TN and Kerala have fought the Covid tsunami well so far

TN and Kerala have fought the Covid tsunami well so far

A Triaging System & Stocks Of O2, Meds Play The Most Crucial Roles

Rema Nagarajan & Pushpa Narayan TNN

25.04.2021

The tsunami of Covid cases has led to a collapse of the health system in state after state exposing the lack of preparedness. People are begging for help as they run from one hospital to another looking for a bed, oxygen, drugs, ambulances or even hearse vans. With helplines clogged, nodal officers unreachable and dashboards and apps without real time data, some are turning to social media Samaritans in desperation. But there are two states — Tamil Nadu and Kerala — that have not witnessed such scenes yet. Both these states seem to have learnt important lessons from the last surge and stand out for their public health approach to tackling the pandemic and preparedness in terms of putting a system in place that takes responsibility of guiding treatment once a person tests positive for Covid.

In contrast to other states, how different has been the approach in Tamil Nadu and Kerala? In Tamil Nadu, Chennai has the highest number of cases and 75% of Covid beds are occupied. But instead of frantic relatives running around, the corporation has stepped in to reassure citizens that they need not approach hospitals directly. “Whosoever has a serious condition, they will be given first preference to get quality care and immediate treatment will be started. It is common sense. Those with mild symptoms should go to the screening centre,” explained the corporation commissioner G Prakash adding such a patient management system was important to avoid what was happening in other cities where people were lying on the road waiting for treatment.

Similar arrangements have been made in every district in Tamil Nadu. The state government has also stocked oxygen and centrally procured all the drugs needed for treatment of Covid. These arrangements have ensured that people don’t throng hospitals in panic. It has also prevented patients in a desperate situation being looted in the name of providing ambulances, oxygen or medicines. Ambulance, screening centre services and RTPCR tests are free for patients.

In Kerala, also a triaging system involving the public health cadre and the different tiers of the health system has been put in place along with tele-consultation facilities for patients to consult doctors without having to travel to hospitals. Barring a small percentage of walk-in patients who choose private hospitals and opt to pay for it themselves, for most, all Covid-related services are free of cost in the public health system. “We are preparing for an even bigger patient load. But no health system can go on expanding. So we are trying hard to bring the number of cases down to take the load off the system,” said Dr Mohammed Asheel, executive director of Kerala Social Security Mission even as daily Covid cases in the state have crossed 28,000 from about 14,000 a week back. By making use of the public health cadre and the different levels of treatment centres, these states have managed to minimise the load on the health system even as they get ready to face a surge.

“If a patient reaches a hospital, it should be the responsibility of the hospital to find the nearest bed so that patients need to go to just one place. There is an urgent need for a properly run control room which will know the number of beds open for admission and where. What patients are being put through is shocking and unacceptable,” said Dr T Sundararaman, global health coordinator of Peoples Health Movement.

Kapil Chopra of Charity Beds, which has been helping people find beds in Delhi, says the number of cases has deluged the system. “The government keeps talking of beds being available. Just go to their hospital and you will see a line of ambulances outside. People are sitting in ambulances and dying in ambulances. It is too late to talk of a system,” he said.