To the casual observer, Kerala’s clash with coronavirus started on the 27th of January when three Indian students returning from Wuhan tested positive for Covid-19. In actual fact, the story of Kerala’s much envied response to the pandemic starts a whole two years earlier.
It was from the lessons learnt during the Nipah outbreak in 2018, an even deadlier virus that claimed up to 75% of those infected, that health minister KK Shailaja enacted her plan. Shailaja had co-ordinated the state government’s swift response and put protocols in place should a deadly virus strike again. A week before that plane from Wuhan had landed in Kerala, Shailaja had already held a rapid response team meeting, the first of many. A central control room was set up and each of Kerala’s 14 districts were instructed to do the same. Each district was asked to dedicate two hospitals for Covid-19, while each medical college set aside 500 beds. The state adopted the WHO’s “test, trace, isolate and support” protocol and by the time the plane landed, they were ready. Passengers underwent temperature checks and were isolated in hospital if necessary. The remaining passengers were quarantined at home.
Kerala was always more vulnerable than most Indian states owing to its connectivity to the rest of the world. It has a high expatriate population serviced by four international airports. It is also a large tourism hub and one of the more densely populated states in the country. When a NRI (non-resident Indian) family returned to Kerala from Italy in February, without declaring their travel history and flouting quarantine rules, surveillance officials had their work cut out having to trace their contacts. This cluster of over a hundred contacts was eventually quarantined and the spread contained. So effective and efficient was this tracing, that the total number of cases was limited to just six.
Even before the country wide lockdown, Kerala imposed strict social distancing rules and implemented them through effective use of social media. Schools were closed, and the state government convened a meeting of local religious leaders of all faiths before prohibiting the continuation of religious services, festivals and gatherings. While this was met with protests in some Indian states, this resistance was noticeably absent in Kerala. The “Break the Chain” campaign was launched and the state utilised the influence of local celebrities such as Mohanlal and Mamoothy to spread this message on Facebook and other social media platforms. Where we have seen dissent and even open violation to lockdown rules in western countries, Keralans have adopted this new normal in the right spirit.
In fact, the community contribution to the coronavirus fight in Kerala can hardly be overstated. A top down approach has been seen in developed European countries along with a vociferous spread in infection rates. Kerala’s advantage lies in its strong local government, decentralised public health system and investment in public education. Kerala boasts the highest life expectancy and the lowest infant mortality of any state in India; it is also the most literate state. MP Cariappa, a public health expert states as such. “Nowhere else are people so invested in their primary health system. With widespread access to education, there is a definite understanding of health being important to the wellbeing of people.”
The strict lockdown was matched by equally important outreach policies. The social mobilisation initiatives have helped the state tackle issues head-on and with little delay. A 250,000 strong volunteer force was set up in a little more than 2 days. Over the next week, they were trained and assigned roles commensurate to their qualifications. These volunteers covered roles ranging from standby ambulance drivers to quarantine surveillance.
Community kitchens were set up with free food rations home-delivered daily to those quarantined. Regular, clear communication channels were set-up to dispel any fake news. The state also set up camps to house, feed and provide medical care to the migrant workers from other states. “We have also been accommodating and feeding 150,000 migrant workers from neighbouring states who were trapped here by the lockdown,” says health minister Shailaja. “We fed them properly – three meals a day for six weeks.” Those workers are now being sent home on charter trains.
It’s a testament to the work done by Keralans, that the state reports a total death toll of just three since the pandemic began. Kerala stands as an example to the rest of the world, on how to learn from the past, galvanise a community and work towards a common goal.