Rapid Response Teams need to be trained again on surveillance and contact tracing and the case-contact ratio has to be at least 10-15 contacts for every case.
The strategy of categorisation needed to be re-examined. It suggested that the monitoring of containment activities in panchayats where the TPR is high (above 10%) should be done in consultation with the medical college hospitals and the State’s expert committee on COVID.
They have also recommended that the option of strict lockdown for 14 days should be explored in wards where the TPR remained high for a long time.
The six-member team had visited eight districts – Alappuzha, Kollam, Pathanamthitta, Thiruvananthapuram, Malappurum, Kozhikode, Kannur, and Kasaragod – in the first week of August.
Published - August 11, 2021 08:21 pm IST
