With a large number of its expatriate population expected to return by next week, Kerala is set to take the fight against the Covid-19 pandemic to the next stage by showcasing a plan to protect the aged and people who suffer from co-morbidity conditions.
Kerala, which has the lowest mortality and highest recovery rates in the country, has prepared a blueprint for ‘reverse quarantine’ and grassroots health workers have started monitoring health conditions of aged and people who are immuno-compromised.
No new cases were reported on Sunday. The state has recorded 499 cases of Covid-19 out of which 95 are active.
Experts say reserve quarantine is a practice of isolating the most vulnerable people, aged or people with co-morbidity conditions, from the rest and monitor their health conditions closely to protect them from infection.
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“In Kerala we have 70 lakh people who are above 65 years of age and suffer from diabetes, cancer, blood pressure, heart ailments, kidney disease and respiratory tract infections. They are sitting ducks. Our priority is to detach them from others and protect them,” said Dr B Ekbal, who heads an expert panel that advises the state government on prevention of coronavirus.
“In case of a community spread we can isolate vulnerable populations and check their mortality rate effectively unlike what happened in some of the western countries. We have formed grassroots committees to monitor their health conditions. Besides local body members, Asha workers, resident association office-bearers, youth volunteers and local police officers will be part of these committees,” he said.
{{/usCountry}}“In case of a community spread we can isolate vulnerable populations and check their mortality rate effectively unlike what happened in some of the western countries. We have formed grassroots committees to monitor their health conditions. Besides local body members, Asha workers, resident association office-bearers, youth volunteers and local police officers will be part of these committees,” he said.
{{/usCountry}}Dr Ekbal said reverse quarantine was nothing new and had been tested during earlier pandemics but was not widely publicised.
Experts like him feel that reverse quarantine is a viable option against Covid-19 till a vaccine is found. Once a person is in reverse quarantine a separate room with a bathroom can be given to him/her and his/her interaction with other family members will be limited. Even if they interact, social distancing and using masks are must for them in the house. If he/she takes it in the right sense that it is for his/her sake it will be a success, they said. In north Kerala many cancer patients are already in reverse quarantine now.
“Since it is a new virus we need a multi-pronged strategy to deal with it. Reverse quarantine is one among them. We can’t say how long the virus will be active and achieve herd immunity. So we can isolate people who are more prone to it. As Kerala is an informed society it is better to practise here,” said epidemiologist and former principal of the Vellore Christian Medical College Hospital Dr Jayaprakash Muliyil.
Experts say during reverse quarantine a sense of deprivation and neglect will be quite high among people and it has to be addressed adequately by family members and counsellors. In certain areas especially north Kerala palliative care is strong and services of those volunteers can be used here, said Dr Ekbal.
“We can’t live in lockdown like this for long. We have to live with it till a vaccine is found. So we have to evolve a mechanism to suit this. Like social distancing, reverse quarantine is a way to check mortality rate,” said another expert.
The key is “minimum exposure” of the vulnerable to the outside world, he said.
In red zones in Kerala, there is a ban on people above 65 and children below 10 years of age stepping out of their houses.
The state is planning reverse quarantine in a big way as it expects an exodus from the west Asian countries by next week. At least 3.50 lakh people have been registered on a website opened by the government. The government is being more cautions this time after some of the returnees from Dubai in March jumped home quarantine and infected many others with Covid-19.