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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.

Thiruvananthapuram, Feb 6: The Kerala government on Wednesday said three foreign nationals were among the 2,528 people under observation in the state for the novel coronavirus infection and no new cases have been reported.

At least 93 people with minor symptoms of the virus have been lodged in isolation wards of various hospitals, state Health Minister KK Shailaja told reporters in Thiruvananthapuram.

India's three positive cases for the virus has been from the state's three districts of Thrissur, Alappuzha and Kasaragod.

All the three are students of China's Wuhan university, the epicentre of the virus.

"No new cases of coronavirus has been detected in the state today. At least 2,435 are under observation at home while 93 are in isolation wards at various hospital across the state," Mr Shailaja said.

The minister also said two foreigners have been quarantined in Ernakulam district and one foreign national at Thiruvananthapuram.

"The foreigner in Thiruvananthapuram has been kept at general hospital but not because he was showing symptoms but for observation as he travelled from China," an official said.

The health status of the three patients, who had tested positive for the virus, "remains satisfactory", the minister said.

After three cases were reported, the Left Democratic Front (LDF) government had declared the epidemic as a "state calamity" on Monday.

The health department has issued advisories to the education, tourism and the animal husbandry departments on taking precautions.

"The students, teachers, other staff members residing with families of Wuhan/China returnees who are already in home isolation should not attend classes...," an advisory issued to the education department read.

Rajan Khobragade, Principal Secretary (Health), said the health department has directed the District collectors to hold a meeting with the religious leaders of the district to create awareness during prayer meetings.

"We have directed district collectors to meet religious leaders and talk to them about the seriousness of the situation and create awareness among them and their followers on how to contain the spread of virus," the minister said.

Mr Shailaja also said the department got messages from some Kerala students studying in China, who returned to the state after the virus outbreak, that their Universities had asked them to return and attend classes.

"We have got some messages from the students that they were being recalled by the universities in China. We discussed the matter and it was decided that the centre will contact such universities and convey the message that it was not possible to send the students back to China until the epidemic was under control," the minister said.

Mr Shailaja also said even though there were no positive cases for the second consecutive day on Wednesday, the state needs to remain vigilant and reiterated the 28 days quarantine period for those returning from China.

Of the 2,528 people under observation, the maximum number is from Malappuram (383), followed by Ernakulam (333), Kozhikode (306) and Thrissur (241).