Are 14 Days Enough? Kerala's Case For 28-Day Quarantine

On March 19, as the first flush of COVID-19 cases were being reported from across the country, a man flew from Dubai to Kerala's Kannur and was promptly asked to self-isolate at home for 28 days, despite showing no symptoms associated with the novel coronavirus.

He was tested on April 14 - 26 days later - while he was still asymptomatic; the state took this precaution because his travel history placed him in a high-risk category. Two days later he was found to be COVID-19 positive.

On March 20 two others returned to Kannur from Dubai and both were placed in isolation. They too were asymptomatic, meaning they showed no symptoms. As with the above case, samples were collected on April 14 and they returned positive for the novel coronavirus on April 16.

According to the Kannur District Medical Officer, of the 248 people who had returned from abroad and were tested for the virus, 17 were found COVID-19 positive. Around 95 per cent of these 17 cases were asymptomatic.

"We are following a strict 28-day isolation (period) and high-risk category people are being tested, even if asymptomatic. There is nothing to worry about because all these people have been in strict mandatory isolation with regular follow-ups," K Narayana Naik, the medical officer, told NDTV.

However, the story is a little different in most other parts of the country, where the testing criteria for COVID-19 is still the display of symptoms during a 14-day isolation period.

"There was a case in Wuhan where symptoms appeared on the 27th day. At least five per cent of cases have an incubation period longer than 14 days. That is the logic behind Kerala standing strong on a 28-day isolation period," Dr Mohammed Asheel told NDTV.

Dr Asheel is a public health expert and a member of a core team involved in COVID-19 containment measures in the southern state

"In Kerala it is not like the incubation period is 26 days. Rather, the incubation period is seen as the number of days between exposure and appearance of symptoms and almost 60 per cent of COVID-19 cases have only minor symptoms," he added, noting, "There are cases here where the incubation is anyway more than 14 days".

Across India over 13,000 COVID-19 cases have been reported and 437 deaths linked to the virus (File)

According to studies published in various journals, around 95 per cent of people develop symptoms between 0 and 14 days (or a median of five days). The remaining five per cent are outliers and can turn symptomatic even after 24 days and up to a month.

Although that five per cent could translate into a statistically small sum, it highlights the chances of a fresh outbreak, or an intensification of the current, of one of the most contagious viruses in recent times.

"The most important lesson we need to learn is that even asymptomatic people can spread the virus - beyond 14 days. And this may be beyond just five per cent of cases," Dr Asheel said.

Kerala, which reported the first three coronavirus cases in India, has detected 395 cases of the contagious illness so far. Interestingly though, only three deaths have been linked to the virus (Maharashtra has 194 deaths, Madhya Pradesh has 53 and Delhi and Gujarat have over 30 each).

More importantly, the state has discharged 245 people after receiving treatment. Only Maharashtra (which has over 3,000 confirmed cases) has successfully treated more people.

Across the country over 13,000 cases have been reported and 437 deaths linked to the virus.