Delaying COVID-19 tests and hospitalization a major threat, Tamil Nadu health secy Dr. J Radhakrishnan to WION

Tamil Nadu Chief Minister Edappadi K Palaniswami flagged-off 118 ambulances at the Secretariat in the city. The vehicles are meant to bolster the state’s effort in the fight against the deadly COVID-19 pandemic. 

Eighteen ambulances that were flagged-off were donated to the government by the ZEE group as part of its Corporate Social Responsibility(CSR) initiative. The ambulances are the first batch, among the total set of 45 ambulances that the media conglomerate would be handing over to the government.

The ambulances are set to join the "108 Emergency service" that is run across the state of Tamil Nadu to provide rapid and free-of-cost medical transport to the nearest medical facilities. Of the ambulances launched on Monday, 108 units would serve as means for transport for citizens in case of a medical emergency and the 10 others are meant to be mobile blood banks. 

In the event which was presided over by the chief minister, the state government commended the efforts of ZEE group for having donated the ambulances to strengthen the state's health infrastructure at a time when the country has been fighting the pandemic.

As on Sunday, Tamil Nadu has recorded a total of over 4.22 lakh COVID-19 cases which includes 3.62 lakh recoveries and 7,231 deaths. The capital city of Chennai alone has seen over 1.34 lakh cases. The state is witnessing nearly 6,000 cases in recent weeks and the state had performed over 4.5million RT-PCR coronavirus tests. 

On the sidelines of the handing over ceremony and a day ahead of the Unlock 4.0 guidelines coming into effect across Tamil Nadu, the health secretary, Dr. J. Radhakrishnan spoke to WION. 

WION: Starting September, Tamil Nadu is opening up as a part of Unlock 4.0. Everything, except for Educational institutions is opening up. How do we foresee a spike in cases and what is the government doing to prevent this spike ? 

Dr. J. Radhakrishnan: Regard to COVID-19, the regular message during all phases of unlock has been to follow the  Least Common denominator of - mask-wearing, physical distance and frequent hand-washing and cocooning the vulnerable. We have decided that every Government and private organization will have a Covid monitoring officer, with whom the government will interact. We have expanded the testing capacity to be able to conduct 1.5lakh RT-PCR tests in a day. 

Even in the case of remotest symptom, we urge the public to come and get tested. We will continue the aggressive policy of testing 75,000 tests per day. We need public cooperation, this relaxation comes with a lot of duties. They need to understand that it’ll be a win-win if we all work together until there is a specific vaccine or cure. 

WION: The daily case numbers in Tamil Nadu are consistent, despite the increase in the number of tests done. Daily cases have been around 5500-6000, how do you explain it?

Dr. J. Radhakrishnan: Numbers as far as the whole state is concerned, are consistent. 

When we look at the districts, there is a marked shift. Earlier it was Chennai and surrounding districts, but now it is Coimbatore, Salem and Cuddalore. Earlier, our results were from about 60,000 RT-PCR tests but yesterday it was almost 83,000 tests. Now we are looking at positivity - roughly 9 districts are having more than 10% positivity rate. 

Overall, our state’s weekly positivity has come down to below 8 per cent. We are de-segregating the data, giving district-level dashboards to collectors, informing them what is happening and getting feedback from districts. We are also seeing urban-rural differences from various pockets. 

WION: As far as Chennai is concerned, about two months ago the cases were 2000 per day and now its come down by half. How is this turnaround made possible in terms of strategy? 

Dr. J. Radhakrishnan: For Chennai, the Honorable Chief Minister pushed us to go in for aggressive testing - we went from 3000 tests per day to 13,000. We have a very focussed, specific strategy for slums, for row houses and for workplaces. 

The city was divided into 15 zones and we had a coordinating mechanism, we started control rooms in every zone. Even senior ministers were assigned for that work, apart from that we had a marked increase in fever camps. 

Even those with remotest symptoms were tested near the fever camps. It was a lot of micro-level and street level planning and we are continuing same. 

As of now, North Chennai cases have come down and workplaces and business districts cases are on the rise. 

WION: As a part of Unlock 4.0, does it mean that people coming in via flights or train will quarantine be relaxed or are any new guidelines in the works ? 

Dr. J. Radhakrishnan: There is a separate guideline coming in for that also. For international flights there is 96hrs quarantine if they do RT-PCR test. Even then, when they come based on international flights, there is a specific kind of home quarantine or institutional quarantine. 

In case the passengers are not tested, they will be tested. Detailed and separate comprehensive guidelines based on Government of India directives is being prepared. This will be issued in consultation with the Chief Minister and the public department. 

WION: The Sero-survey that was performed in parts of Tamil Nadu, how have the results been? And what is the inference from the sero-survey ?

Dr. J. Radhakrishnan: So far, officially they have not submitted the sero-survey. They did it in parts of Chennai and we asked them to do it in other parts of the state as well. We are also awaiting. 

Personally, I feel, the biggest challenge is that, even now, certain people avoid coming to the hospital for the first 3-4 days and some don’t even test. So they end up with severe lung involvement and that is why we start losing people. 

That is the message we are giving, we urge people to come to the hospital before they get heavy lung involvement, so that they can get cured with available medicines.

Whether the sero-survey shows a higher disease prevalence and the disease comes down is one part. But we should really reduce the case fatality and that is the focus area. Last few weeks it has come down and now case fatality is at 1.71 per cent and we are want to slowly bring it to at least 1 per cent. 

WION: There were some projections made by the MGR University pertaining to how the COVID-19 pandemic would evolve until March next year. What is the government’s approach towards those numbers and data? 

Dr. J. Radhakrishnan: Various agencies give their projections. At the cutting-edge level we are looking at much more simpler messages, because more than creating a scare, our job is to sensitize people. At present, whatever others say, the full safeguard is mask-wearing, hand-washing, physical distancing and cocooning the elders. 

If these are followed and if aggressive testing is done, even if somebody wants to get tested, they are able to get a test result within 24hours and that too - the reliable RT-PCR test.