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Kasaragod, Apr 19: Kasaragod, Kerala's COVID-19 hotspot, is the only district in the southern state lacking adequate health infrastructure.

In spite of treating the highest number of COVID-19 patients in the state with meagre infrastructural facilities and even without the support of a medical college in the north Kerala district, no deaths have been reported due to coronavirus.

The state health department views the performance of M Kunhiraman and his team, consisting of Janardhana Naik and Krishna Naik, at the General hospital in Kasaragod as a success story.

"Not only did they control the situation quickly with minimum infrastructure, they also started turning out a large number of negative cases within a few weeks and creditably ensured zero mortality.

This can be showcased as a best global model," Chairman of the Information Education and Communication (IEC) Committee and Project Director Kerala State Aids Control Society, R Ramesh said.

Recalling the ordeal, Janardhana Naik said his first major challenge was the physical examination of a patient with suspected COVID-19.

"Even with the PPE kit, nobody knew how effective they were and it took a whole 30 minutes to wear them properly.

But as time passed, we got accustomed to it," he said.

The traditional method of dealing with a patient involved knowing his or her history, observation and physical examination.

For hundreds of years, the hands-on body approach has been the soul of the doctor-patient relationship -- taking the pulse, tapping on and listening to the chest, feeling lumps.

With the onset of COVID-19 all that has changed.

"In fact, the whole exercise was fraught with grave risks because everything connected with COVID-19 was new.

Doctors have to keep a distance even though the physical examination wearing a Personal Protective Equipment (PPE) is difficult.

Sounds from the body are inaudible, vision is blurred through the smog-covered goggles and a stethoscope seldom has any use," Janardhana Naik said.

It was from March 15 that the hospital started receiving COVID-19 patients, primarily from Dubai.

By the time the first person came, the hospital was ready for him.

Soon, patient numbers began to swell and in a couple of weeks they reached about 91.

From then on, it was teamwork.

Committees were formed for each and every task, including the help desk, IT, treatment, medical board, training, food, waste disposal and data maintenance.

Initially, patients had many misgivings about the hospital.

"Some were disillusioned and even aggressive. Some were not happy with the facilities the hospital had to offer.

But gradually through good treatment and counselling by a psychiatrist, who visited the hospital on alternate days, the confidence and mood of the patients changed and they became friendly with the staff," Naik elaborated.

Counselling was also given to the concerned family members of the patients.

Besides treatment, the medical staff had to spend a considerable amount of time clearing the doubts of patients.

When they got discharged some patients insisted on seeing the faces of the medical staff, who till then were anonymous entities covered from head to toe.

Some even wanted to take selfies with them.

However, the medical team politely turned down their requests and preferred to remain hidden in their work attires.

The mood of the patients also rubbed off on the doctors and hospital staff.

All the physicians and hospital staff are now more confident of dealing with contagious diseases after treating COVID-19 patients.

"Our previous experience of treating H1N1, Chikungunya and Dengue cases helped us a lot.

Words of encouragement from the Health Minister K K Shailaja, Health Principal Secretary Dr Rajan N Khobragade and Health Services Director Dr Sarita R L gave us the impetus to build up confidence.

Moreover, the field health workers did a wonderful job in containing the viral spread," Naik added.

As the number of coronavirus cases rose, the state government on April 5 deputed a 26-member medical team from Thiruvananthapuram to set up a COVID-19 hospital in the district.

They turned a block of the under construction Government Medical College as a hospital-like facility, setting up a 200 bed facility to treat coronavirus patients.

Karnataka on Saturday reported 12 new cases, the highest in a single day so far, taking the tally in the state to 76.

Late at night, the Mysuru district commissioner said five more people had tested positive in the district. But it was yet to be confirmed by the state health department.

Of the cases, 41 are from Bengaluru, eight from Chikkaballapur, while Uttara Kannada and Dakshina Kannada districts have seven each.

Interestingly, the highest number of patients are those from Dubai or those who had transit travel via Dubai. Out of 76 cases, 17 cases (22%) have travel history to Dubai, the capital of Emirate of Dubai and the most populous city in the United Arab Emirates (UAE).

Medical Education Minister Dr K Sudhakar, who is also in-charge of COVID-19 operations, said that Dubai has been a major concern as far as Karnataka COVID-19 patients are concerned. “Most of the positive cases have come through Dubai suggesting something amiss there,” he said. 

Echoing the same, Dr Prakash Kumar, Joint Director, Communicable Diseases, Department of Health and Family Welfare, said, “The layover in Dubai is around six to seven hours. We are seeing Dubai to be the new epicentre of the virus as far as India is concerned.”

