The Kerala Government Medical Officers Association has warned the State government that mass vaccination events as rolled out on a few occasions during the last week can act as a super-spreader and should not be encouraged even while it agreed that vaccine is the best tool to contain the Covid-19 pandemic.

A detailed note issued by GS Vijayakrishnan, State President, and TN Suresh, General Secretary, of the association, noted that sufficient doses of vaccine are not being issued to the State even though Kerala has a better average in vaccine distribution.

No guidelines available

“Vaccinating the maximum people in the shortest possible time should be our aim. But this should be scientific, rational and taking our available human resources into consideration. Unfortunately, no State-wide guidelines/standard operations procedures have been issued for streamlining the process.”

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The association had suggested specific criteria (based on house number or voter ID number and taking the marginalised sections into account) for choosing beneficiaries for offline registration. This could avoid untoward incidents in which healthcare workers have come to be manhandled at the vaccination sites.

Taking vaccination registration process fully online is an alternative. If government wants to continue with 50:50 online and offline, the registration process must be entrusted completely with the local self-government (LSG) body with a healthcare facility overseeing the actual vaccination process.

Covid curve in plateau phase

The beneficiary list may be prepared and accepted by the LSG to be given on previous day during duty hours to the respective medical officer. Beneficiary registration can be done in a Google format with voter ID as mandatory field to ensure accountability (a separate Government Order may be needed here).

The association notes that the Covid curve is now in a plateau phase with the number of new cases and cured ones almost evened out. Almost 55 per cent of the population might have acquired some degree of immunity also, either through vaccination or as a result of clinical/subclinical infection.

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“Considering these and taking socio-economic factors also into account we feel it not advisable to continue with the present lockdown strategy. Instead, restrictions should be imposed in specific micro containment zones such as wards rather than the whole panchayat/municipality/corporation.”

Contact tracing should be restored

The present strategy of categorising areas based on test positivity rate (TPR) alone should be replaced by indicators such as daily positive cases per 10,000 and active cases per 10,000 along with TPR. Setting targets and criteria for testing to reduce TPR should be avoided.

The purpose of testing should be to identify cases rather than creating a false sense of security. So, targeted testing of all symptomatic and their contacts must be the rule. More effective surveillance and testing must be done in thickly populated areas like colonies and the coastal belt, among others.

The time-tested strategy of contact tracing and isolation, which ensured an effective control during the first Covid wave, must be restored. Contact tracing must be entrusted to the local Rapid Response Team (RRT) with the help of workforce from other non-essential services.

Avoiding large gatherings

All positive cases must be quarantined for 17 days. Those with Covid-like symptoms must also be quarantined even if they test negative on Antigen testing and RT-PCR must be repeated if symptom persists. Proper reporting of fever and adverse reaction events must be ensured.

Market places may be opened strictly ensuring physical distancing and other appropriate behaviour. Congestion has to be eased out by extending their time of functioning. Health officials must be given more powers to implement the Covid protocol. All large gatherings must be avoided at any cost, the association has said.

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