Care and chaos

Chennai's lockdown from June 19 alone will not contain the spread of Covid-19

TOPSHOT-INDIA-HEALTH-VIRUS Spray and pray: A firefighter sprays disinfectant in a containment zone in Chennai | AFP

Aarthi Ravikumar (name changed), 46, a staff nurse at the Tamil Nadu Government Multi Super Speciality Hospital, Omandurar Estate, Chennai, is physically and mentally tired. She is currently on a seven-day home quarantine, after having nursed Covid-19 patients for a fortnight. She had become used to seeing at least four deaths a day at the designated Covid-19 facility. “It is a horrible experience,” she said. But Aarthi consoles herself saying that she could save a Covid-19 patient with diabetes, with her timely intervention.

Nursing has become an ordeal these days. “Taking care of patients has always been my love. But my experience in these three months was terrible,” she said. The Omandurar Estate hospital, where she works, has two towers and 14 floors with more than 400 beds for Covid-19 patients. The hospital is one of the biggest government facilities in the state for Covid-19 patients.

Tamil Nadu has more than 46,000 Covid-19 cases; 73 per cent of them are from Chennai and majority are active. As per data available from the Greater Chennai Corporation, 15,385 people in Chennai are still under treatment for Covid-19, and at least 5,000 of them are in home care (as on June 15).

“The numbers strike a fear,” said Parthasarathy Ranganathan, 56, a resident of West Mambalam in Chennai. “Recently, more than 50 shops in my locality were closed. My neighbour said that a shop owner tested positive for Covid-19. I used to shop from most of the shops which have been closed. I feel no precaution can save Chennai anymore.”

On June 15, the state government announced that Chennai and the neighbouring districts of Tiruvallur, Kancheepuram and Chengalpattu will have an intense lockdown from June 19.

Apparently, it was only on June 12 that Chief Minister Edappadi K. Palaniswami had said that the government had no intention to declare an intense lockdown.

The upcoming lockdown will be for 12 days— including two Sundays, without relaxations. Sources in the Chennai Corporation and the state health department said that during this lockdown, there will be a coordinated effort to collect data of the infected people and to intensify contact tracing. But the 12-day lockdown might not be sufficient to bring down the numbers, say experts. In fact, the medical expert committee wanted a stricter quarantine and increased monitoring and testing in containment zones, instead of a lockdown.

“What can a lockdown achieve when the past five lockdowns have not yielded results as expected?” asked infectious disease expert Dr Subramanian Swaminathan. “For disrupting transmission [of virus] we need at least three weeks, and these 12 days will not be of any help. It does not make any epidemiological sense.”

Apparently, members of the medical expert committee also said that bringing Chennai under control within a 12-day period is “impossible”. They also pointed out that even if the numbers are brought down as of now, the city might witness a second wave like in China. “The only way out is to encourage hand hygiene and social distancing,” said Dr J. Amalorpavanathan, former director at the Institute of Vascular Surgery, Madras Medical College. He feels that the previous lockdowns did not yield the expected results as the government failed to ramp-up testing.

A study by the Tamil Nadu Dr MGR Medical University in May predicted that the spread and the death rate in the state will see a new peak by July: With loosened lockdown, at least 1,50,244 cases and 1,654 deaths (by July 15); without lockdown, cases up to 2,10,197. The study also predicts a bigger peak in September-October.

“The infectivity rate in Chennai is high,” said Dr S. Poongulali, senior consultant at Voluntary Health Services, Infectious Diseases Medical Centre. “Out of 18,000 people tested daily, at least 2,000 people test positive, which means close to 11 per cent of the cases are positive. Lockdown will not help without increased testing rate and contact tracing. Lockdown cannot be a strategy by itself.”

Dr Jayaprakash Muliyil, former principal at the Christian Medical College, Vellore, however, feels that Chennai is slowly coming out of the epidemic. “Piece by piece, each cluster is coming to an end, and each containment zone has got herd immunity,” he said.

There is a general notion that the Koyambedu cluster was responsible for the spread of the virus in Chennai. But experts question the source for Covid 19 clusters in the police department, government hospitals and Puzhal Central Prison, and a cluster at Kannagi Nagar slum area.

The high exposure of doctors and nurses at the government hospitals could also not be controlled due to the shortage in man power. According to Aarthi, many staff nurses at the Rajiv Gandhi Government General Hospital (RGGGH) and Omandurar Estate hospital, who had tested positive for Covid-19, have underwent treatment and returned to work. Incidentally, Thanga Lakshmi one of the staff nurses at RGGGH, who had a second exposure, died on June 14.

At Omandurar Estate hospital, 140 nurses work in two batches. At a time, one batch will be in quarantine, while the other batch (split into three groups of 23-24 personnel) works in three shifts. “Just 23 people for 400 patients. Imagine the burden on us,” said Aarthi.

Meanwhile, the government has greenlit a controversial step to increase the man power. On June 14, an advertisement in a Tamil daily said a private firm named Gentleman HR Recruiting Agency is recruiting for the posts of ward boys, lab technicians, radiologists and dialysis experts at the government hospitals. The permission given to the agency for the recruitment was apparently cancelled by the government on June 17, following criticism from the media and the opposition. “The government is working round the clock to serve the people. We are very transparent in handling the pandemic,” said Health Minister Dr C. Vijayabaskar. 

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