Lapses in tracking virus carriers expose Bengal to COVID-19 risk

The state health department in West Bengal on Friday (March 20) scampered to prepare a socialisation map of its second COVID-19 patient for contact-tracing even as it has now instructed strict quarantining of all passengers coming from abroad.

Chief Minister Mamata Banerjee, who also holds the health portfolio, directed the police to take action against those refusing to undergo the mandatory 14-day quarantine, said state health officials.

After the chief minister’s directive, the Kolkata police, in an announcement, said action would be taken against those violating home-quarantine advisory.  The state has already invoked the Epidemic Disease Act, a 125-year-old law to enforce its advisories on COVID-19.

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The directive came after a youth in his early 20s, who had returned from the UK on March 13, tested positive for the novel coronavirus on Friday. He was admitted at the Infectious Disease and Beliaghata General (ID&BG) Hospital in the city with COVID-19 symptoms on Thursday.

Officials said the youth was advised home quarantine after initial screening on the very day he arrived from London. However, the youth reportedly went on with his outdoor activities.

According to state health department sources, family members of the youth are also under isolation at the quarantine facility set up for asymptomatic persons exposed to risk at the New Town campus of the yet-to-be inaugurated Chittaranjan National Cancer Institute.

A senior health official told The Federal they are now trying to prepare a list of persons the youth had come into contact with in the past few days. The official said contact-tracing in this case would be very difficult as he had socialised, flouting isolation protocols, for almost a week.

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The first positive case in the state, an 18-year-old boy, had also gone about with his regular socialising, setting alarm bells ringing in the government. Subsequently, the state government traced 17 high-risk passengers who had travelled with the teenager in the Etihad Airways flight via Abu Dhabi to Kolkata on Sunday (March 15).

After preliminary medical check-up, the passengers have been advised home isolation. Meanwhile, two domestic helps of the teenager tested negative for coronavirus. They have also been sent for 14-day isolation at the New Town quarantine facility.

The teenager’s mother, a senior bureaucrat, and his father, a child specialist, and their two drivers have already been undergoing a fortnight’s isolation at the facility even though their first test was negative.

The health department official, on condition of anonymity, said there were possibilities that many more such foreign returnees, who were sent to home quarantine, might have actually jumped the protocol.

Medical experts said this approach of self-home isolation is clearly not working. Instead, they said, arrangements should have been made for mandatory sending of all passengers returning from abroad to government-run quarantine centres.

Gap in the protocol

Currently, the official said, only the passengers coming from 10 most-affected countries, and those who have directly come in contact with any carrier (of the virus), are being hauled to the quarantined facilities of the government.

All asymptomatic passengers arriving at the Kolkata airport from China, South Korea, Iran, France, Germany, Italy, Spain, Oman, Kuwait and the United Arab Emirates are being sent to the quarantine unit on the cancer hospital campus.  Three Middle-East countries were included in the list only after March 18.

For those landing at the Bagdogra airport, another facility has been established at Hatighisa, around 25 km from Siliguri.

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The official admitted selective screening was done since the state does not have enough infrastructure to isolate all passengers. But he promptly added existing infrastructure was more than enough to enforce the guidelines provided by the Indian Council for Medical research (ICMR).

The fact that both the affected persons in the state happened to be travellers from the UK, has only exposed the ineffectiveness of putting only select countries in the high-risk list out of over 180 countries grappling with the disease.

Till the detection of the first positive case on Tuesday, there was no thermal screening test for domestic passengers in the Kolkata airportThe official, however, blamed the Centre for the lapse, saying the protocol for quarantining passengers coming only from high-risk countries were laid down by New Delhi.

Existing facilities

The quarantine centre at the New Town campus of the cancer institute has 500 isolated beds. The government has also kept ready another 200-bed isolation centre on the yet-to-be-opened campus of NBCC Ltd in New Town, about 6 km from the first facility in the city.

Another 100-bed facility has been established at Hatighisa, around 25 km from Siliguri, mainly to cater to passengers de-boarding at the Bagdogra airport, the second operational airport in the state.

Besides, the number of dedicated quarantined beds in government hospitals has also been increased.

The Bed strength at Beliaghata ID hospital, where both the coronavirus patients are undergoing treatment, has been increased from 22 to 100. Another 150-bed facilities has been prepared at the MR Bangur Hospital and a 50-bed facility at RG Kar Hospital. Similar isolation facilities are also operating in various districts.

Chief Minister Banerjee, in an emergency meeting with representatives of the government and private hospitals, mooted private-public partnership to fight against the COVID-19 pandemic. She was particularly keen to rope in private pathology laboratories in screening process, saying their services would be requisitioned as soon as the ICMR gives its nod.

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At this juncture following the reports of community mixing by two carriers, experts say, screening will be crucial as has been evident by the alarming rise of COVID-19 patients in Kerala and Maharashtra due to lack of medical screening and precautionary tests.

At present, the state has only two facilities, both in Kolkata, for swab test — one at the National Institute of Cholera and Enteric Diseases and another at Institute of Post Graduate Medical Education and Research. The health department has approached the ICMR for permission to open four more centres in other parts of the state for conducting such tests.

Expansion of test and screening facilities also assume necessary as the Centre has now came out with a new guideline asking the states to track down all the passengers who have come from the virus-hit countries since January 1. The directive was issued to chief secretaries of all the states only on Tuesday, said the health official.

He said in the last two and half months, over 90,000 passengers came from abroad and tracing them now would be a humongous task. Help of the bureau of immigration has been taken to do the job, he added.

Screening at land borders

As in the case of airport, medical teams at 108 land entry points and three ports are screening those entering the state through roads and waterways. Each of these medical teams comprises of 15-20 persons. The state shares international border with Bangladesh, Bhutan and Nepal, and inter-state borders with Assam, Bihar, Jharkhand, Odisha and Sikkim.

According to the government, 79,082 persons have been screened at Kolkata and Bagdogra airports, and 4,81,238 persons have been screened at the seven land border checkpoints along Nepal and Bangladesh till Friday. Also, 4,792 crew members of ships have also been screened at the three ports in the state.

The health official admits this number is too less for a state having 9.13 crore population.