How do you tell someone that they could be under risk of contracting the Nipah virus, because they were directly or indirectly in touch with a Nipah patient? How do you do this without causing instant fear, and spreading panic?
The Kerala Health Department, which is ‘contact tracing’ those who may have been in touch with the Nipah patient currently admitted in Ernakulam, have a tough job on their hands. But the officials are handling the situation in a cool, collected manner, with sensitivity and caution.
Health Department and Revenue Department staff, including village officers and village assistants, panchayat and municipality members, have been given the job of contacting people at risk. And these officials in turn reach out to friends and acquaintances of the people on the risk list.
During the outbreak of Nipah in 2018, as many as 2,649 people in Kozhikode were put under surveillance. This year, a team of health experts have made a list of 311 people who need to be observed for symptoms. The surveillance team includes Dr Indu from the Virology Department of Thiruvananthapuram Medical College; Dr V Meenakshy, the Additional Director for Public Health); and Dr Manjula, head of Social and Preventive Medicine in Ernakulam.
“We give directions to the people that they shouldn't go out and interact with others, and we reach out to them through others who are close to them or familiar with them. We shouldn’t make them panic – shouldn't make them feel like they are at high risk. Secondly, we monitor through phone calls from a cell that we form," a health department source tells TNM.
As of now, 110 of the 311 people have been contacted.
“The private hospital where the patient has been admitted gave a list of 233 people, and adding that made the list a long one. All of them were not in direct contact, there are secondary contacts too. We are putting those who had primary contact under surveillance. As of Wednesday, the number of people under direct contact is 135; but that will keep increasing every day," the source further said.
Dr RS Gopakumar, health officer of Kozhikode Corporation, told TNM that the people in the list will be monitored for 21 days. "We will omit people after 21 days and cut down the list if they don't develop any symptoms. People will show stiff objection if we call them over the phone, asking us why we are calling them. It is because of this that the then Kozhikode Collector UV Jose brought in village officers and village assistants into confidence last year, to call the people through those who are their acquaintances,” he said.
Dr Gopakumar was the person who conducted the funeral of Nipah victims in 2018.
The contact surveillance list, according to a statement by Dr T Jayakrishnan, Additional Professor, Community Medicine wing, Kozhikode Medical College, is made using a protocol similar to that for Ebola virus by the World Health Organisation. The list is divided into high risk and low risk categories, the statement said.
On Tuesday Principal Secretary Health Rajan N Khobragade told media persons that a priority list of people who had been in contact with the patient would be released on Wednesday based on the number of direct and indirect contacts.
On how far it would be possible to prevent the transmission of the virus, Dr Gopakumar said that it depends on the variant of the virus.