Tamil Nadu’s modus operandi couldn’t keep up with pandemic spread, opine experts

From interventions that did not keep pace with the virus transmission to lack of cooperation from the public, experts cite several reasons why the universal model of lockdown, testing and isolation was not as effective to break the chain of COVID-19 spread in Tamil Nadu.
Tamil Nadu’s modus operandi couldn’t keep up with pandemic spread, opine experts


However, Dr Anantharam Raghavendran from virology department of Vellore’s New Naruvi hospital said if not for the lockdown, the pandemic would have peaked much earlier, putting strain on the health infrastructure. Another reason that several public health workers raised was the lack of coordination among several arms of the government like Local Administration, Health department, Greater Chennai Corporation and Disaster Management.
Long curfew helped TN docs to prepare better for COVID battle

From March 25, when the lockdown was imposed, the State only had 15 COVID cases. Today, on July 2, after 100 days of lockdown, health officials have come a long way in fighting the pandemic even as the cases continue to pile. Though the numbers are high- with the tally crossing 90,000 - officials express confidence about having gained more insight into the disease and know how to manage it better.

While fever, breathlessness and dry cough were the only recognised symptoms earlier, doctors now associate loss of smell, taste, general weakness, fatigue and even abdominal pain as warning signs.

Officials from the Directorate of Public Health and Preventive Medicine said that various co-morbidities that would make a person vulnerable are also clearer now. As a result, cocooning and monitoring of such people is being better planned and this has also led to an evolving strategy. Though the basic protocol on quarantine, isolation and other preventive measures remain the same, treatment strategies have greatly improved. The time period of quarantine has also come down from 28 to a maximum of 10-14 days and there is no discharge test needed anymore. Also, use of steroids, injections and other drugs has been well established over a period of time.

“Heparin can be used as an anticoagulant drug to save critical patients. Steroids can be life-saving drugs; anti-viral drugs including Remdesivir, Tocilizumab, and Enoxaparin can also be used. The effect of these drugs on patients has been understood over the past three months. Case by case review also helped in coming up with better treatment standards and the use of Ayurveda and Siddha medicines to build immunity has also proved beneficial,” said public health expert and former public health director Dr K Kolandaisamy, who had been spearheading the public healthcare system until his retirement recently. “Though we stressed on strict lockdown earlier, the effectiveness could not be established. We now know that only vulnerable people need to stay indoors and controlled lockdown can be implemented,” he added.

Health officials also said that the spike in cases led to strengthening of the public health sector, including infrastructure and capacity at government and private hospitals. “Despite having one of the best health sectors pan India, we had to ramp it up completely. Besides, ensuring adequate testing was also a major task. We realised micro level plans are needed. Earlier, we did not have local influencers but now many NGOs help COVID management in slums,” said Health Secretary J Radhakrishnan.

He pointed out that standard protocols were not available then and doctors and researchers had to analyse ICMR and international recommendations for solutions. “We now have plasma therapy trials. Besides we are continuing with add-on therapies and studies on effects of Indian medicines. At present, we have 11 standard protocols, especially for those with co-morbidities,” said Radhakrishnan.

As more than 50,000 people have recovered, doctors have realised that early treatment can help reduce mortality rate. “COVID-19 being a new strain, people are not yet immune to it. Besides, there is no 100% compliance to masks, social distancing and hand washing as people are generally negligent till they are affected,” Radhakrishnan added.
(With inputs from Tharian Mathew)

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