How a Kerala doctor couple used community medicine expertise to check coronavirus

How a Kerala doctor couple used community medicine expertise to check coronavirus
Dr Sethulakshmi and Dr Amjith Rajeevan

Since the first week of this month, Dr Amjith Rajeevan and Dr Sethulakshmi have been part of a mission to check the spread of coronavirus in Kerala.

Three weeks of their tireless efforts, with the help of a dedicated group of health workers and administrators, appear to have paid dividends as, of late, the state has seen a decline in COVID-19 cases, the disease caused by the virus. But the doctor couple says their task is far from over.

Amjith, who works at the Primary Health Centre in Nilackal in Pathanamthitta, played a pivotal role in stopping the community spread of the virus.

He had traced all the persons who came in contact with the first three positive cases in India (Three medical students who came from Wuhan University were tested positive after they reached Kerala). A few days later, he was tasked with the contact tracing of three Italy-returned persons, who in the beginning, were reluctant to co-operate with the health workers.

Amjith said it was easy to trace the contacts of the students from Wuhan, but those came from Italy posed a bigger challenge. “They had been dodging screenings, visiting places and spreading the virus unknowingly. Hence we decided to take their full case history, trace every person they contacted, connect the missing links in their route and identify and alert as many secondary contacts as possible,” he said.

Sethulakshmi's contribution came in identifying the primary contacts. “It was not an easy task because a person contacts 50 or 60 persons everyday. So we had to trace all of them and alert them to stay at home. So we split into six to eight teams of three to four members each and went to all the places the suspected COVID-19 patients had visited, spoke to people to establish the missing links. We maintained safe distance and ensured regular handwashing during contact tracing,” said Sethulakshmi, who works at the Primary Health Centre in Kulanada in Pathanamthitta district.

The results were there to see. In just three days, the team traced 900 persons who came in contact with the persons came from Italy. Kerala's healthcare system would have felt the pinch if the contact tracing had not been carried out properly.

“It was a great team work by over 100 volunteers. The team included doctors, medical students and assistant professors at the community medicine department. All of us were exhausted, but we never lost our spirit,” she said.

Mapping tool

After this, Dr Amjith devised a mapping tool to ensure that high-risk cases were following the quarantine norms. “Apart from GPS tracking, our call centre team contacted them regularly to ensure that they remained in quarantine,” said Amjith, who is trained in the Epidemic Intelligence Service (a training programme in applied epidemiology known for its investigative and emergency response efforts).

Media surveillance team

The media surveillance team too was the brainchild of Amjith. “The team monitors print, visual, social media and fake news. From scaling every inch of the daily, focussing on complaints, demands and tip-offs, to dissecting each comment in popular social media posts and uploads, we take note of any clustering and do the needful – which includes, initiating action, reporting to cyber cell, busting fake news, promoting inspirational act and prompting others to follow. The reception was mind boggling,” he said.

The achievements notwithstanding, Sethulakshmi says that the scare helped change public perception on community medicine. “Community medicine, so far, was looked down upon by many, both the doctors’ community and the general public,” she said.

Both Amjith and Sethulakshmi chose Community Medicine for their post graduation despite many trying to discourage them. And it was during those days that they fell in love. They got married in 2016 in what Sethulakshmi calls ‘a revolutionary act’ against their parents wishes. Hailing from Thiruvananthapuram and Thiruvalla respectively, Amjith and Sethulakshmi now have a one-and-a-half-year-old son Adyuth. “Our parents are now happy about us. If they had any concern about our professional choice, that might have vanished now. We are glad that our passion is now receiving appreciation,” she said.  

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