COVID-19 : Trace, Test and Treat : Indispensable three Ts
The three Ts. A vigorous adherence to the three Ts of Trace, Test, Treat, will obviously not be possible in India, where health infrastructure comes very low in the order of priorities, more so in a State like Manipur, where till date only two testing centres have been set up-one each at RIMS and JNIMS. Poor infrastructure no doubt and couple this with the growing number of people in the quarantine centres set up across the State and one can imagine the immense pressure that must have been mounted on the State Government, but can this be the reason to throw in the towel ? The fact is, the number of people testing positive for COVID-19 is growing with each passing day and all things taken together say that the Government cannot afford to relax any of the procedures taken up to ensure that the COVID-19 cases do not turn into one of community transmission, not to speak about cluster transmission. At the moment, Manipur has registered a total of 71 positive cases for the virus with 60 active cases, and significant to note that all the 71 cases have come from people who have returned from other parts of the country, with one, the first positive case having returned from England. With more and more people coming from different parts of the State and the Nationwide lockdown having been relaxed to a large extent, the number of cases will increase in the coming days but on the very important condition that positive cases can only be known after a test. This is where the information that the State Government is mulling over the possibility of sending those in the quarantine centres for home quarantine without testing them, provided they have completed 14 days at the Government run quarantine centres, is disturbing ! The condition under which the Government is mulling over this possibility is understandable, but it should not be forgotten that all the positive cases (save for the first two/three cases) have come from the quarantine centres. This means that all the positive cases have come from those who have returned from other parts of the country.
This is where the importance of the three Ts becomes important. Trace, Test and Treat was the formula followed with vigour in South Korea and that this worked well for the Asian country is there for all to see. Fortunately at the moment, the Government is not burdened with the task of tracing the contacts of the positive people, as all of them are returnees and are staying at designated quarantine centres. And almost all of them are asymptomatic. But let them go back after 14 days without testing and this is where the tricky part enters. There is a reason why a further 14 days home quarantine is recommended even for those who have reportedly recovered and there are reports of the infection becoming symptomatic even after 20 days, thereby bringing a question mark over the number of days that a person is asked to remain in quarantine. Testing all the returnees is the best option, but if the pressure is too much on the Government and if this model is not practical, then at least, classify the returnees. The Government may identify returnees from certain States or regions and make testing them mandatory if not for all the returnees. This is a model which other States like Karnataka has taken up and there is no reason why it cannot be followed here. Make testing compulsory for those returning from places like Chennai, Mumbai, Pune, etc and let others complete the 14 days quarantine separately. Don’t lump returnees coming from different parts of the country together. It would be a negative move to mix returnees from say Mumbai with those coming back from say Kohima. They must be kept separately.