What TN did right and where it went wrong

What TN did right and where it went wrong

In A Two-Part Series, TOI Looks At How The Pandemic Has Affected Tamil Nadu, The Way The State Govt Has Handled It, The Problem Areas And What Should Be Done

Jaya.Menon@timesgroup.com

11.06.2020

About a week ago, when Tamil Nadu’s Covid-19 dashboard showed the state was racing towards 30,000 positive cases, Greater Chennai Corporation quietly rolled out technology-based manoeuvres to contain the spread. The GCC’s strategy involved GPS trackers wherein people in containment zones in parts of north Chennai were monitored. Every time, someone moved 50 metres, the tracker would beep. The strategy teams went another step forward and introduced tele-medicine to residents in the area.

But the hi-tech surveillance and health monitor comes a little too late. Royapuram (Zone 5 of the Chennai corporation) stands out as a blot in Tamil Nadu’s war against Covid-19. With positive numbers racing to more than 5,000, close to 15% of the state’s total number of cases, the zone is an example of how the outbreak should not have been handled.

“We have been fighting hard to educate people on social distancing and importance of wearing masks,” said fisheries minister D Jayakumar, incharge of Zone 5. “Royapuram is an old town, congested and densely populated. We are now using technology to check the spread,” said the minister.

Tamil Nadu had begun its Covid innings well — scrupulously screening its initial travellers, scouring the state for the 1,000-odd Tablighi Jamaat members who were infected during a conference in Delhi. “We started off really well, with Tamil Nadu’s strong healthcare system keeping it ahead of the pack,” said National Institute of Epidemiology deputy director Dr Prabhdeep Kaur, a member of the chief minister-led task force committee. The state’s three-pronged strategy of surveillance, testing and contact tracing drew appreciation. It was meticulous, conscientious and transparent. The initial strategy was built on a sound public healthcare system and a strong lab infrastructure with its network of medical college hospitals keeping pace with the rapidly changing ICMR testing norms, said Kaur.

“We put down the lockdown on time. It was well-timed to blunt the cases going up in an exponential fashion,” said infectious diseases expert Dr V Ramasubramanian, also a member of the task force to battle Covid headed by CM Edappadi K Palaniswami. “It was beautiful for two weeks until we realised we didn’t have a sound social security system and that we hadn’t given a thought to our migrant labour force and livelihood issues,” said Dr Ramasubramanian.

Soon, as the caseload rose sharply, the system began to crumble. The Koyambedu cluster was a shocker. Chennai messed up in its slums in the northern parts of the city where congested lanes and homes provided a fertile breeding ground for the infection. The virus exploded in north Chennai where residents cocked a snook at social distancing and compulsory donning of masks. Elsewhere in the state, as the Koyambedu cluster carriers spread out to their native towns and villages, the virus hit the hinterlands. The state was further tested with the exodus of guest workers. Tamil Nadu began to flounder. “I don’t blame the government. If you have not played the game before, you don’t know the rules and you don’t play it well enough,” said well-known epidemiologist Dr Jayaprakash Muliyil, who is also a member of the National Task Forceconstituted research committee on Covid.

Lack of coordination within and across government departments and the 10-odd committees proved to be another set back. While the Covid blueprint appeared impressive, the execution through various levels of bureaucracy was flawed. Then came the decision to reduce the number of samples being tested. The numbers were erratic for a significant part of May when the lockdown continued to be strict. Experts say, TN missed the golden opportunity to contain the spread during lockdown when businesses were shut and people were forced to stay indoors. “Added to this, there was gross indiscipline and social irresponsibility. There was no adherence to social distancing, as we saw in the case of the Koyambedu cluster, and people refused to wear masks,” said Dr Ramasubramanian. The mammoth job of tracking down contacts too slowed down with an overworked team. While the government and its massive workforce slogged on the ground, people refused to cooperate.

And, finally, a lack of transparency in adding up the Covid positive numbers, mortality figures and admission that the state may have slipped up in vision and strategy began to show at the last mile — the hospitals. The growing challenge for the government now is to provide the increasing number of Covid patients good and affordable healthcare.

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It was beautiful for two weeks until we realised we didn’t have a sound social security system and that we hadn’t given a thought to our migrant labour force and livelihood issues

— Dr V Ramasubramanian | INFECTIOUS DISEASES EXPERT