UAE was initially not on the list of countries from where passengers were screened. It was added much later when clusters of patients with travel history to Dubai began popping up all over the country.

Patient-19 has infected the maximum so far.

Out of the 12 cases that tested positive on Saturday, five are contacts of Patient 19. All of them are being treated at a Chikkaballapur hospital. Two of them are from Hindupur, Andhra Pradesh, and three are residents of Gauribidanur taluk in Chikkabalapur district.

P19, a 31-year-old man from Chikkaballapur, had travelled to Mecca, Saudi Arabia, and returned to India on March 14. Existing patient clusters suggest that P19 had infected the maximum number of people. Officials did not reveal how many people he originally travelled with to Mecca.

Amid the rise in cases, Jawaid Akhtar, Additional Chief Secretary (Health), maintained that the state had not reached stage 3. But he had no definitive answer as to how the Mysuru patient contracted the virus despite health officials he was in touch with not testing positive.

Health Commissioner Pankaj Kumar Pandey said around 1,000 primary contacts of all positive cases have been classified as high-risk and low-risk. The high-risk patients are in government hospitals while the low-risk ones in quarantine facilities.

Bengaluru, Apr 8: A 65-year-old man from Kalaburagi district became the fifth COVID-19 fatality in Karnataka, where six new positive cases were confirmed, pushing the tally in the state to 181, the health department said on Wednesday.

The man with Severe Acute Respiratory Infection (SARI), died at a designated hospital in Kalaburagi on Tuesday, a day after being shifted from a private hospital where he was initially treated for two days.

"On April 4, he had got admitted to a private hospital, on April 6 he was shifted to ESI hospital, where he passed away," Primary and Secondary Education Minister Suresh Kumar told reporters here.

The private hospital had been locked and its entire medical team quarantined, he said, adding a notice had been served on it for act of "criminal negligence" (by not referring the patient to designated hospital) and will be followed with a police case.

"He was suffering from SARI, on collecting his sample, tests have revealed that he was positive....investigation is on to find how he got infected," the Minister said.

Noting that the hospital in this case did not refer the patient to the designated hospital and kept treating him for two days, he appealed to all private healthcare facilities to inform authorities if anyone showed any indications for COVID-19.

"As of 5 PM on April 8, cumulatively 181 COVID-19 positive cases have been confirmed in the state, it includes 5 deaths and 28 discharges," the health department said in a bulletin.

Out of the positive cases, 71 are those who had come back from foreign countries, while remaining 110 are contacts and those who had gone to Delhi, the Minister said.

Kumar also said an expert committee comprising Narayana Health founder-chairman Dr Devi Prasad Shetty and Jayadeva Institute of Cardiovascular Sciences director Dr C N Manjunath among others, constitutedto devise an exit strategy for the lockdown, has submitted its reports with various recommendations to Chief Minister B S Yediyurappa.

The chief minister and officials were examining it which was likely to come up before the cabinet meeting on Thursday after which the details will be shared, he added.

The health department said the six fresh cases reported on Wednesday included the elderly man from Kalaburagi who died.

Among the positive cases are a woman from Uttara Kannada with history of SARI and contact of a Dubai returnee, a 72- year-old woman from Kalaburagi, who is mother of a patient that tested positive for the disease; a man from Mandya with contact to two patients.

Others include a man from Chikkaballapura with travel history to Delhi and a woman from Bengaluru also with a travel history to the national capital.

Contact tracing is in progress for all the cases, the bulletin added.

The department said out of 148 active cases in the state, 146 COVID-19 positive patients (including 1 pregnant woman) are in isolation at designated hospitals are stable and two in ICU (one each on oxygen and ventilators).

It said out of total 181 cases in the state, six are transit passengers of Kerala.

Bengaluru accounted for the highest in the state with 63 cases, followed by Mysuru (35), Dakshina Kannada (12) Bidar (ten), Uttara Kannada and Kalaburagi (9 each), Chikkaballapur (8) Belagavi (7), Ballari (6), Bagalkote (5), Mandya (4) Davangere, Bengaluru Rural and Udupi (three each), and Kodagu, Tumakuru, Gadag and Dharwad one each.

Those discharged include 16 from Bengaluru, four from Dakshina Kannada, two each from Uttara Kannada, Kalaburagi and Davangere, and one from Bengaluru Rural; while among those dead are two from Kalaburgari and one each are reported from Bengaluru, Bagalkote and Tumakuru.