Other interesting and far-reaching developments are happening in the remote corner of N-E India, unknown and unsung, by our Indian brethren
By Dr Suresh Singh
Delhi is celebrating the opening of Defence Research and Development Organisation’s (DRDO) 10,000 bed largest COVID hospital in just 11 days. This is indeed a remarkable achievement, which was inaugurated by the Lt. Governor earlier this month. This is India’s largest COVID centre and will cater to mild and asymptomatic patients.
Tangkhul Co-ordination Forum of COVID19
Other interesting and far-reaching developments are happening in the remote corner of N-E India, unknown and unsung, by our Indian brethren. This is about Manipur’s “Tangkhul Co-ordination Forum of COVID19”, a confederation formed by 15 different NGOs, including many women, students, religious and local leaders. Under this apex body, every village has a Village Quarantine Centre (VQC) developed and run by Tangkhul Naga Community at Manipur’s easternmost two districts of Ukhrul and Kamjong.
What is this Community Quarantine Centre (CQC)?
These Tangkhul NGOs are one of the most powerful and most active in the state Manipur fighting for justice in every facet of society. In the case of Corona, it came up with the development of VQC, one each for every village situated at the two districts mentioned above. It is entirely created, run and maintained by the community by self contribution and seeking donations from the affordable including local MLAs. And the families of the returnees also contribute a major share to this.
In these centres, COVID patients or returnees who completed 14-day quarantine at the Government maintained Institutions/QCS/paid QCs etc. and discharged by the authority are again kept for another 14 Community Quarantine under the strict surveillance of the concerned village community. After this, another seven days home quarantine is enforced by the community. Thus the total quarantine period is 35 days (14+14+7). This is in short triple quarantine or three-layer quarantine enforced by the community to make sure 100 per cent protection from Corona.
Around June 17 last, 10 returnees who were kept at Govt. QCs and completed 14 days quarantine but test results awaited were transferred to one such community centre. This particular one was managed by Tangkhul Naga Long, one of the 15 NGOs functioning in the state. Later on, they were found positive and taken back to Govt. QCs for treatment and for further quarantine. There was a hue and cry for this in media and others.
Another is the confused test status of 25 returnees belonging to Ukhrul district. Their samples were collected on June 22nd and 23rd June by the Regional Institute of Medical Sciences (RIMS), a medical college under Central Government. On June 26, their test results were declared as –ve, however, next day i.e. on June 27, another result came out which tagged them as +ve. By the time the 2nd result came, all the 25 returnees were either at different VQCs or at home quarantine under the aegis of the Apex Body “Tangkhul Co-ordination Forum of COVID19” mentioned above.
Later on, they were taken back again to government QCs for treatment and further necessary measures.
Had it not been for these CQCs, there would have been 1000s of COVID cases spread by these returnees. 20 to 30 cases are enough to spread to 1000s in the community by virtue of high infectivity of Covid19. Then imagine 1000s to many 1000s taking multiplicity rate of Corona (21/2 -3 numbers minimum). The community has saved 1000s of people from the onslaught of this dreaded disease. The fallacy in the test result is the so-called false -ve results or negligence on the part of the concerned laboratory. These are also happening in other parts of India. Hence, three cheers to our Tangkhul brethren.
Unsung and unrecognised:
Many important events took place in our N-E states. Manipur has also many unique history and unique events. These are either ignored or unattended to by the Centre/ central leaders for decades. No, doubt, with the coming of BJP government in the centre, PM and his team started giving attention to these states and people started appreciating it for good reason. One notable worth mentioning is the monthly visit of Manipur and N-E region by central ministers under the direction of PM Modi.
Coming to the present topic of the corona, Manipur has a very strict rule of contact case tracing – one of the best in India and comparable to Kerala and Karnataka model. Because of this, we don’t have community transmission at present, unlike many other Indian cities/places flooded with Community transmission. Once community spread occurs, it will be uncontrollable in the state as seen in other Indian cities.
Hence Manipur’s special contact tracing and these Village Quarantine Centres (VQC) need special appreciation from the centre. No doubt, the state has drawbacks like lack of beds in QCs for the returnees, chaos in testing/less testing, mismanagement in QCs etc. But these were in the initial stage as is done everywhere. Lessons have been learned and remedial actions taken by the authority.
Lessons learned from Manipur experience :
This also applies to the whole country.
i) The state, once free from corona has now 1,430 case at the time of this writing. All returnees from major big cities of India are carriers with heavy Corona. Many are from red spot Corona QCs of these cities which underwent mandatory 14-day quarantine. This shows the irrelevance of QCs of big cities. One also can ponder how a person in a quarantine zone is allowed to travel without a -ve test certificate. Many corona spikes in N-E states and other parts of India is due to this.
ii) False –ve test results due to time variation or mistake by the lab experts are very high leading to community spread. I recommend two times testing, 7 days apart, to avoid this situation.
iii) The chances of cross-infection are very high in QCs. The same is seen in many QCs of the state. To avoid this, test results be made available within a day or two and +ve ones be kept in a separate wing/ward of the QCs during the mandatory 14-day quarantine. It is a question of sound management.
iv) Manipur Government’s order of discharging returnees who have completed 14-day quarantine without test results should be scrapped immediately. Many returnees, becoming +ve later on, is due to cross-infection in the later stage of their 14-day quarantine in the respective QCs. It is irrevocable proof of cross-infection.
v) With the 41 +ve cases of police and VDF personnel involved in disembarkment of returnees at Jiribam rail station (Manipur’s only one), there is the need to supply and apply PPEs to those involved directly in Corona fight. This is in addition to medical staff.
The “Tangkhul Co-ordination Forum of COVID19” is worth to be emulated by other villages of the country. The work is worth-praising. With India witnessing a huge spike in the COVID positive cases, India needs such innovative ideas. India urgently needs to revise its strategy to fight Corona infection. Establishing such VQCs at every village of the country is such one count among the many.
(The author is MD, WHO Fellow (Holland & UK) Chairman, Ex-Director Health, Manipur. Views are personal.)