- As on May 31, Tamil Nadu has 9,400 active COVID-19 cases
- Tamil Nadu has dedicated 167 hospitals for treatment of COVID-19
- The state is testing over 10,000 people per day
New Delhi: Tamil Nadu is among the top three states with highest number of confirmed COVID-19 cases in the country after Maharashtra. While all 37 districts of the state are affected by the pandemic, capital district of Chennai is the worst affected. According to the Department of Health and Family Welfare, as of June 30, there is no fear of community transmission in the state, which refers to the stage of the outbreak where the virus becomes part of large social circles and it the source of infection for patients is not known. The recovery rate is at 55.5 per cent, the incremental rise in fatality rate (defined as deaths from a COVID-19 compared to the total number of people diagnosed with it) from 0.5 per cent during April 1.13 per cent in June is something that government is striving to keep under check.
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Here is how Tamil Nadu has fared so far in its fight against COVID-19 and what is the state’s plan to deal with the challenges ahead.
Big Jump In Cases In April, Chennai Became The Epicentre
The first case of COVID-19 in Tamil Nadu was recorded on March 7. A resident of Chennai, who had returned from Oman, started developing symptoms including fever and cough, said an official at the Rajiv Gandhi Government General Hospital where he was admitted. The official added that the patient recovered soon and was discharged within a few days. The second case was confirmed on March 18 who was a man who travelled by train from Delhi to Chennai.
In April, a month after Tamil Nadu recorded its first case, the total number of positive cases was 124. April saw a significant spike across the State as the number increased to 2,199 cases, despite the lockdown. This surge, according to Dr. T. S. Selvavinayagam, Director- Public Health, can be attributed to the increased testing across the state. The number of positive cases in the state has gone up by almost 10 times by the end of May, mostly because of the increased testing, return of participants of a religious event in Delhi and influx of migrant workers, he said.
As of June 30, Tamil Nadu reported a total of 90,167 confirmed cases, including 38,889 active cases, 1,201 deaths which is about 1.13 per cent of total cases, while 50,074 people have been cured of the virus which is 56.3 per cent of total cases, according to the daily bulletin updated by the Department of Health and Family Welfare, Government of Tamil Nadu.
Further looking into the trend of a rising number of cases, the state took about 60 days for positive cases to cross the 5,000 mark whereas it took a mere eight days to cross the 10,000 marks and another eight days to cross the 15,000 mark.
The data on COVID-19 patients provided by the state shows that men are most affected by the infection. The total number of males tested positive in the state till date are 55,502 which is almost 61.5 per cent of the total number of cases. Number of females and transgenders tested positive are 34,644 and 21 respectively.
The age-wise data of COVID-19 patients provided by the state shows that there are 1,286 cases are children in the age group 0-12 years, 18,995 cases are between the age 13-60 years and 2,052 cases are citizens who are above years of age.
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Commenting on the fear of community transmission in the state, Dr. A M Kadri, Secretary General, Indian Association of Preventive and Social Medicine (IAPSM), a Delhi-based not-for-profit organization of preventive medicine and public health specialists said,
It is not fair to say that the whole state is in community transmission phase. As a matter of fact, even the whole district of Chennai does not have community transmission yet. However, there are clusters and areas where community transmission is well established in the city.
Dr. R. Narayanababu, Dean, Government Medical College, Omandurar Government Estate, Chennai said that most of the cases who could not survive were also having co-morbidities, which refers to the presence of one or more additional physiological or psychological conditions like hypertension and diabetes.
Till June 30, the state received over 2.8 lakh (2,83,660) passenger from various states and countries out of whom 3,472 have tested positive. This influx has also added to the spike in the number of cases in the state.
With 58,327 active cases in Chennai, the state capital has over two-third of Tamil Nadu’s cases. Out of the total cases in Chennai, more than half, 34,828 have been discharged while 888 people have succumbed to the disease as on June 30.
About 1,533 migrant workers who returned to Chennai largely from Maharashtra in the month of May were tested positive spiking up the cases in the city.
