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Tamil Nadu gets new health secretary as death toll comes under scanner
Three-member central team visited the state’s seven worst affected districts to study how Tamil Nadu, which has one of the highest testing levels in the country, is dealing with the pandemic.
Tamil Nadu on Friday appointed current revenue administration commissioner J Radhakrishnan as the new health secretary, transferring Dr Beela Rajesh to the commercial taxes and registration department, a day after the state’s data on deaths due to the coronavirus disease came under the scanner.
The move also comes at a time when a multi-disciplinary team appointed by the Centre to study the state’s low mortality rate, among other parameters, is expected to submit its report to the Union health ministry. It had visited the seven worst affected districts in the state, including Chennai, earlier this month.
“Our concern is to prevent and contain the disease. If it spreads, we should not lose lives. In that context, Tamil Nadu emerges as the best in the country. This visit will offer us insights which can be emulated in other states,” Rajendra Ratnoo, the nodal officer in the central team coordinating between the Centre and the state, said. The team is also expected to assess gaps in the state’s response to the pandemic, and recommend areas of improvement.
Earlier this week, the TN Directorate of Public Health (DPH) and Preventive Medicine found that the death registry maintained by the Greater Chennai Corporation had recorded 236 deaths that were not added to the state’s tally. A nine-member committee has been formed to reconcile Covid-19 related deaths for Chennai.
When asked whether a rectification of Covid-19 death numbers would affect the report, Ratnoo said, “We have asked the government to share all the data with us which we will analyse again after it’s updated.”
As of June 11, Tamil Nadu (38,716) had the second highest number of cases in the country after Maharashtra (97,648). While Chennai accounted for 70% of the caseload in the state, other affected districts include Chengalpattu, Kacheepuram, Thiruvallur, Ariyalur, Villupuram and Cuddalore.
The central team, which included two doctors from Puducherry’s Jawaharlal Institute of Postgraduate Medical Education and Research, arrived at the capital city on June 4 and travelled to the worst hit districts over three days to study the measures undertaken by the state to tackle the spread of the coronavirus pandemic, including testing levels, containment strategies, quarantine facilities, treatment and clinical management.
The team is currently analysing the data and will submit the report soon, Ratnoo said.
The Centre has deployed a three-member multi-disciplinary team each in 50 districts of 15 states with a high burden of the coronavirus disease (Covid-19) for direct monitoring of the situation, and assist in the management of the pandemic.
TAMIL NADU’S TESTING LEVELS
Tamil Nadu also registers the second highest tests per million among the 10 worst affected states in the country. While the national average is 4024 tests per million, Tamil Nadu conducts 8662 tests per million. The only other state that tests more than it is Delhi, which had 34687 cases as of June 11, and a testing average of 13703 per million.
According to experts, the state’s public healthcare system that has been in the making for decades is responsible for the robust testing mechanism in place. A turning point was the swine flu outbreak in 2009 when laboratories with RT-PCR (reverse transcriptase polymerase chain reaction) facilities were increased across the state. This existing infrastructure resulted in approvals for 77 government and private labs to test Covid-19; one of the highest in the country.
“Years of work in strengthening our system is yielding results now,” says Dr K Kolandaswamy, who retired as Director of Public Health on April 30. “Availability of equipment, knowledge of testing, trained manpower helped us to quickly expand efforts during Covid-19.”
RT-PCR machines were also mobilised from medical colleges and departments of animal husbandry, agriculture, biotechnology and fisheries.
This allowed the state to scale up testing during outbreaks such as when attendees of a religious conference in New Delhi returned to the state in March, or when the Koyambedu wholesale market in Chennai emerged as a hot spot.
The state scaled up testing to thousands of samples everyday after it mismanaged one of Asia’s largest wholesale markets in Koyambedu located in the heart of Chennai. From this epicenter the infection spread rapidly across Tamil Nadu and all the way to Kerala and Andhra Pradesh. This compelled extensive contact tracing and testing to contain transmission. More than 3,000 positive cases have been linked to the market and officials say it has been contained. Now, efforts are underway to trace domestic and international travellers using air and rail.
“Koyambedu market was our most massive and difficult contact tracing exercise,” said a doctor, who did not wish to be named, at the emergency control room in Chennai from where he oversees contact tracing for the entire state. From mapping international co-passengers to watching wedding videos to track guests, this team coordinates with the state’s health, police and revenue departments, as well as the control rooms in all districts.
In one of the earliest cases in March, contact tracing found that a staffperson at Chennai’s Phoenix Marketcity had contracted the virus from a Kerala-based customer who tested positive on landing in Sri Lanka.
At a hyperlocal level, contact tracing helped contain transmission at a single street in Chennai in May. A volunteer who distributed food to residents in his neighbourhood was the primary source. A flow chart of the locations he visited and all people with whom he had interacted was prepared. Health workers went door-to-door and police rang up contacts to check for symptoms; 42 cases were reported solely from the street of the volunteer’s residence. A week later it surged to 88 including adjoining lanes. All patients have now recovered. There are 360 containment zones in Chennai currently.
“There is an intense street specific approach being taken to root out coronavirus by tracking, tracing, isolating, testing and treating the patients,” J Radhakrishnan had said earlier this week. “The high numbers are an opportunity to bring out positive cases and their contacts so we can limit the spread.”
Radhakrishnan, a 1992 batch IAS officer, was appointed as Special Nodal Officer for Greater Chennai Corporation to coordinate coronavirus-related issues with the civic body chief on May 1.
“We are looking at team work, interdepartmental coordination and cooperation from the public,”Radhakrishnan said after taking charge.
