Why this small coastal district in Kerala has become a hotspot for coronavirus

Authorities in the district have dismissed the possibility of community transmission and attributed the high figure to people with travel histories.

Medical staff members wear masks and protective suits outside an isolation ward in Kochi | PTI Photo
File image of medical staff wearing masks and protective suits outside an isolation ward in Kochi, Kerala | PTI

New Delhi: Kerala’s Kasargod, a small coastal district in the north of the state, has become the hotbed of coronavirus infection with 82 positive cases — which is half of the state’s total cases.

According to the health ministry website (which updates coronavirus figures twice a day), Kasargod has 78 positive cases, which is the second highest after Mumbai, where the figure stands at 81, as of Monday evening.

But District Medical Officer Dr A.V. Ramadas told ThePrint that Kasargod has 82 positive cases so far.

Authorities, however, have dismissed the possibility of community transmission in the district, attributing the high figure to people with travel histories.

“Almost all of the positive cases are from Dubai. This is because around 1.5 lakh people from Kasargod reside in Dubai. That’s why most of the cases are being reported here,” Ramadas told ThePrint over the phone. 

Kasargod shares border with Dakshina Kannada, a district of Karnataka.

It is difficult to find a family in the district who doesn’t have ties with either Mangaluru in Dakshina Kannada or Dubai.

According to the district administration’s data, 7,042 people came to the district after 20 February, of which 127 symptomatic people were hospitalised and 6,915 were put under observation


Also read: Isolation, counselling, paracetamol — how Kerala is treating coronavirus patients 


Blame it on the returnees

In February, Kasargod had reported the third coronavirus case in the country — a student from China’s Wuhan, the epicentre of the highly infectious novel coronavirus. The first two cases were reported from other districts in Kerala. All three patients had mild symptoms and were cured and released soon after.

Since then, the state has seen a drastic spike in the number of cases. As of Sunday, Kerala had 165 positive cases. Of the 20 new cases reported Sunday, seven were from Kasargod. 

Ramadas said the district authorities are not worried about the situation since only a few of the positive cases are of those who are family members of the coronavirus-positive patients. As many as 72 of the 82 positive cases are of people with travel history from Dubai, he confirmed.

Several of these patients belonged to Naif, a crowded commercial-cum-residential area of Dubai, which has emerged as a Covid-19 hotspot.

The district has, however, been on the edge over some cases in which the patients had travelled and met several people. For example, the case of a man from Kasargod’s Eriyal village who had extensively travelled for six days despite being advised to remain under home quarantine.

According to the route map that was released by the administration, he had stayed at a hotel, visited Calicut International Airport multiple times after his arrival, eaten at a restaurant, visited his brother’s home at Maipady, attended a marriage function and played football during this time.

Ramadas said most of this patient’s contacts had tested negative, but Kasargod MLA N.A. Nellikkunnu was livid at the “negligence”.

“The moment they (the Gulf returnees) landed at the airport, the district authorities should have apprehended them and put them in an isolated area. However, these kind of measures were not adopted by the district authorities in the beginning, which gave these people an opportunity to go about their whims and fancies,” he told ThePrint.

On 22 March, the MLA had also written to Chief Minister Pinarayi Vijayan, demanding that those with travel history be compulsorily subjected to 14-day isolation. His letter had also highlighted the case of the patient from Eriyal and demanded that residents of the specific panchayat in the village be tested. 

Such cases had also prompted the neighbouring Mangaluru district administration to seal Dakshina Kannada’s borders with Kasargod, even two days before Prime Minister Modi announced a 21-day nationwide lockdown.   


Also read: Why a 3-year-old in Kerala being diagnosed with coronavirus is a crucial statistic


The measures

The district authorities in Kasargod have identified quarantine centres in every panchayat for those who’ve returned from abroad.

“They will directly go to these centres, which will have one assistant public health inspector, one staff nurse and the doctor in-charge of a Public Health Centre will be on call,” Ramadas told ThePrint.

Swab tests are done on suspected cases and if the test results come back positive, the patients are admitted in different hospitals based on the severity of their case.

Most of those who tested positive are asymptomatic, said Ramadas.

The asymptomatic patients are sent to primary treatment centres, which are hospitals that have been identified by the local administration. The symptomatic cases, which Ramadas pegged at 4 or 5 or those with co-morbidities, are sent to either the General Hospital in Kasargod or the District Hospital in Kanhangad.

About 30 isolation wards have been marked out in the two hospitals. The more severe cases are treated at Kasargod Medical College. 

So far, one positive patient has been cured while results from the third round of testing are awaited in a few cases.

MLA Nellikkunni, however, raised concerns over the number of health personnel in the district and the testing procedure.

“In the coronavirus-affected areas, we do not want police personnel, we want doctors and other medical facilities. According to my knowledge, even now there are 30 doctor vacancies in Kasargod district,” he said. 

Ramadas, however, dismissed the issue and said, “This is a far-off city and there are not many educated people here. Yes, there is a [personnel] shortage and, but we are managing.”

Concerns were also raised about the testing process amid the lockdown.

Currently, samples from every district in the state are sent to the National Virology Lab in Allapuzha, which is 410 km away from Kasargod.

“But it will take time because postal services and courier services had been affected. These facilities should be extended to every primary health centre and community health centre in every panchayat,” Nellikkunnu said.

ThePrint contacted the state health officials, but they were unavailable for comment.


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