Goa’s health minister explains how the state became India’s first to have zero active Covid-19 cases

On April 20, Goa discharged its seventh and last Covid-19 patient, making it India’s first state with zero active cases, 24 days after it reported its first case on March 27. The state attracted eight million tourists in 2018 – the year for which latest data is available – making it susceptible to the spread of the Covid-19 pandemic.

Preparing for Covid-19 cases even before the state reported its first case, and other early steps such as lockdowns, random testing protocols, and awareness campaigns have helped the state fight back against Covid-19, Vishwajit P Rane, Goa’s health minister, told us in this interview.

The number of positive cases in India has crossed 23,000 and more than 700 people have died.

With mining shut and tourism affected, industry – which is heavily dependent on migrant labour – is the only “pillar of strength” in the state, Rane, who is also the minister for industries, trade, women and child development and skill development, said.

Edited excerpts:

Given that all seven Covid-19 patients have now recovered, what is Goa doing currently?
Initially, when the cases slowly started rising in India, we were one of the first states to go into a lockdown and we were insisting that there should not be movement of people inter-state. We put our systems in place, took all precautions, creating a tremendous amount of awareness among the people about [the novel] coronavirus, and most importantly, putting our labs in place – all protocols we needed to do, we started doing at that point in time. When we were [at] zero [cases], we started making the right type of noises, putting the right type of training among our staff, creating capacity.

When did you go into full-blown action?
Actually, before we detected even one [the first] case in Goa, we started drawing up the protocols. The minute we got the first case, basically our whole system was so activated that we were doing all the tracking of the patient – of where [they] came from – all the protocols, our system was well-equipped to trace the people. So all the seven people who were positive came from a ship, and as I have always been saying, our worry was people coming in from the ships from places such as Spain and Italy, which were infested with coronavirus.

What we did as a strategy was checking, with random testing protocols in place, and quarantining, whatever basic protocols are there. But in addition, we were suspending all the out-patient departments. We were trying to track the foreign tourists, who were in Goa, where they were located. And, a random testing protocol was put in place.

I think we were the first state to put random testing protocols in place to check people, even the foreigners who were there. So we were in a better position to assess what is happening in the state of Goa. And simultaneously, we were trying to reduce interface between the people and the doctors using innovation in technologies such as CallDoc [which is today used by the Delhi government] and tele-consultations. Simultaneously, we kept enhancing the protocols in terms of testing.

I have always said, even if Goa is [at] zero [cases] today, we will know the actual position – as you know, industrial activity has started – the more you go to test. You know there are issues with rapid testing kits. As you increase the spectrum of testing, which we are in the process of doing, as we speak, I have told my secretary that we should further strengthen the virology lab, we should increase testing setups in several district hospitals and in other places. So that the industrial workers, migrant workers and people who need to be tested on a random basis can get tested. Like I told you, the random testing protocol that we put in place is helping us today.

Now, as we speak, we have a big issue of seafarers coming into the state. We are now very well equipped to handle that.

Goa has started setting up kiosks in various places, where people can go and get tested. What is the strategy that you are following now on – now that part of the lockdown has been lifted and people have started going back to work in industrial estates?
Basically, now we are not using antibody testing as we are not a hotspot. But we have certain places, which are hotspots around us. This is a big challenge for us – Goa is surrounded by Karnataka, Maharashtra and Kerala. Now, we are making kiosks available at the borders, in industrial estates, making sample collection also easy.

Also, the second aspect is, we are encouraging the industry to tie up with us. There has been a lockdown, people have been at home for more than 14 days. But even then, as a matter of great caution, the government under the chief minister has completed widespread surveillance and done a door-to-door survey and identified 5,000 people to be tested. For a small state like Goa, that is a big number that is going to be tested for Covid-19. [Goa had an estimated 1.5 million population in 2018]. These are people with symptoms such as pneumonia and fever. We are quietly doing our activity; following the [Indian Council of Medical Research] guidelines, and in parallel talking to the experts and drawing our own protocol within the overall protocol of the country.

And what is the load currently, in terms of the capacity of your hospitals – both private and public?
We have a sufficient number of private hospitals. We have two large hospitals — Manipal Group of Hospitals and Healthway, run by local prominent doctors, [and] we have Apollo [Victor] and we have government capacities in place. At the moment, as we speak, we have sufficient bed strength. The Government Medical College itself has sufficient bed strength, we have managed with that. We have a dedicated Covid-19 hospital. And now that we are [at] zero [active cases], we are trying to build capacities in the Covid-19 hospital.

We have time now, and so we are building capacities. At this moment, in government hospitals, if you ask me about ventilators, luckily none of the patients needed the ventilator, and we were able to declare them as negative as per the protocol that has been defined. We have 100 ventilators within the setup, but we have already placed an order, nearly a month back, for 400 ventilators. We are already training our staff backend, giving online training to the nurses, so we are preparing ourselves in case there is any eventuality or situation in the future.

