Coronavirus: How did a Tamil Nadu district move from hotspot to safe zone?

Once a hotspot with 70 positive COVID-19 patients, the Erode district in western Tamil Nadu now has no active coronavirus cases. Also, the district, a famous textile cluster, is moving from red to orange zone as it has not reported any positive COVID-19 patients since April 15.

For latest updates and live news on coronavirus, click here

Out of the 70 patients, all have recovered and are currently under mandatory home quarantine while one died during treatment. Erode reported its first case on March 21 when two Thai nationals, part of the Tablighi Jamaat congregation, tested positive for COVID-19 and the last case was reported on April 15 when six people tested positive for the virus.

“Since April 15, we have not had a single positive case. The last set of patients, who were receiving treatment at the IRT Perundurai Medical College Hospital, also left for home on Tuesday. The district now has zero active cases and has not reported new patients for 15 days,” Dr S Soundammal, Deputy Director of Health Services, Erode, told DH.

The district is moving from red to orange and will further move to green if there are no cases for another 14 days. Tamil Nadu has only one green district – Krishnagiri -- that shares borders with Karnataka and Andhra Pradesh with no COVID-19 positive case being reported so far.

Erode district saw an increase in cases from March 21 to April 15 and the majority of them were related to a “single source event”, an oblique reference to the religious congregation in Delhi. It was in Erode where the Tablighi link was established as officials came to know that a large number of people from the state were part of the event while questioning the Thai nationals. 

Focus on containment zones

Institutional quarantine of suspected patients, home isolation of their family members, immediate barricading of areas where positive patients lived, contact tracing through CCTV footages, and deploying drones to monitor containment zones are some of the activities that the district administration took to prevent the spread of COVID-19.

Also, the district administration adopted novel ways to keep people, especially inside the containment zones, confined to their homes besides taking everything that they need from ATMs to vegetables to fruits to provisions to their doorsteps. Drawing competitions for children and rangoli competitions for women were also announced to keep them indoors.

“When people got everything at their doorstep, they didn’t feel the need to come out. We even arranged for mobile ATMs and ensured that people do not step out of their homes. And we were transparent with the prevailing situation that made people trust us and cooperate with our activities,” Erode District Superintendent of Police S Sakthi Ganesan told DH.

He said effective coordination between various departments and active surveillance at district borders, where every vehicle was checked and its driver screened for fever, contributed majorly to the district turning orange from red.

The district administration also ensured those who went inside the containment zones to provide essentials to the people took necessary precautions like wearing gloves and masks to prevent further spread of the disease.

As soon as a patient tested positive, the SP said, the entire area was barricaded and the entry and exit of the people were restricted. He also said the police extensively relied on drones to monitor the containment zones, besides keeping a tab on the movement of people.

“We made optimum use of technology to keep people inside their homes. Competitions were announced and people were asked to send their entries through WhatsApp and other apps. When we give what people need, they will cooperate with you,” Ganesan added.  

Active contact tracing

Though it has tested only 4,000-odd persons – the testing rate per million population is just 440 but the district administration believes effective containment activities and restricting people to their homes has helped it contain the spread for now. Out of the 18 containment zones, restrictions have been relaxed at eight and we will do the same in the remaining 10 as well once the “mandatory period” ends.

Soundammal said CCTVs installed near two mosques, which were frequented by the Thai nationals, provided “vital clues” on their contacts who were immediately quarantined.

“We were met with some resistance in the beginning as many feared isolation, but people realised the magnitude of the spread and cooperated with us. The primary contacts of the Thai nationals were quarantined at IRT, Perundurai and their family members were home quarantined. When the contacts tested positive, tests were also conducted on their family members,” Soundammal added.

She said every house within the containment zone was visited by health workers every single day to check for any COVID-19 symptoms from people living there. She also added that enough care was taken to fulfil the dietary needs of the patients in the IRT hospital.

“Enough care was taken to ensure that the food given to patients was healthy and would supplement the treatment being provided. As far as patients were concerned, we gave them choice and asked them to inform us the previous night,” Soundammal said.

Besides the patients and those under institutional quarantine, people inside containment zones were given the highest priority. “We were the first to distribute kabasura kudineer (herbal mix) to those living inside the containment zones. It is just an immune booster and we clearly explained that to the people,” the district health officer said.

How the Thai link came to the fore

It was on March 14 that the Erode administration came to know that a group of foreigners are in the district for religious activities after a Thai national, who was part of the group, came to the Coimbatore airport to board a flight back to his country.

By then, thermal scanners had been installed at the airport, and officials refused to let him fly because he had a fever. The 49-year-old Thai national was quarantined at ESI hospital in Coimbatore but tested negative for COVID-19 though he had exhibited symptoms of fever.

“It was a piece of information given by the Thai national, who died of complications caused by diabetic nephropathy, helped us track those who attended the conference. We came to know about the presence of Thai nationals in Erode only after talking to this traveller. We then began tracking the Thai nationals and quarantined six of them,” a senior official with the Health Department had said.