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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.

Mangaluru, May 23: Criticising the Karnataka government's fresh protocol for management of Covid-19 as expensive, a prominent physician in the city has demanded its withdrawal.

According to Dr B Srinivas Kakkilaya, the protocol released by the Health and Family Welfare Department on May 15 enlists unnecessary and unconfirmed tests and treatments. 

The protocol has classified Covid-19 cases into three categories and has provided for hospitalisation of all three categories of patients, from asymptomatic to the most severely ill.

In a letter to the government, Dr Kakkilaya said: "The protocol suggests several investigations to be done right on the day of admission, including blood counts, liver and renal function tests, chest X Ray, ECG, CT scan of the chest, and other special investigations, all of which, if done, will cost Rs 25,000 per patient."

"In the coming days when lakhs of patients are likely to be infected with SARS CoV2, is it necessary and feasible to hospitalise and test all these patients at Rs 25,000 per person," he questioned.

The treatment options suggested in the protocol are also surprising, he pointed out. "The protocol recommends choloroquine, azithromycin, oseltamivir, zinc and vitamin C for all patients, from asymptomatic to the severely ill, and also anti coagulant injections for many patients. All these would cost at least Rs 5,000 per patient. For severe cases of Covid-19, many unproven and experimental treatments have been suggested, which are very expensive and highly questionable," Dr Kakkilaya notes.

Therefore, this protocol, he asserted was not evidence based and likely to do more harm than good. He said these unnecessarily expensive tests and allowing private companies to conduct trials on Covid-19 patients is likely to be misused by vested interests and must be immediately withdrawn, and instead, a protocol that is evidence-based, simple and avoiding unnecessary expenses, must be developed.

Kasaragod, April 9: After Supreme Court intervened and settled the Border issue with Karnataka authorities who had consented to allow the critically-ill patients from in and around Kasaragod and nearby areas to cross over to nearby Mangalore for getting urgent and critical care treatment, the Karnataka authorities is alleged to continue to be hostile either by blocking way ahead or turning a deaf ear to the patients reaching there.

It was on Wednesday onwards that the check post at Thalapadi near here on the Kozhikode-Mangalore National Highway was opened for the critically-ill patients to cross over to Mangalore hospitals for medical treatment.

However, reports reaching here said two out of the three critically-ill patients, who made it to Mangalore were allegedly ill-treated or given no treatment forcing them to return back to Kerala.