You mentioned the seven patients and said none of them became serious. Did all of them have basic symptoms, or did any of them progress to more severe symptoms?
Six of them came in from a ship, they travelled from abroad and came to Mumbai, one of them came from the United States to Mumbai and then to Goa, others were also on the same route who came into the state of Goa – all were from the ships. And there were all on the sea cruise and sea liners and other things. So basically, once they came in, we checked them; one of them got a call saying one of his friends was Covid[-19]-positive. So he immediately came to the hospital; we were in any case testing everybody at the airport and checking everybody’s histories. So we could go backward and get them admitted, the minute we tested them, they came positive. So basically, we had to go for quarantine and other things, which is the normal protocol we need to follow. But one of them who was infected was the brother of one of the boys who came from the ship. But they were in pretty good condition, we gave them the line of treatment, none of them had to go close to the ventilator at all.

Goa is an unusual state, in as much as people want to come into Goa and visit rather than go out, which is happening with other places, particularly with migrant laborers. So how are you seeing May 3, when the nationwide lockdown is set to lift?
As both of us speak, we both know that the cases in the country are rising, and the active cases are closing in on the confirmed cases. This is a situation of great concern. For us, the inspiration has been the Prime Minister and his guidance from time to time via video conferencing. And also the Health Minister of the Government of India.

As you mentioned, everybody has interest in coming to Goa. Now that is good, but we also do not want a situation where people start coming in large numbers to the state of Goa. What I have suggested to the cabinet, my chief minister, is that we should insist on everyone carrying a Covid-[19] negative certificate before they fly. But I do not see flying also starting so fast.

According to a lot of people who we are in conversation with, we feel that though we say the lockdown is going to end on May 3, with the rising number of cases, it is a matter of caution for all of us, we need to take precautions.

Industry, as far as tourism is concerned, I do not see it reviving over the next six or seven months. Because I do not think any of us, even me, if you give a free ticket and say fly to Mumbai or Delhi, I do not think I want to fly to either place. Everybody is going to be at their place, everybody is concerned because there is no cure for Covid-19 as we speak. And everybody is tuned into the channels, what you watch everyday is only about Covid-19, [and] death by Covid-19. So there is fear in everybody’s mind. I do not see tourism reviving.

As a result, as you know, industry, lives and livelihood has been the slogan of the honorable Prime Minister, and they both need to be balanced. With this we want to take maximum precautions. We have got hotspots touching us. We do not want to allow anybody to enter the state of Goa without having thorough checks done, we are [waiting for] clarification from the Government of India whether we can use antibody tests at the borders, but they have said no, because [Indian Council of Medical Research] does not believe that antibody test should be used at the borders.

Similarly, we want the people to come into the state of Goa carrying the Covid[-19]-negative certificate. We want to be strict, we are a small state, we have got limited capacities, we have been doing well, we have been following protocols but somewhere if we open up, there is a possibility that this will be very difficult for us to handle.

You are also handling additional portfolios of industry, women and child development and skills. As you look ahead, how do things look beyond the public health crisis? How are you seeing the fortunes for Goa beyond that?
Industry, as far as pharma is concerned – we have been emphasising on pharma here, the fourth largest exporter of pharmaceutical products is Goa. Apart from this, there has been a demand from the industry, I think the list has already come from the Ministry of Home Affairs. So all the list is being followed to the T. We are trying to see and facilitate as per the norms given by the Government of India and ensure that there is proper flow of trade and other things. Whatever guidelines have been given, we try to follow as those are the industries that need to start.

For us in Goa, we have two issues – one, tourism, on which we are totally dependent; and two, mining, on which we were dependent to a great extent. Mining is shut, tourism [is] affected, so there is a tremendous shortfall in terms of revenue. And this is a major cause for concern. We cannot allow industry as a hub to shake. Industry is now the only pillar of strength, for this state government here in Goa, we need to see that the industry runs smoothly and at the same time following the guidelines as listed by the Ministry of Home Affairs. Even then, there is going to be a drop in production. Production is not going to be full capacity.

And migrant labour from the state of Goa have gone back [when they could travel]. So there is a big question. Once the lockdown opens, I may not be correct, I hope I am not correct, but a lot of migrant labour are waiting to go home. They do not want to stay in Goa, I think everyone wants to go back home. Because the fear of coronavirus is so much – whether it is a construction worker or a road worker – he does not want any help from the state government. All he wants is to go back home. So this is a matter of great concern. If they go [back], again this will reduce capacities to a great extent.

You are, like other states and cities, dependent on migrant labour yourself.
Definitely, we are. They are a major portion for us in the state of Goa. They have been helping in the industries, in production, many of the industries where you have unskilled labour such as packing and other industries, including multinational companies where they are being used, also for us in the tourism sector and hospitals.

I find that there is a large chunk of people who want to go back. And I do not think we will be able to bring back industry to that level and that capacity either. It is going to be very difficult, it is a challenge, but we will live up to the challenge...try to see how to best look after them. All the industries – how the government could step in and take care of this aspect which is now on everybody’s mind: what is going to happen after the lockdown – it is not necessary that they are going to be here. If the production further gets affected, it is a big challenge to the state government.

This article first appeared on IndiaSpend, a data-driven and public-interest journalism non-profit.