Once travel restrictions were relaxed, Northeast witnessed a huge influx of returnees straining the healthcare system of the region. But here's how Manipur, Tripura and Sikkim tackled the situation
Guwahati: COVID-19 pandemic has forced state governments across the country to ramp up its facilities and provisions of public and preventive healthcare. Since the outbreak of the highly contagious virus, India has seen bigger states struggle to get the sample swab testings done on time, and the situation for smaller states, especially for some from Northeast India, was worse.
The situation can be called decent during the first phase of the nationwide lockdown when there were travel restrictions across the country. The states got time to enhance their healthcare provisions, getting quarantine centres and beds ready, acquiring ventilators and getting the required testing kits and machines. The number of coronavirus cases remained minimal in Northeast, and many of the states from the region had declared themselves COVID-19 free after curing the limited number of cases the region had detected.
However, once the travel restrictions were relaxed, people started travelling back home in hoards. It started posing a grave threat, as, in Northeast, a huge chunk of population resides in metro cities across the country hoping for better employment opportunities and education. And some of these metro cities are heavily infected with COVID-19, recording the highest number of cases in the country. With the reverse migration, the healthcare systems in Northeast started getting strained and backlogs started piling up. With few states yet to get even one Viral Research and Diagnostic Laboratories (VRDL), the reliance on neighouring states increased for tests, all while trying to ensure that there is no community transmission.
Let us take the example of three states from Northeast India -- Manipur, Tripura and Sikkim -- and see how they have fared so far in terms of COVID-19 tests and dealing with backlogs, if any.
J Suresh Babu, chief secretary, Manipur
Earlier this month, Manipur requested the Union ministry of civil aviation to temporarily suspend flight services for 10 days into the state, from June 18-28. One daily flight would continue to operate between Delhi and Imphal. However, that cap has now been raised to five flights a day
Now why did the state have to put up such a request?
It is because the health care facilities in Manipur was overwhelmed with a number of stranded people coming back to the state, and low testing capapcity, which lead to packed quarantine centres and huge backlogs.
EastMojo had reported that chief secretary J Suresh Babu wrote to the ministry of civil aviation joint secretary Usha Padhee requesting her to stop all passenger flights for ten days to complete pending COVID-19 tests and reduce congestion at quarantine centres.
Currently, as per official reports, owing to heavy inflow of flight passengers the state has over 15,000 samples waiting to be tested.
Since May 25, the state has been receiving least 600 to 700 flight passengers daily. The returnees are kept at various quarantine centers for 14 days’ mandatory as a precautionary measure to control the spread of the virus. The quarantine centres are also full and need to reduce inmates."
In the letter, Suresh Babu wrote, "The government of Manipur is following strict quarantine protocol for all the people arriving Manipur in order to contain community spread. All of them have to undergo RT-PCR test mandatorily and only those tested negative are allowed for home quaranyine. Due to heavy inflow of poeple, there is substantial delay in testing all these people and there is a huge backlog of 15,000 samples pending results."
As per updates given by additional health director Dr Sasheekumar Mangang on June 15, a total of 24,046 samples were already tested in the state. On an average, 1,500 samples were being collected in a day and tested in two Venereal Disease Research Laboratory (VDRL) at Regional Institute of Medical sciences, Imphal (RIMS) and Jawaharlal Nehru Institute of Medical Sciences, Imphal (JNIMS), with a cumulative testing capacity of 1,000-1,200 samples a day.
Further, to address the issue of backlogs, the state decided to set up TrueNat machine in Senapati, Ukhrul, Jiribam and Churachandpur districts and for procurement, PHED minister L Dikho was assigned the task. A total of 5,758 returnees are being kept at Institutional quarantine centres while 15,321 are at various community quarantine centres.
By June 28, as per stats issued by state surveillance officer, IDSP Dr L Tomcha Khuman, the number of tested samples had almost doubled to 49,084. The average samples being tested in the state was increased to 2000 to 2600 samples per day, and there were no more backlogs. As per the status update on COVI-19 issued on Sunday, the state has successfully completed 49,084 tests, and is very likely to cross the 50,000 test mark by the month end.
Manipur's efforts to reduce the backlogs by reducing the inflow of passengers and increasing its testing capacity, to almost double, helped the state clear a huge backlog of 15,000 pending COVID-19 tests.
On March 24, Manipur reported its first COVID-19 case when a 23-year-old returnee from United Kingdon tested positive for the highly contagious virus. And as per updates at the time of filing this report, the total number of COVID-19 cases reported in the state is 1,260, with 681 active cases. A total of 579 have recovered so far, and it has not recorded any coronavirus related deaths so. The recovery rate in Manipur stands at 45.95%, as of July 1, 2020.