Chengalpattu is the second worst-hit district with 5,419 cases, followed by Thiruvallur which has 3,830 cases. The district of Dharmapuri has the least number of cases- 81 and Nilgiris has 89. Of the 37 Tamil districts, 12 are in the red zone while 25 are in the orange zone. (Red Zone includes hotspot districts that contribute to more than 80 per cent of cases in the state or with doubling rate less than four days and Orange Zone include districts without new cases in last 14 days)
Meanwhile, Chief Minister K Palaniswami has said that 86 per cent of COVID-19 cases in the state are asymptomatic- positive cases showing no symptoms. He also said that the mortality rate in the state was the lowest when compared to other states and even some foreign countries.
Earlier in May, the state government allowed treatment at home for people with mild symptoms and issued guidelines for the same.
While talking about the rising number of cases in the state, Tamil Nadu Relief Commissioner Dr. J. Radhakrishnan said,
Ultimately the behavioural change is missing. 10-15 per cent of people are actually putting everyone else to risk. A jump in the number of cases is also because of the consistently increasing testing. Don’t worry about the numbers. Testing and identifying patients is more important. The number should come down organically and not by reducing testing.
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Ramping Up Of COVID-19 Testing In Tamil Nadu
During the initial period of the pandemic, the state faced criticism for the low number of tests. According to the Department of Health and Family Welfare, by mid-March, the state had tested only 90 samples while the neighbouring states of Kerala and Karnataka had tested more than 1500 and 750 samples. Dr. Selvavinayagam said,
The health department is following test protocols established by the Union Health Ministry. There has been a drastic increase in testing per day. The state has also tested for community transmission and there is no fear of it as of now. But sure in the coming future, the state may face community transmission stage but that’s a fear that all states share.
By June 30, the state was testing at a rate of 30,000 samples per day, on an average. This accounts to over 15,466 tests per million people, according to the Department of Health and Family Welfare.
As of June 30, over 11 lakh (11,70,683) samples have been tested.
According to the testing guidelines dated May 11, among the persons coming to districts from other districts in Tamil Nadu, testing to be done only for those coming with symptoms while all individuals to undergo home quarantine for 14 days. Among people coming from other states and Union Territories, testing needs to be done on each of them, says the guideline. If they test positive, they are taken to a hospital and in case of a negative result, they need to be under institutional quarantined for seven days.
There are currently 85 testing facilities across the state including 45 government and 40 private laboratories.
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While talking about the challenges faced by laboratories that are testing for COVID-19, Dr. Amrose Pradeep, Chief Medical Officer at YRG CARE, an ICMR (Indian Council of Medical Research) approved private laboratory testing for COVID-19 at YRG Hospital, Taramani, Chennai said,
There are two major challenges that we are facing as of now. And I know these challenges are there because this COVID-19 situation is new for all of us and we are gradually preparing for it. One of the challenges is related to testing asymptomatic persons. There are set guidelines of the government for testing asymptomatic persons. It says that those asymptomatic persons need to be tested who were in contact of a COVID-19 positive patient. But we receive testing requests from a lot of persons who show no symptoms and who have not come in contact with positive persons. This is because hospitals ask them to get tested before letting them see doctors for a non-COVID ailment, before surgeries and other medical procedures and if they require to travel to other state and the state authorities ask them to get tested first. It becomes difficult for us to decide either reject their request and follow only the guideline or test them because a majority of them literally plead us to conduct the test. A lot of people call for appointment every day. The fear is that catering to every test request may not be fair to those who need testing more urgently.
The second major challenge the Dr. Pradeep shared is a logistical challenge related to the introduction of mobile applications and government testing portal updating that needs by the technicians. He said,
Most lab technicians are not tech savvy. That’s our second major challenge. Although there have been multiple training sessions but since the standard operating procedures for recording tests and testing data are fairly new, it will take some time for then to get a hang of it. There is an RT-PCR mobile app of the central government which requires the suspected person to fill up testing request form which are then dealt by the technicians. Apart from this, they are also required to frequently update the central testing portal and the state government testing portal with the details of the tests done including the demographic details of the person tested. This is an additional work that technicians do and there are high chances of mistakes which can reflect on the national portal.
