Local authorities in Kulathupuzha, a border town far east of Kollam district, are desperate to draw up the route map of a 30-year-old who had tested positive for COVID-19 on April 21. But they are not getting the response they are looking for, and still cannot complain.
Unlike in some earlier cases where the patients had been unwilling to cooperate, this Kulathupuzha patient, Manikantan, has a slight intellectual and cognitive disability. He just cannot give proper and consistent answers to the questions put to him by health workers and local body representatives. “We are not even sure whether he has realised the gravity of the issue,” a doctor said on condition of anonymity.
Since they have no time to lose, a route map has been drawn up covering all areas Manikantan could have possibly taken while returning from Tamil Nadu. Some 50 people have been asked to go on home quarantine and 16 have been isolated in various hospitals in Kollam district.
Likely travel history
It was on April 3 that Manikantan left for Puliyangudi in Tamil Nadu's Tenkasi district, some 70 km from Kulathupuzha, to attend the funeral of his uncle.
He hitch-hiked on a vegetable truck that was returning after supplying vegetables to a wholesaler in Kulathupuzha. Regular cross-border movement of essential goods is allowed during the lockdown.
The youth is said to have returned on April 6, after staying at his uncle's house for two days. It was a cousin, or perhaps a friend, who had dropped him close to the Kerala border on a two-wheeler. From there, he once again got a free ride on a vegetable truck that was bound for Kerala. By around 10pm on April 6, he was asked to get down at Thenmala, inside Kerala's border.
As he was walking past the entrance of Rehabilitation Plantations Limited, he saw an ambulance and waved. He jumped in the moment the person who was seated at the back opened the door to check on him. But when he realised he was coming from Tamil Nadu, the ambulance driver asked Manikantan to get out. By around midnight he managed to reach his home in Kulathupuzha.
This seemingly plausible travel history was patched up from what Manikantan told at least 10 people, including revenue and health officials, and local body representatives. His account kept changing with the person asking questions. “It was like he was giving out a new story every time he opened up,” the health official said.
Unseen exit and return
The encounter with the ambulance turned out to be true and the ambulance driver and the other person who was in it when Manikantan jumped in, are now isolated in a COVID-19 care centre at Pathanapuram. Vishnu BS, the elected member of Kulathupuzha ward where Manikantan lives, is also isolated at the same facility.
“He did not tell me that he travelled in an ambulance. He told me that he had come through Aryankavu,” said Vishnu. He said no one had even noticed that Manikantan had left for Tamil Nadu and returned.
“He has some intellectual disability and was therefore unpredictable. Even though we take food daily from the community kitchen to the house where he lives with his uncle, we did not notice he was absent on certain days. Since he is not in the habit of coming out when our volunteers reach the house, it was usual for them to place the food packet on a table at the front room and leave. His uncle, who too has some behavioural issues, did not bother to tell us either,” Vishnu said.
Alert by Tamil Nadu police
Vishnu came to know of Manikantan's short visit to Puliyangudi only on March 19, when the Tamil Nadu police contacted him to ask about the whereabouts of Manikantan. “Some 15-odd people at his uncle's funeral at Puliyangudi had tested positive and when the police started gathering details they found a man from Kerala had come for the funeral and returned. They got his details from his mother who is still in Tamil Nadu. They wanted to know whether Manikantan was the source of the infection, whether he had taken it from our place to Pulinyangudi,” Vishnu said.
It was then that authorities were alerted and Manikantan was tested. He has not shown any symptoms and is now isolated in Parippally Government Medical College.
Not a dangerous spreader
Vishnu says Manikantan would not have come in contact with many people as he is a loner. He does not look like a super spreader either. Manikantan's mother had tested negative for Sars-CoV-2. Two other close contacts, including the uncle with whom he lives in Kulathupuzha, have also tested negative. Moreover, Manikantan is asymptomatic, a sign that the infection is weak.
But Vishnu said he visited a tea shop in the town regularly and took bath daily in the Kallada river. Some who frequent the tea shop and those with the habit of taking a dip in the Kallada river have also been asked to quarantine themselves in their homes for 14 days.
“We also know that he has some friends who provide him with 'ganja' and other intoxicants. Manikantan has still not revealed their names. He is not being wilfully uncooperative. It is just that he has not fully understood what he has been asked,” Vishnu said.
The plan now is to WhatsApp Manikantan's photographs to elected ward members in Kulathupuzha, Aryankavu and Thenmala grama panchayats so that they could forward it to people in their areas. “We are told he could have come through Aryankavu this way but since we don't know this person it would be useful if we could get his photograph,” said Aryankavu ward member Jessy.
