Kerala, Apr 06, 2020: Days after Pathanamthitta nearly managed to ‘flatten the curve’ with several COVID-19 patients in the Kerala district being discharged from hospitals, a fresh case has now rattled officials.
Flattening the curve refers to implementation of social isolation measures to reduce the number of cases which may potentially occur. The term curve here is used to denote a hypothetical number of cases which may be seen based on analysing existing data.
A 19-year-old student, who traveled from Delhi to her hometown of Pandalam in Pathanamthitta, tested positive for the virus on Sunday, April 5.
For Pathanamthitta’s administration, this particular case proves to be especially daunting on two counts:
a) the young patient, who is a student in Delhi, has remained entirely asymptomatic throughout her observation period and
b) she tested positive 19 days after she was possibly exposed to the virus, which is well over the current incubation time period of 14 days; suspected cases are monitored or quarantined based on this universally accepted standard.
‘Tested as Delhi is a hotspot’
The 19-year-old had boarded a train— the Mangala Lakshadweep Express— the Hazrat Nizamuddin railway station in Delhi on March 15, arriving at the Ernakulam Junction station on the morning of March 17.
The student reached Chengannur in Alappuzha in a general compartment after boarding a local train from the Ernakulam North station. The patient’s route map, released by district authorities, shows that from Chengannur, she had taken a Kerala RTC bus to her hometown of Pandalam on March 17.
For the next 19 days, the young student showed no symptoms of the virus as she spent her days in home quarantine.
However, with the Kerala government testing all those who had arrived from COVID-19 ‘hotspots’, which included Delhi, the student was identified as a carrier on April 5.
“We knew that Delhi is a hotspot due to the Tablighi Jamaat conference which has resulted in hundreds of cases across India. The student had taken a train from Nizamuddin, where the Tablighi Jamaat conference had taken place. So we decided to send her swab sample for testing on April 3, just to be sure,” District Medical Officer, AL Sheeja told TNM.
On April 4, the student was shifted to a hospital isolation ward in the district and health authorities in Pathanamthitta began quarantining her primary and secondary contacts.
Although the source of the young patient’s infection still remains a mystery, according to reports, several people who had attended the Nizamuddin Markaz conference had traveled back on the same train on March 17.
In Pathanamthitta alone, district authorities have identified 21 people who had attended the Tablighi Jamaat conference in Nizamuddin. Nineteen samples from this pool had been sent for testing, out of which 16 have tested negative for the virus. The results for the other three are still pending.
According to the DMO, the patient remained asymptomatic on April 5, even after her test results returned positive.
On March 31, the Kerala government issued guidelines for high-risk contacts and those with symptoms to observe a 28-day quarantine period or ‘double incubation period’.
According to the guidelines, a ‘high-risk contact’ was modified to include persons who had traveled ‘to a locality where active COVID-19 community spread is suspected or clustering of confirmed COVID-19 cases is detected in the last 14 days.’
Chief Minister Pinarayi Vijayan, in his press meet on April 1, stated that those who had traveled to Kerala, from anywhere within the country, between March 5 and 28 should observe home quarantine for 28 days. This was prompted by cases in the state where patients exhibited symptoms after the 14-day quarantine period, according to officials in the health department..
New measures for Pathanamthitta?
The District Medical Officer confirmed to TNM that as of Monday, persons with travel history from high risk areas were being monitored for 28 days. No other district-specific measures have been put in place yet, the DMO said.
“We have quarantined around three to four primary contacts of the student and a few secondary contacts. However, there is a huge task ahead for the state with regard to identifying the larger group of people she came in contact with in the KSRTC bus, the railway stations etc. Measures to identify these people too are now being taken,” the DMO added.
Speaking to the media, Pathanamthitta district collector PB Nooh said that identifying the larger pool of people who came in contact with the student would prove to be an arduous task for the state.