Kerala Health Minister seeks better, local public health to fight epidemics
Thiruvananthapuram, Jan 25 (IANS) Kerala Health Minister K.K. Shailaja says that improving the public health system and increasing the number of Primary Health Centres is the best way to contain contagious diseases like coronavirus.
In an interview to IANS, she noted that Kerala is still in the process of containing Covid-19 and that the government is on the right track. She said that delaying the peak was one of the strategies and that containing the mortality rate has been a major achievement for the health workers and the state government.
Following are excerpts of the interview.
Q: Kerala had contained the Covid pandemic and flattened the curve during the early days and you had won accolades from across the globe. However, the situation is turning worse and the state is now at the number one position in the country as far as the daily Covid cases are concerned. Why is this?
A: Kerala did manage Covid-19 in a systematic and strategic manner and we could contain the disease while it was surging ahead across the globe including in advanced and developed countries like the US, the UK and throughout Europe. During lockdown, we were improving our health facilities, increasing the number of beds, equipping ICUs and all the health infrastructure in general and we were successful.
As of now, there is a surge in the disease as the state has not yet peaked and we are focusing on delaying the peaking. It is also important to note that the mortality rate of the state owing to Covid is very less compared to developed countries and other states of India. This was our primary focus and we are successful in that. It may be noted that during peak of the disease in several countries, many people lost their lives and mortality rate was too high... this we could contain and saving lives are more important.
Q: The test positivity rate is also at a high, rather the highest in the country. What do you say?
A: Test positivity rate is directly proportional to the number of samples tested per day and if there is a surge in the cases, naturally test positivity rate will also increase. However the methods we have adopted will bring results and as I said in my previous answer, we are focusing mostly in preventing the mortality of the patients and to a large extent, we are successful in that.
Q: What you feel is the major reason for a surge in the disease?
A: You know the graph was flattened for quite some time even after the lockdown was lifted in May. We opened our airports for the biggest evacuation - the Vande Bharat Mission. People from all parts of the globe reached the state and still we were managing. However following the festival season, right from Onam and opening up of the shops and malls, people came out and this led to an increase in the Covid cases.
The recent local body elections increased the surge as people used to come in contact with one another. Also the mass agitations conducted against the government also led to people coming in contact with each other, thus increasing the number of cases. However, the surge is only temporary and the health system is in place and we will manage this.
Q: Vaccination has commenced and there are reports of health professionals showing laxity in taking the vaccines. Do you feel that there is a hesitation on the part of health workers including doctors and nurses to take the vaccine?
A: I don't think that our health workers including doctors, nurses and paramedics have shown a reluctance in taking the vaccine. Instead, I find them to be enthusiastic. Of course some people may have their own apprehensions in taking the vaccine but they will all be inoculated soon.
Q: Kerala has 133 vaccination centres and it is learnt that the state has requested for more. Why is it so?
A: We are far ahead as far as health infrastructure is concerned and the Centre has restricted the vaccination to 133 centres here in accordance with other parts of the country. I have already spoken to the Union Health Secretary for allowing more centres as we are equipped for 1,000 centres so that maximum health workers including doctors, nurses and paramedics are inoculated at the earliest. More than this we have to provide booster doses and once we get more centres, we will be more comfortable.
Q: What was the major threat you faced while preparing a road map to contain the disease?
A: Our main concern was the population density of the state. Kerala is an extended village quite unlike other states and the density of population is the highest in the country. This was one of the main issue we had to take into consideration before rolling out a strategy to contain the disease. Secondly, Kerala has the highest geriatric population of the country and the highest number of diabetics and lifestyle diseases. We developed our strategies based on these facts. I feel that containing the fatality rate fighting against these odds was a challenge and our health system has risen to the occassion.
Q: You said that betterment of the public health system and increase in the number of Primary Health Centres will help containing contagious diseases. Please explain?
A: Every state and nation has to improve its public health system which will help to contain all contagious diseases as common man will be benefitted by this. Primary Health Centres are the immediate solace for the general public and increasing the number of PHCs is very important in the fight against epidemics, pandemics and viral attacks. The PHCs help to get primary treatment and detection of diseases and getting treatment at the immediate neighbourhood will help contain the spread and to focus locally.
Q: When do you feel the state will flatten its curve?
A: The state is in the process of flattening the curve and the health professionals, including doctors, nurses and paramedics along with the Health Department, are in a firefighting mode to achieve that. As far as the government is concerned, we will not be going for a lockdown and even movie theaters are now open in the state. Hence the possibilities of the increase is high but people are aware and we have created a proper awareness among the public for the use of masks, sanitising and more importantly, keeping a distance from one another.
As I said earlier, the most scientific method to contain a pandemic is to delay the peak as this would cause an increase in the number of beds needed. For instance, we have used only 50 per cent of our hospital beds, 50 per cent of our ICUs and this is owing to the delay in peaking and this helped in containing the number of deaths. In several countries and even in places like Dharavi in Maharashtra, there was a sudden surge in death cases before the curve was flattened.
We could manage the number of cases within the threshold of our health care system and our fatality rate is only 0.4 per cent. We are bringing up an awareness programme "Back to Basics" by which people with symptoms of the disease will be tested and more observation will be conducted.