Uninterrupted delivery of medicines, clinical devices and PPE kits to the vast network of government hospitals is the backbone of Kerala‘s battle against COVID-19, thanks to the relentless efforts of Kerala Medical Services Corporation Ltd  (KMSCL) in keeping the supply chain moving despite the lockdown constraints.

A fully-owned state government company under the Health and Family Welfare Department, KMSCL has also played a pivotal role in stepping up the state’s testing facilities, which has proved to be a decisive factor in flattening the corona curve.

State Health Minister K K Shailaja has taken a series of meetings and guided the team to put in place an effective epidemic control and mitigation mechanism. As many as 18 committees, including the one for procurement and supply chain management through KMSCL, were formed. There were daily reviews and on the basis of their feedback, appropriate guidance was provided to all verticals, including that for the procurement management.

On the day when the first COVID-19 case was reported in January this year, the Rapid Response Team (RRT) set up to counter the pandemic entrusted the corporation with the tasks of material procurement, logistics and supply chain management.

“Meticulous planning and implementation with clinical precision are vital for dealing with unusual situations,” said Dr Navjot Khosa, Managing Director of KMSCL.

She said the first thing that the corporation did was to constitute an internal COVID Cell with all department heads as members. Each critical activity was entrusted with one manager and each one of them forming his or her team.

Despite severe logistical constraints imposed by the lockdown, KMSCL organized its operations through teams for five verticals—logistics, equipment procurement, critical medical commodities procurement, ambulance management and IT team for data management, said Dr Dileep Kumar S R, General Manager, KMSCL

“The first major challenge was to make available personal protective gear to the frontline healthcare workers, which included PPE kits, N95 masks, surgical masks, gloves and hand sanitizer. Even in a crisis situation, the corporation was able to ensure the quality of the commodities by validating the quality certifications insisted by Government of India,” he said.

Dr Khosa said: “The global supply chain disruption, the raw material shortage from China and huge demand nationally created hurdles. However, the company explored all its sources and ensured adequate supply without landing into scarcity.”

Significantly, KMSCL proved to be the backbone of the ‘break the chain campaign’ by mobilizing over 500,000 litres of WHO-approved hand sanitizers through its sister concern Kerala State Drugs & Pharmaceuticals Ltd.

The corporation made the district drug warehouses to collect data online through Google sheets from all sub-district health institutions and also monitored the stocks. The hurdles created by lockdown were managed by using the services of its own and rented vehicles beyond the state’s borders, which effectively curtailed supply chain disruption.

Another crucial operation of the corporation has been strengthening the laboratory network for COVID-19 surveillance through RT-PCR (reverse transcription polymerase chain reaction), as WHO has emphasized the testing of all suspected persons with primary and secondary contacts with the diseased.

With the continuous efforts of the corporation, the state could reach the average number of tests from 500 to 1,200 in a span of 14 days, which has been a critical factor in Kerala’s containment policy.

Initially, the state had only four testing centres, which have now been increased to 14 under the government with 45 PCR machines. The approved labs had only one or two PCR machines, severely limiting the number of tests done per day. Then it was decided to shift the 17 RT-PCR machines available in various university labs to the PCR testing labs.

The shifting of all the 17 machines to the labs from Thiruvananthapuram to Kasargod was done by KMSCL within 24 hours and their installation was completed in the next 24 hours.

Also, KMSCL was roped in to address the crisis caused by severe shortage of extraction kit required for the isolation of RNA from the sample, which posed a challenge to the continuation of PCR test itself. The testing became a challenge at this juncture due to lockdown across the globe and spread of COVID-19 in Europe and the USA, the main suppliers of lab consumables.

The corporation set up a special team and identified 12 suppliers in India and abroad. The vehicles of KMSCL were rushed to collect the material from all southern states. With the help of the satellite unit of the state war room, the transportation of these items through international cargo carriers was sorted out. It also managed to get supplies even from foreign manufacturers.

KMSCL has sourced as many as 148 different types of consumables required for the PCR labs and ensured smooth supply to all the testing laboratories.

The corporation chipped in with its expertise in supply chain management and assisted KITCO for converting the under-construction academic block of the Medical College in Kasaragod into a COVID Care Hospital, as in mid-march the number of COVID-19 cases in the district shot up. It has also operated ambulance service to mobilize the Covid-19 suspects / patients from their households/ exit points to the isolation facilities.

By Manoj

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