New cases in Thiruvananthapuram, Kollam cast doubts over IQ testing protocol

THIRUVANANTHAPURAM: As Kerala grapples with an increasing case load in the third phase of Covid-19 outbreak, it is caught between challenges posed by the Centre’s insistence on 14-day institutional quarantine for expatriates and its endeavour to save up treatment and testing resources for a worst-case scenario.
Lack of concrete evidence on incoming travellers being tested abroad and doubts over test accuracy are adding to the confusion, as was demonstrated in Kollam and Thiruvananthapuram on Monday.
Officials had circumvented guidelines and tested persons in IQ which proved crucial in identifying six positive cases among those housed at a Covid care centre. They had arrived in state on Saturday on the Abu Dhabi-Thiruvananthapuram flight.
In the state capital, officials identified the candidates based on the verbal communication provided during screening at the airport. In Kollam, authorities came to know that persons housed in the institutional quarantine centre (IQC) had voiced suspicions that they may have tested positive before boarding the flight. They had reported that before boarding the flight, 11 passengers were kept apart for some time and they believed they may have been positive with some reporting themselves as contacts.
The self-reporting format (SRF) and flight manifesto do not help authorities either. “The test was conducted based on what they told us. Guidelines call for testing only in symptomatic cases and high-risk contacts and as per ICMR strategy this has to be done between day five and day 10 of coming into contact with a confirmed case. The passengers did not have any documents about test results and we are in the dark about the exact confirmed case of which they were contacts,” an official said. They may even have undergone antibody tests, which are not considered standard protocol for confirming infection, the official added.
Both Kollam and Thiruvananthapuram are now dealing with possibility of tracing and testing remaining passengers on the flight and all contacts of the confirmed cases since their arrival and travel to the care centre. There were a total of 177 passengers on board the flight and Kollam team has found that 67 persons had come in contact with three confirmed cases. With limited resources, Kerala is not in a position to initiate mass testing of returnees under institutional quarantine, however, compromise in protocol within IQCs could result in an outbreak within the centre; something the state can least afford.
Officials say that Kerala’s time-tested strategy of home quarantine is the way forward in the light of challenges being faced in IQCs. “Our treatment and testing strategy clearly says that no testing is required for category A patients; those with mild symptoms. If we could strictly adhere to room isolation, it would help us reduce chances of spread of infection and will also ensure judicious use of testing and treatment,” a health official said.