Till date, a total of 43,000 people, mostly returnees from other states, were kept at various institutional and community quarantine centers across the state. At present, there are around 7,200 people are at the quarantine centers, and apart from those tested COVID-19 positive, the remaining have sent them home for home quarantine after tested negative.
The state government has also initiated and set up TrueNat machines in Tamenglong, Senapati and Ukhrul in order to test the samples of new returnees within 24 hours.
Also, after a semi suspension of flight services with single flight plying from Delhi to Imphal for 10 days, normal services have resumed on Monday in the state, with five flights landed at Imphal Airport.
A total of 538 passengers arrived in five flights from Delhi, Kolkata, Guwahati and Dimapur. While, 383 persons flew out from Manipur to other states.
Having declared itself COVID-19 free after curing the only two reported cases by April end, Tripura witness an explosion in COVID-19 infections as cluster of cases emerged from a Border Security Force (BSF) camp in Tripura's Dhalai district headquarters Ambassa. The first case was reported on May 2 and the numbers quickly escalated to 151 within a week. Making it the first state in Northeast to cross 100 cases mark.
Significant number of infections in three BSF battalions started brewing the fear of community transmission among the security forces in the state. Even so, the small Northeastern state today has recorded one of the highest percentage of recovery rate is around 80% on June 30, against the national average of 59.43% on July 1.
Currently, Tripura tally stands at 1,352 cases, of which 1,085 have recovered from the virus, one has passed away and only 259 remain as active cases.
Tripura has set a phenomenal example not just for Northeast, but for the entire country in terms of recovery rate and tests conducted per million population.
On June 15, with just one lab approved by Indian Council of Medical Research (ICMR) having three machines, of which, one was placed recently, on an average around 1200 to 1500 samples were being tested while, around 1200- 1600 were being collected each day, informed Tripura's nodal officer for COVID-19, Dr Deep Kumar Debbarma.
Till then, a total of 48,632 samples had been collected of which 46,019 samples were tested till Sunday evening, June 14.
Tripura's law minister Ratan Lal Nath on Monday, June 29 said that around 1,000 samples are being tested, while around 1,053 have been collected till 6 pm. State's cumulative testing figure is 63,331, while samples collected so far is 64,642.
Now, Tripura has a single lab with four machines at Agartala Government Medical College (AGMC). Each machine has a testing capacity of around 300 samples a day.
The state has a testing per million numbers with 15,050 tests conducted per million population as on Saturday, which is the highest in Northeast, and among the top bracket through the country.
Tripura's tests per million population beat some of the much bigger and technological and medically advanced states in the country like Maharashtra which stands at 7,371 tests per million population; Kerala which conducts 5,963 tests per million population. Tamil Nadu, which is known for its medical facilities and attracts a huge number of people each year for 'medical tourism' also falls behind Tripura with 13,774 tests per million population.
The landlocked Himalayan state of Sikkim was the only state in India to remain COVID-19 free, until relaxation in travel restrictions enabled the virus to travel home, and the state reported its first case of coronavirus on May 23.
With a mere population of around 6 lakh people, Sikkim has reported 88 cases of COVID-19 till June 29, of which, 50 are cured and discharged, 1 has migrated to another state and only 38 cases remain active. The state recorded a recovery rate of approximately 56 per cent.
Initially, the state did not have a Viral Research and Diagnostic Laboratories (VDRL). It sent all its samples for testing to North Bengal Medical College and Hospital (NBMCH) in Siliguri, West Bengal.
The medical college had tested 1,711 samples from Sikkim up to May 28, after which Sikkim stopped sending in more samples to NBMCH as the state got its own lab. Further more, a backlog stretching to over a week remained with the West Bengal hospital of 287 samples.
Meanwhile, in the Himalayan kingdom, the viral research lab was inaugurated on May 21 at the STNM Hospital in Gangtok, but it became function over 7 days later, that is, from May 29. Subsequently, Sikkim retested the 287 backlogs from North Bengal Medical College and Hospital in a period of 7 days.
As per latest updates on June 29, the number of RT-PCR tests conducted in virology lab of STNM Hospital is 7,041, and 1,688 TrueNat tests have been conducted. Looking at a cumulative figure, sample tests conducted in North Bengal Medical College and Hospital, and on RT-PCR machine and TrueNat machine at the STNM Hopsital lab comes to 10,440.
Sikkim is conducting tests only on returnees and contacts of persons who have tested positive for the virus. There is no transmission among the masses or community spread, and no random sampling tests are being conducted in the state.