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What India Can Learn From Kerala’s Handling of COVID-19 Crisis

Success of Kerala healthcare system is in teamwork, meticulous tracing, ensuring people follow quarantine norms.

Published
COVID-19
5 min read
Pathanamthitta collector PB Nooh carries supplies to a hilly area where tribals reside.
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The first cases of coronavirus in India were recorded in Kerala on 30 January, and since then there has been a steady rise in the number of infections, with the total number of cases in the country exceeding 9,000 as of 13 April. But while many states have had a rapid rise in cases, with multiple states crossing the 1000 number mark, Kerala has largely managed to flattened the curve, reporting just two to three cases daily in the last 3 days. As of 13 April, the state has only 376 cases. Of them, 179 persons have recovered.

With just two deaths, the rate of casualties due to COVID-19 is just 0.54 %, which is well below the global average.

Meanwhile, its neighbour Tamil Nadu, with 1,075 confirmed cases as of 13 April is second to Maharashtra.

So what has Kerala done that others can lean on?

The state owes its success to coordinated teamwork, meticulous contact tracing and strictly ensuring people adhere to the lockdown protocol.

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Amid this global outbreak of the coronavirus, the state has earned praise from a BBC talk show panel for its effective and efficient handling in limiting the number of cases.

News anchor Devina Gupta in a discussion with Chinese journalist Qian Sun, virologist Dr Shahid Jameel and Subodh Rai, senior director of Crisil Ratings, discussed how Kerala has efficiently managed to contain the spread of the virus, and leaned on their experience of dealing with past outbreaks like the Nipah.

The infection curve is flattening, with few new infections being reported in the past week. The recovery rate is more than the infection rate.

This was achieved through relatively high number of testing, surveillance, quick identification of suspected and infected cases, efficient tracing of contact and travel history, quarantine measures, follow-up, and mental health awareness.

The infection curve is flattening, with not many new infections being reported in the past week. The recovery rate is more than the infection rate.
The infection curve is flattening, with not many new infections being reported in the past week. The recovery rate is more than the infection rate.
(Photo Courtesy: Kerala Government Website)

For every patient, spatial mapping is done and a detailed travel history with specific routes, contacts, vehicles travelled in is created. This is later circulated in the local neighbourhood and social media for people to also identify if they have been exposed to the virus.

This is the route map of a patient in Allapuzha.
This is the route map of a patient in Allapuzha.
(Photo Courtesy: Kerala Government Website)

Ensuring Strict Quarantine Norms

While this has been quite tricky for every state government, the district administrations have come up with novel methods to ensure people follow quarantine and social distancing norms.

For instance, Pathanamthitta which saw the first influx of cases in the country has hardly nine active cases today. Abey Sushan, District Programme Manager with National Health Mission, Pathanamthitta told The Quint that this was possible through a three-tier system.

  • First, with the help of a questionnaire by the community medicine team of the Trivandrum Medical College, they began assessing and identifying people who were likely to break quarantine. These questions were also administered while making calls by a control room.

  • Second, the reason people were breaking quarantine was because they had to buy essentials. So with the help of community volunteers and panchayat, medicines and provisions for the home, baby food, even cattle feed was delivered to their doorstep.

  • Third, an Asha worker and a neighbour was put in charge of every home where a person is supposed to be in quarantine. These persons informed the police if the anyone defied the quarantine rule.

Only two deaths have been reported so far.
Only two deaths have been reported so far.
(Photo Courtesy: Kerala Government Website)
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Community Kitchens Scale Up Production to 2.8 Lakh Packets/Day

Community kitchens have been set up all over the state and are now cooking and distributing 2.5-2.8 lakh of food packets a day.

Across 1,255 community kitchens in 14 districts, strict social distancing norms are being practised and they maintain hygiene.

Community kitchens have been set up all over the state and are now cooking and distributing 2.5-2.8 lakh of food packets a day.
Community kitchens have been set up all over the state and are now cooking and distributing 2.5-2.8 lakh of food packets a day.
(Photo Courtesy: Kerala Government Website)

The initiative was to ensure the state is hunger-free during the lockdown as they cater to migrant labourers, homeless people and the destitute rehabilitated under the Ashraya integrated project. Other sections of the public can pay Rs 20 per packet and Rs 5 as delivery fee.

The kitchens are run by women volunteers empowered by the Kudumbashree project, and also includes cooperative societies and voluntary organisations.

The kitchens are run by women volunteers empowered by the Kudumbashree project, and also includes cooperative societies and voluntary organisations.
The kitchens are run by women volunteers empowered by the Kudumbashree project, and also includes cooperative societies and voluntary organisations.
(Photo Courtesy: Kerala Government Website)

Prepared for the Future

The state is geared to face any influx of cases that may come their way in the future. Chief Minister Pinarayi Vijayan said that though the curve is flattening, they will not let their guard down.

Six walk-in kiosks for mass collection of samples for coronavirus testing, inspired by South Korea, have been built in Kerala's Ernakulam district. A WISK (Walk-in Sample Kiosk) is a mobile cubicle with a sealed glass front, and have extended gloves attached in the front, through which a medical practitioner standing in the cubicle can collect samples. Thus, a test can be done without any direct exposure.

Around 1,000 rapid sample testing kits for coronavirus have already been flown in. Thiruvanthapuram MP Shashi Tharoor has ordered for a total of 3,000 sample testing kits from Pune-based MyLab with Rs 57 lakh, paid from the MP’s funds.

Thiruvananthapuram is one of the seven hotspots in Kerala, with 10 confirmed cases and over 18,000 people under surveillance.

The state is also working with South Korea, Germany and Dubai to procure more testing kits, said an official.

The state has joined hands with a public-funded research institute to develop a low-cost rapid diagnostic kit for COVID-19.

Houseboats in Alappuzha, which have been abandoned due to the lockdown, will operate as isolation wards, if the need arises.

The district administration has also identified 5,806 beds with attached toilets in Alappuzha district, from hotels, resorts, hostels and lodges in order to accommodate patients if needed.

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Lifting Lockdown in a Phased Manner

Kerala’s stand on the nationwide lockdown is that it should be lifted in a phased manner. Briefing on the details of the discussions with Prime Minister Narendra Modi during the video conference with chief ministers, Vijayan said he had also sought the centre's intervention to operate special flights to bring back Keralites stranded in various countries. The state had suggested that it was not ready to go back to the pre-lockdown situation.

Restrictions are especially necessary in the seven hotspots – Kasaragod, Kannur, Kozhikode, Malappuram, Thrissur, Ernakulam and Thiruvananthapuram, which accounts for most of the cases from the state, till 30 April, he had suggested.

What India Can Learn From Kerala’s Handling of COVID-19 Crisis
(Photo Courtesy: Kerala Government Website)

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