Dr. Pradeep further shared that more than 50 tests are being done every day at their lab. The cost of each test is Rs. 3000 and the lab ensures that the results are provided the same day. Till now we have not faced any shortages of testing kits. On availability of testing kits, he said,
We have ample stock of RT-PCR (Real-Time Reverse Transcription Polymerase Chain Reaction) tests and we always get the new stock when we ask for from the state government.
By the end of May, the state has possession of 11.51 lakh RT-PCR (Real-Time Reverse Transcription Polymerase Chain Reaction) test kits, a majority of which was procured from a South Korean firm. Out of these, 5.03 lakh kits have been exhausted, said Chief Minister Palaniswami while addressing the media on June 2. He added that about 4 lakh RT-PCR test kits are expected to be received by the state. The state had also ordered 5 lakh rapid test kits.
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Tamil Nadu’s Health Infrastructure
While talking about the health infrastructure and medical supplies, Dr. Narayanababu said,
There is no shortage of beds. The state is not facing any challenges on the medical supplies front as well. A large number of doctors have come forward to provide service in the fight against the pandemic. There is no shortage of medical staff. The state has been recruiting nurses and other medical staff as the requirement arises.
According to the Department of Health and Family Welfare, there are 167 dedicated COVID-19 hospitals across the state along with 105 dedicated COVID-19 health centres and 69 dedicated COVID-19 centres. Among private hospitals, 115 are currently offering COVID-19 treatment facility.
The state has dedicated over 29,000 beds for COVID-19 patients, as of May 11 including over 6,500 beds in private hospitals. Over 4,000 ventilators are currently available in the dedicated COVID-19 hospitals including 418 in private hospitals and the state is procuring another 2,000.
Earlier in April, the Chennai Trade Center in Nandambakkam was converted into a 550-bed COVID-19 quarantine ward and as many as 747 marriage halls and 50 schools have been identified in Chennai to be converted as COVID-19 care centres.
Efforts Taken To Address The COVID-19 Situation In The State
According to Dr. Selvavinayagam, the state government started acting from February itself, soon after the first COVID-19 case was reported in the country. Measures included checks at railway stations and airports, sealing of the borders and the government shutting down its border in mid-March and implementing the lockdown thereafter. The government has also established helplines for the public and launched a mobile App for officials to monitor people under home quarantine.
The state government has so far allocated Rs. 4,033 crore towards various efforts related to COVID-19, as per a statement released by the CM’s office during the first week of June. A major portion of this sum, according to the statement, is being utilized in strengthening health infrastructure, including the appointment of more doctors and nurses and increasing testing laboratories and hospitals. Rest of the amount is supporting the state in steering the economy back on track.
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Measures Undertaken By The State To Provide Relief To The Poor
To provide shelter to the homeless persons and migrants workers during the lockdown, the state administration converted community halls into shelter homes and these are being disinfected regularly to ensure cleanliness.
To address food security, during the months of April, May and June, free ration, including rice, daal, cooking oil, and sugar is being provided to over 2 crore ration cardholders in the state. Apart from this, Rs. 1,000 is being given to about 35.65 lakh unorganized labourers per month by the state government.
The Chief Minister informed during a video conference with the Prime Minister on May 11 that the state government has also provided 2.56 lakh of migrant labourers with free ration that includes 15 kilograms of rice, 1 kilogram of dal, and 1 litre of cooking oil. Free ration comprising of 12kg rice, 1kg Dal, 1litre cooking oil per head is being given to the members of the third gender. Subsidised food is being provided via Amma kitchens and community kitchens to the poor and needy and over 1.71 lakh labourers are provided with cooked food, on a daily basis.
Dr. Narayanababu said that the government is taking up all kinds of measures for people’s welfare and to provide them support as the state fights against the contagion. He added that people must reciprocate by providing their cooperation and following government guidelines. The daily bulletin released by the state government along with numerous awareness campaigns advise people to follow social distancing, wash hand regularly for at least 20 seconds with soap and water and cover the nose and mouth while stepping out.
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