By Najiya O, TwoCircles.Net
Out of the more than 4000 Covid positive cases in the country, 327 are in the small state of Kerala. Nearly 60 people, including an elderly couple, have been cured of the deadly virus, while two people have succumbed to the illness too. Presently, 266 people are undergoing treatment in various hospitals in the state as of 7th April 2020.
“From about 150 patients in the Pariyaram Medical College Hospital in Kannur, only a few are in an acute stage and in the ICU,” informed a doctor requesting anonymity adding that the rest are stable with slight symptoms like cough and fever.
Most number of cases reported is in the northernmost district of Kasargode with more than 100 people infected and thousands under home isolation. More than 50 people have been infected in Kannur, while nearly 20 positive cases have been reported in Ernakulam district.
The first case of the Covid 19 in the country was reported in Kerala on January 30. In the initial stage, only three cases were reported and the state had successfully overcome the outbreak by mid-February. The second stage of infection which began on March 8 with a family that had returned from Italy is continuing for a month with more cases being reported. In order to avoid a situation where the medical staff is overworked in case of an emergency, the government has directed that some doctors be kept as reserve. Working hours of doctors are variable according to different institutions. Some institutions follow a system in which doctors work for two weeks and then take the next week off, while others follow different methods.
“There comes the large number of expatriate community from the state,” said the doctor, explaining that nearly 20-25% of the tests in India are conducted in Kerala. The Kerala Migration Survey 2014 conducted by the Centre for Development Studies estimates that more than 24 lakh Keralites live in various countries around the world, a large number of who when the pandemic began to spread, preferred to come back to Kerala. On being asked about how the state is dealing with this sudden influx of Kerala’s expatriate fraternity, he discussed that tests are immediately conducted on those who have come from abroad. While some are kept under home quarantine, some others like those coming from the UAE are quarantined in hospitals.
The suspected cases are then admitted to hospitals and if tested positive, they are admitted to the isolation wards with necessary precautions.
“There is shortage of equipment generally and we use them with utmost caution to make sure that those who have an absolute requirement for the PPE are not kept exposed,” said Dr Shimna Azeez of Government Medical College, Manjeri, in Malappuram district. Dr Azeez, who fears the worst case scenario of a community spread, shared that the staff has essential personal protection equipment (PPE) but they utilize it judiciously, making sure that those in direct contact with patients do not suffer from scarcity in times of dire need.
Although majority of those infected in the state are people who have returned from abroad and their primary contacts, the government has decided to do random tests too. This is after 2 cases that were reported in which the infected persons were not confirmed to have been in touch with any who had come from abroad. Subsequently, a few Covid 19 positive cases have also been reported of people who had come from other states in the country. At such a time, while a large majority of the population abides by the government directions of social distancing and breaking the chain, a few refrain from following them too, creating tension at least in some places.
When asked about medical community’s response to this unprecedented situation, Dr Azeez said, “Even my teachers haven’t witnessed such an outbreak as this.” She then explained that the doctors have to review protocols often and when confusions arise, they discuss and tackle them by new methods which are then implemented. Decisions and corrective measures are alike taken together. She admits that “it is a peculiar team work and even if there are any flaws, nobody can advise others beyond a level.”
“This is a learning experience for everyone in the health stream at a global level,” she said. She explained that while being in the frontline of this grave battle, the medical staff has to battle staying away from their families too. It is important to understand that all of them are going through a situation in which they have instant chance to get infected despite necessary precautions, detailed Dr Azeez who has kept her two children and her mother away as she lives alone due to her professional duties.
Some other doctors like Dr Shifa Muhammed, have decided to postpone important life events like her wedding itself. A house surgeon at Pariyaram Medical College, Dr Shifa decided to postpone her wedding which was planned for March 29, due to the virus outbreak. Soon after she took the decision, she was assigned duty at the Covid 19 ward in the hospital, informed her father.
“May be because of fear, but people’s cooperation is beyond words,” said Dr Azeez when asked about the worsening situation globally. She credits the handling of this difficult situation by the state government along with the cooperation of the people. She discussed that in the screening OP (outpatients’ section) where at least 10-15 minutes are needed for each patient, even though all patients have to wait outside for a long time, they don’t show any sign of irritation or being fed up. Instead they sit peacefully and provide the medical staff necessary details regarding their route map – the aeroplane which they have travelled, the flight and seat numbers etc. Amid staying away from families, medical staff feels relieved to have cooperative patients around, who make their work easier.
“They have answers for each question that we ask, and in case they don’t know, they phone and inform later.” Said Dr Azeez.
“The number of outpatients in the hospital has come down by 50% percent,” said VK Ruby, general manager of KMH Memorial Hospital in Manjeri. Pointing towards the situation of non-Covid cases in hospitals which might get ignored amid the high attention paid to Covid cases, a doctor informed that to avoid such lag, several hospitals and medical bodies such as Association of Pulmonologists in Kerala, the IMA, the IAP and others have begun tele-consultation for common illnesses.