Kerala is the state where first case of Corona was reported in the country and by march it was among top 4 states of corona patients. In May it reported zero new cases for three consecutive days and hence its strategic management was highly appreciated. The Health minister of Kerala K. K. Shailja was honoured by the United Nations on its Public Service Day 2020 who managed the outbreak of pandemic in a state which is home to around 35 million people.
All of this Kerala model is successful becauses Kerala government understood the danger of this pandemic even before India acknowledged the state of pandemic and Indian medical council released any advisory or guidelines. Since the state has seen and recoverd from Nipah virus and disasters like flood recently it has been paying more attention to cure things like this unannounced pandemic.
Kerala is the state which took the coming of pandemic seriously since the very beginning and in mid january formed an expert committe of 18 persons for different facets of the outbreak control covering from contact tracing to screening to logistic and to mental health. It made panels to isolate people including home quarantine and looked for existing provisions of equipments including N-95 masks and PPEs (personal protection equipments).
On 24 january Kerala was first state to start screening of all passengers coming from China and isolating the symptomatic patients. The first case of country was reported in Kerala on 30 january who was a student returned from Wuhan. As soon as the patient was found all 172 passengers of the flight was traced and 70 people who were in contact was asked to quarantine themselves.
Kerala ministers know that majority of the state population and students are in foreign and that too in China where students go for studies. hence they were preparing themselves and the authorities from top to bottom for the coming outbreak understanding the importance of contact tracing and breaking the chain for further spread and flattening the curve.
Before going through base strategies which the state implied there are some basic reasons why Kerala is been successful in managing the pandemic.
According to the government data Kerala is comparitively a well off state with per capita GDP of 184,000 indian rupee in 2017-2018. Kerala spents 6.5% of its GDP on Health where after Nipah 4000 crore rupees were spent on public healthcare system for strengthening primary and preventive care centres and training of health workers, shifting to generic medicines, making relief shelters for guest workers and community kitchens.
Apart from the budget and capital spent on health Kerala is a state with highest life expectancy at birth, lowest infant mortality rate and lowest maternal mortality rate marking their strong immunity from birth which is big factor for recovery in corona.
Kerala understood all this concept of pandemic and its outbreak and breaking the chain as its also the state with 94% literacy rate in 2011 census. that makes it easier to communicate the advisories and guidelines and the Do's and Don'ts to the common public. All of these basic facts about Kerala has supported state in the long run for proper implementation of the startegies planned against the pandemic.
The Kerala model for straightening the curve is based on WHO guidelines from beginning to end which is to TEST, TRACE, ISOLATE and SUPPORT.
First step they took is to decentalise the power from state to local bodies and panchayats including primary healthcare centres and Aasha workers thinking about where and what work they could perform at very ground level for real tracing and testing of the coming patients. They ensured proper communication and avoid confusion in these matters to continue consistency in their work. Community were provided necessary information related to pandemic to built better understanding of the threat and related issues and avoid panic.
Rapid testing has been done continuosly as soon as first cases were being reported which is the first step to know about the virus.
After the test is known positive, immediate shift to isolation wards and hospitals were arranged where they released and publicize the route map of patients travel and contact history of past few days, where and which place the patient have been, in which vehicles and other things. This helped the government to expose it to other peoples the risks they are taking when stepping outside. Further in any way if they have been in contact they are asked to quickly quarantine themselves. It's impact was 95% of cases diagnosed by health system could be traced back to the origin cases.
After testing, tracing and isolation, the support of Kerala Government is admirable as it's the first state to announce relief package among lockdown and to release the helplines numbers for food, security and health issues.
Kerala Government made sure that no one sleeps hungry keeping in mind elderly, homeless and disabled persons who can't go out purchasing essential needs and made around 1000 community kitchens in each panchayats making food kits and food delivery to household that is free for needy and poor people while rupees 20 priced for others.
Kerala Government carried the emotion of empathy towards patients and workers long before the country has its caller tune to fight against the virus and not the one who are suffering. With small conveniences like providing free WiFi, allowing family members to share room, keeping beds near windows and such gained trust and confidence of patients through efforts of health workers.
The health minister K.K. Shailja, former teacher, herself made her personal presence in motivating the health workers by calling them and asking for their needs and speedy recovery. She dedicated each video conference of her to some special workers including medical staffs, nurses, aasha workers, volunteer organisation and many more in the line. The government overall in all the stages of decentralisation created the "we" feeling among everyone. She created a three point agenda of government hospital being patient friendly, high tech and cutting the unnecessary expenditure. Primary healthcare centres having the testing kits and medical Colleges to have new equipment and good infrastructure.
Kerala made sure that no hospital or care centre reach up to mark of full beds and used hotels and other institutions as isolation and quarantine centres. Kerala in shortage of manufacturing units and factories closed come up with the idea to use manpower of jails to cover the supplies of face mask and sanitizers. Where the first batch was ready by 14 March.
The other important actions include was lockdown of places where public gatherings happens like cinema and shopping malls, religious places and sealed the state and districts boundaries.
For making public aware about the pandemic the government took help from influencers, celebrity, religious leaders, local bodies and civil society organisations and included them in policy design and implementation. They ask public to stay home, wash hands and wear masks so more and more people will know the importance of these three actions in preventing the spread of virus and breaking the chain. To make the communication effective it was circulated in different languages to educate all including illeterate and migrants. To prevent themselves from infection and adapting the term physical distancing and social solidarity instead of social distancing.
The other important thing which the government did is to keep transparency among whatever actions and planning they are doing in order to control the outbreak and releasing the data of how current patients are doing, reporting of new patients, patients who have been recovered and the testing done on daily basis. Keeping it simple and clear and not thinking twice about any questions of their failed effort for controlling but to tell the real condition.
Hence the measures taken by Kerala Government is been acknowledged by the whole nation and internationally which starts with credible leadership and policy design and implementation including mass representative of every section of society and workers, Rapid testing and tracing of patient history, providing mental support and motivation to all frontliners and patients, maintaining transparency of information and keeping updates, Making every plan keeping the most vulnerable at the centre and proper communication and coordination among all in the hierarchy to fight against pandemic.
Source :
https://theprint.in/india/this-is-how-kerala-govt-police-and-residents-are-helping-the-poor-and-fighting-covid-19/389533/?amp
https://m.thewire.in/article/health/the-covid-19-crisis-should-prompt-us-to-course-correct-and-focus-on-public-healthcare/amp
https://amp.cnn.com/cnn/2020/05/12/asia/india-coronavirus-kerala-flatten-curve-intl-hnk/index.html
https://indianexpress.com/article/opinion/covid-19-pandemic-kerala-model-nipah-virus-coronavirus-6393517/lite/
