Keep returnees in quarantine centres for 14 days, test twice

Heaven will not fall upon Manipur with 23 active Nobel Corona, important is to keep returnees in quarantine centres for 14 days and test twice as per ICMR guidelines.
Recently Manipur has seen a spur in corona +ve, 16 cases in a  day on 20/05/20. Besides the previous 2 –ve  cases, counts are 1 from khurai, 1 nurse from kamjong, 3 on 16th , 2 on 19th & 16 on 20th. All are exported from outside and not indigenous. By nature, we are blessed without Corona and a corona free state. All the spikes are native returnees, either by cars, ambulances, buses or government arranged special trains.
Already, there are about 10,000 returnees, and expectation is at least about 40,000, along with bus returnees of about 6,000.  Question is where to keep them. Are there enough quarantine centres? Media reports had stated that many quarantine centres are opened in all districts and concerned MLAs are also requested to coordinate the same by Hon’ble CM. That is true, many quarantine centres are now functioning in many districts  and new centres are also opened as per requirements. It is a laudable effort by the government. But what are the conditions of these centres.  Are these hygienic, is there enough water supply, what about the bathroom conditions, who are the helpers, who are the essential services carriers etc. etc. What about the PPEs supplied to medical staff, policemen on duty and those associated with these quarantine centres? These are pertinent questions one has to ask and be answered by those responsible including local MLAs.
ICMR zone guidelines : In the last GOI guidelines, declaration of various zones are now delegated to the concerned states through their respective DCs.  As Manipur was a green zone, it remains so as there is no fresh notification so far. I had a copy of the updated version of Containment Plan dt. 16/05/2020. Whether a quarantine centre is an orange or red zone is not clear in the guideline. It only mentioned a cluster as having less than 17 cases. Further mention is the Containment Zone with clear mapping of cases and contacts and having a Buffer Zone delineated around each containment zone. By this guideline, DCs can’t declare any part of Manipur as red or orange zone. If someone has other idea, it is welcomed.
Testing guidelines : Similarly, your writer has a latest copy of ICMR Covid testing strategy dt.18/05/2020. Sl. 5 says –‘asymptomatic direct and high risk contacts of a confirmed case be tested once between day 5 and day 10 of coming into contact. Sl. 8 says- All symptomatic ILI (Influenza like illness) among returnees and migrants should be tested within 7 days of illness’.
 How to quarantine returnees, where and when to test? : With the arrival as well as expected arrival of 1000s returnees, quarantine and testing is the most important strategy now. The state so far has tested around 3,000 persons. But with around 200 cases done testing per day, how long it will take for the whole lot to test? The Chief Secretary once stated that it can test 1000 to 1,500 persons per day. We should now try to enhance testing capacity. Then the all important testing – with the ICMR guidelines stated above - asymptomatic direct and high risk contacts have to  be tested once on  day 5 and another on day 10. Present Manipur policy is - to test all and -ve contacts be sent for home quarantine. With present sudden increase in +ve cases, the policy is fraud with negativity. 14 day quarantine of all returnees in a quarantine centre be made mandatory with compulsory 2 tests recommended above.
 Home quarantine can never be implemented properly, not only in Manipur but in any part of India, because of congested rooms/houses. If 14 day quarantine is not implemented in a designated centre, the +ve cases are bound to increase many-folds. The virus is highly infectious, 1 can spread to 2.5-3 cases average and multiply it - 1x3, 3x3=9, 9x3=27 and so on. Many states have reported many-fold increase after return of migrants e.g. UP : 50 migrants test +ve in Basti, Bihar : 8%  of over 8,300 migrants test +ve and so on. On 17/05/20  in Gujarat - 33,500 super spreaders were screened, out of this, 12,500 were tested and 700 were found +ve.   No social distancing was enforced as seen in Ram Lilla ground Gaziabad (1000s waited for registration and buses), at Thane, Maharastra, Gujarat etc. At the time of this write up, 2317 special trains ran since may 1 ferrying 31 lakh migrants  to their destination, the situation will only worsen. Many new cases are bound to come up in India’s rural areas with 3rd stage of Community spread. Manipur can’t be an exception to this rule.
  India and World latest : At the time of writing (6.30pm,22/05/20), India’s total case stood at 1,18,447, active case at 66,330 with 6,088 highest  new  cases  in a single day with Maharastra alone contributing 2,940. At present, Maharastra, Gujarat, Delhi, Tamil Nadu are worst affected. In Manipur, we don’t know from which zone the returnees are coming. But it is sure that many are coming from highly infected red zone cities. World total stood at 52.31 lakh cases in 213 countries with a  death toll of 3.35 lakhs. There are 12 countries with more than 1 lakh cases- USA being 1st with more than 16 lakh cases and 96,377 deaths. Other top 5 countries are - Russia, Brazil, Spain and UK. India is on 11th position as compared with China on 13th one.
Conclusion : All the returnees should have a compulsory quarantine of 14 days in a quarantine centre and be tested 2 times as per ICMR guideline - once as soon as within a few day of arrival and another on 10th day. If not done, one can see many spikes of new cases in many areas of Manipur. The state has tested very few cases as compared with other states. Now is the time to enhance it. It basically means our every returnee friends be tested twice in 14 days.  We have to convince them that the same is required for their own family and their relatives as well. Regarding manageability, distribute them into 60 assembly segments under respective MLAs. With + &- here and there, an assembly segment can manage about 666 persons easily for 14 days with help of local people. It is a question of sound judgement and sound management. Why 14 day needed is purely on sound medical ground accepted worldwide {IP-2-14 day, a person develops symptoms of disease - cough, fever, respiratory  trouble}. If someone is found -ve in 1st test stated above, the same may be found +ve on 2nd test. Hence we should not take the risk of a home quarantine as explained in preceding paras. We have to convince the returnees, their family/friends, and above all, our society. The society should not see them as outcast, instead be treated with love and care. Many NGOs are doing the same. Let us keep it up. We should not get nervous; heaven will not fall upon Manipur with 23 active cases.