Kerala doctors oppose move to deny free Covid care to unvaccinated

Medical professionals in the southern Indian state of Kerala are calling for the authorities to scrap a decision to refuse free Covid-19 treatment for unvaccinated residents.

Kerala has one of the best public healthcare systems in India but its vaccination campaign has slowed, with only two thirds of adults receiving their second dose, leading to fears the Omicron variant could cause a renewed Covid-19 outbreak.

India has confirmed two cases of the new variant.

The western state of Maharashtra, home to India’s financial capital of Mumbai, has introduced a seven-day institutional quarantine for arrivals from many countries where Omicron cases have been detected. This list does not include the UAE.

The Indian government is introducing door-to-door vaccinations to ensure a greater proportion of its population receives a second dose, with only about 40 per cent of adults fully immunised, before any further spread of Omicron.

However, Kerala is the first state to withdraw free Covid-19 treatment from unvaccinated residents.

Doctors dismayed at withdrawal

“The government will not bear treatment costs for those who haven’t taken vaccine shots,” state chief minister Pinarayi Vijayan said.

“Those who are reluctant to take the vaccine on account of allergy or disease should produce a certificate issued by a doctor in government service.”

Before Mr Vijayan’s announcement, the Kerala government produced data showing about 5,000 teachers and other school staff were unvaccinated.

This caused panic among some Keralites who feared the Omicron variant could spread in their schools unless action was taken.

In South Africa, where the Omicron variant was first detected, children under 2 now account for 10 per cent of Covid-19 hospital admissions, analysis by South Africa’s National Institute for Communicable Diseases shows.

Only 40 per cent of children in Kerala had antibodies in October, the state’s health department said.

While this demonstrates Kerala’s success in keeping infection rates low during previous waves, it means the majority of children remain vulnerable to infection.

Despite Kerala reporting more new cases than any other state in India, infection numbers nationwide have fallen to fewer than 10,000 from a peak of 400,000.

This has given many in Kerala the impression that India has defeated the virus, possibly leading to a rise in vaccine hesitancy.

“A lot of people have misconceptions and we are seeing a lot of anti-vaxxer videos from the West, particularly the United States, being shared in Kerala,” said Dr Arun N Madhavan, chief executive of the private Quality Clinic, in Palakkad, and one of Kerala’s leading Covid-19 experts.

However, Dr Madhavan believes the state government should stick to awareness campaigns to counter misinformation and limit public access for the unvaccinated by requiring proof of vaccination to enter a restaurant or cultural event.

“I think it’s a little unethical. If a patient is very sick and could die then the government shouldn’t say that they can’t be treated for free,” he said.

Dr Madhavan said most of his colleagues were in agreement and feared turning away critical, lower-income patients who cannot afford treatment in the private sector.

Vice chairman of the Research Cell of the Indian Medical Association in Kerala, Rajeev Jayavedan, said he hoped the policy would serve as a “positive message” to encourage vaccinations and would not be a permanent measure.

A non-ICU care room in a leading private hospital in Kerala can cost anywhere between Rs5,000-10,000 ($66-$133) per day. Medical costs remain one of the leading factors pushing Indians into poverty.

E Unni Krishnan, an unvaccinated teacher in the Kannur district of Kerala, said he had refused the Covid-19 vaccine because he was worried about adverse side effects.

“[The new ruling is] unfair and a pressure tactic to force teachers to take a vaccine when it is not mandatory,” he said.

“It undermines the self-determination and liberty of a person to decide about their health.”

He said many older teachers were relying on ayurveda, a traditional form of Indian medicine using herbal treatment to prevent infection.

Mr Krishnan said the majority of unvaccinated teachers would, therefore, remain reluctant to get inoculated and preferred to continue producing a negative RT-PCR test every week at their own expense to be allowed to keep working. Unvaccinated government employees will also be required to test.