New Delhi: Up until mid-January this year, Lakshadweep, an archipelago of 36 islands in the Arabian Sea, was a coronavirus-free paradise in India.
Knowing its inadequate medical infrastructure won’t be able to cope if Covid hit the tiny union territory, the administration had put in place an elaborate containment plan, and managed to successfully keep the virus away through 2020 even as it ravaged the rest of the country.
But all this changed in the new year.
On 18 January 2021, Lakshadweep reported is first Covid case. When the patient’s 31 primary contacts were tested, 13 of them were found positive too, registering a test positivity rate of 42.4 per cent.
In a span of four months since — until 17 May — Lakshadweep has reported 4,986 cases and 14 deaths. The active caseload at present is 1,208 cases.
The UT has thus over 7 per cent of its entire population of about 70,000 infected by the virus.
The opinion on why Lakshadweep saw such a spurt in the numbers, however, differs.
While Mohammed Faisal, the lone MP from the UT, blamed it on the decision to relax the stringent quarantine measures in December 2020, officials in the administration said it was due to the virulent new strain and movement of people as economic activity resumed.
UT Administrator Praful Patel also said since the archipelago’s main connection to the “mainland” was Kerala, it was but natural that the state’s surge in Covid cases would “reflect in Lakshadweep as well”.
The archipelago has three entry points in all — from Kochi and Kozhikode in Kerala and Mangaluru in Karnataka.
Under the old standard operating procedure (SOP), passengers would be quarantined for seven days in guesthouses run by the UT administration in Kochi, and also in two hotels taken there for the purpose, before they took an RT-PCR test. After arriving in Agatti also, they had to undergo another 14-day quarantine.
Similar isolation arrangements were in place in Kozhikode and Mangaluru also.
However in December, a new SOP was issued, which did away with the quarantine period both in “mainland” India as well as in Lakshadweep. According to the new guidelines, all that one needed to enter the UT was a negative RT-PCR report from an ICMR-approved laboratory.
Tests, vaccination and damage control
Collector Asker Ali said it would be wrong to blame the surge in cases entirely on the relaxation in quarantine measures.
Speaking to ThePrint, he said the surge was due to two main reasons — the increased movement of people with economic activity resuming and the “very high” transmission rate of the new strain.
“Between January and May, there was a movement of more than 15,000 people between mainland India and Lakshadweep. Over 400 weddings took place in the past four months, 1,000 tourists also came to the union territory, over 400 mechanised sailing vessels, which take care of supply material, were also operating, fishing started, students were moving up and down for educational purposes. We need to realise that a year on, these were all requirements for livelihoods of people,” Ali explained.
Ali said 95-98 per cent of the cases were asymptomatic, but there were some serious cases too and the patients had to be airlifted to Kochi for treatment at the Sanjivani Hospital of the Indian Navy.
Kochi in Kerala is the “mainland” on which the group of 36 islands, of which only 10 are inhabited, depend for everything — from essential supplies to healthcare. All the islands are 220-440 km away from the coastal city of Kochi, with flights and ships operating mainly from Kochi and Kozhikode.
“Even during Ramzan, people were moving back and forth between Lakshadweep and Kerala. So, naturally if there is a rise in cases in Kerala, it will reflect in Lakshadweep as well,” Administrator Patel told ThePrint.
Kerala saw a record high number of Covid cases in April-end with over 38,000 new cases reported in a single day.
Lakshadweep Health Secretary Amit Satija told ThePrint that the UT also recorded a very high number of cases — 941 — between 19 and 25 April, though he said this was also because testing was ramped up.
To curb a further spread of the virus, meanwhile, the UT has from Monday started clamping a ‘corona curfew’ in four of the 10 inhabited islands — Kavaratti, Andrott, Amini and Kalpeni. The curfew is relaxed for four hours from 6 am to 10 am every day.
In Kadmat and Bitra islands, a night curfew is in place.
The quarantine SOP has also been reintroduced on the Lakshadweep side. According to new rules, family members of the person travelling also need to quarantine themselves if they stay in the same house.
The officials also said focus of the administration is on vaccination.
According to Ali, 32,000 people have already been vaccinated in the UT.
While Satija could not say how long it would take to vaccinate the entire population, he claimed that 90 per cent of the healthcare and frontline workers had got both doses of the vaccine, adding that 86 per cent of the above 45 years population and 98 per cent of the above 60 population had got at least one dose.
“We have received the first batch of 1,250 vials for the 18-44 category. We expect the next batch sometime this week,” said Satij said.
Lessons learnt along the way
The main lessons learnt from this surge in cases, according to both Health Secretary Amit Satija and Collector Asker Ali, was the need to ramp up facilities. These include hospital beds, medicines, oxygen resources.
At present, there are just three hospitals in the UT — Indira Gandhi (IG) Hospital and Rajiv Gandhi Speciality Hospital in Kavaratti, and the Government Hospital in Minicoy. The Indira Gandhi Hospital has 70 beds, while the Rajiv Gandhi Speciality Hospital is a 100-bed tertiary care facility. Besides, there are three 30-bed community health centres in the three islands of Androth, Amini and Agatti.
“We have started discussing preparations for a third wave (if that happens). We need to ramp up physical and human infrastructure. We have also called a critical care expert here so we don’t need to fly out critical patients to Kochi. We will try and treat everyone here. However, if it gets very critical then they will be airlifted to Kochi,” Satija said.
He said the main lesson was to follow the central government’s guidelines of tracking and testing, which made it easier to control the virus.
Satija also said the geography of the archipelago was a challenge for them since the islands are located far away from each other and remote, with connectivity posing a problem.
“We don’t have a Lakshadweep model but an island-centric model,” he said.
Ali agreed. He said each island was considered one unit and the entry points from Kochi, Kozhikode and Mangaluru were being monitored.
“We are also planning on setting up two oxygen plants in Agatti and Kavaratti to prepare for a potential third wave, and they should be ready by the end of this month. And we are also stocking up on oxygen concentrators and cylinders,” he said.
“In Lakshadweep, we work like a family, a team. And all the work is done by the government, with no private players’ help.”
‘Administration to blame’
Mohammed Faisal, the two-term Congress MP from Lakshadweep, told ThePrint that he believed it was the laxity in quarantine measures that resulted in the surge in cases in the union territory. He also said the number of cases being reported would be a lot higher if RT-PCRs were conducted instead of rapid antigen tests.
Faisal said he also took to the streets to protest after the SOPs were changed under the new administrator of Lakshadweep, Praful Patel, who took charge after Dineshwar Sharma, the former administrator, died in 2020.
The MP said: “I had requested them to at least keep the provision of one-week quarantine period before coming to Lakshadweep, but they did not listen. If the quarantine SOPs were continued, there would be no cases. When the entire world was suffering, Lakshadweep was Covid-free. The administration is entirely to blame for the surge.”
Referring to the allegations, Patel told ThePrint he “did not wish to get into them”, but added: “How long could we keep Lakshadweep shut for? It had to open up at some point.”