A visiting multi-disciplinary team deputed by the Centre to Covid-ravaged Kerala has faulted the State administration for not getting the fundamentals of its own defences right even as it misdirected its focus on an esoteric ‘ABCD’ classification of affected areas that failed to deliver.

The ABCD classification based on prevailing test positivity rate (TPR) combined had had limited impact on disease transmission as borne out by the exponential spread in the northern districts. Contact tracing was ‘abysmally low’ here with no more than two contacts per case being traced.

Home care, isolation fail

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, the committee noted. It also took exception to inadequacies in the home care and isolation of Covid-positive patients.

Lack of active surveillance was a major drawback with the State’s Covid strategy, sending daily new cases soaring by the day. While there was hardly any active disease surveillance in the community, case detection was mostly limited to those presenting themselves with influenza-like illnesses.

Flouting of quarantine

The committee found that 85-95 per cent of those testing positive are in home isolation. But there seemed to be low acceptance of isolation facilities created by the government. Quarantine norms were being violated, leading to increased transmission within homes and formation of case clusters.

Also read: Covid-19: In-patient numbers steady in Kerala as TPR dips

The Central team has recommended better and close monitoring of patients in home isolation as many home care patients are being admitted in hospitals in symptomatic phase. The State needed to ensure adequate infrastructure as well as a monitoring framework for dealing with this issue.

Train response teams afresh

The trend in the number of deaths in home isolation as well as the number of people referred in serious condition to hospitals need to be studied separately. The State must improve contact tracing by including not just household contacts but also those in workplaces and close community.

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, the expert committee recommended.

Collaborative efforts needed

Containment activities in panchayats where the TPR is high (above 10 per cent) should be handled in consultation with the medical college hospitals and the State’s expert committee on Covid. Option of strict lockdown for 14 days should be explored in wards where TPR is high for long.

The six-member team had visited the Alappuzha, Kollam, Pathanamthitta, Thiruvananthapuram, Malappurum, Kozhikode, Kannur, and Kasaragod districts in the first week of August.

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