How Kerala Flattened The Curve?

How Kerala flattened the curve? Kerala has porous borders, a large number of migrant workers, and a huge expatriate population who keep traveling back and forth and whose remittances oil the state’s economy.

More than two months after the outbreak of the pandemic, the state has reported three deaths and more than 370 confirmed cases of the infection. More than 100,000 people remain in isolation, at home or in designated facilities.

Many believe Kerala has flattened the curve at a time when the infection is on the rise all over India.

To be sure, the state has been alert and vigilant. It imposed a lockdown a day before the nationwide one, on 25 March. It did rigorous contact tracing, using detailed “route maps” of people coming in from abroad. It set up Covid-19 care centres in all districts to accommodate outsiders who were stuck and had been advised to isolate.

Health workers supported people with special needs and the elderly living alone. Counsellors made more than 340,000 telephone calls to personnel working in affected areas to counsel them on how to handle stress.

It’s not that Kerala tested aggressively. Testing was bound strictly by and limited to federal protocols. More than a dozen labs are testing 800 samples a day.

But, experts say, what really mattered in the end was Kerala’s robust public health system, and a culture of thriving grassroots democracy with power devolving effectively to the village councils. This mainly helped in community outreach, rigorous contact tracing and mass quarantine. The Communist government released abundant information about the developments every day, analysts say.

“A strong game-changer was the decentralized health care system. And village councils took upon themselves to enforce and monitor mass quarantine with the consent of the people. The shutdown also helped,” B Ekbal, a neurosurgeon and head of an expert panel advising the government on prevention of the virus, told me.

Economists like Jacob John believe that the devolution of power in Kerala – local government, community-driven village councils, vigilant municipalities – have helped the state tackle two consecutive floods and an outbreak of the vicious Nipah virus in the last three years.

The three-tier public health system, involving functioning government hospitals, is the result of a more than half-century long legacy of spending on healthcare. “Kerala,” says Dr John, “has spent more on health and education than most Indian states.”

Breathless media reports of Kerala “flattening the curve” could be premature, officials warn.

Like in the rest of India, much of the testing has been limited and delayed.

Mass screening with antibody tests has been delayed because about 100,000 kits which the state ordered haven’t arrived yet.

Fresh cases haven’t dried up completely. Kerala also “got lucky”, as one doctor told me – the average age of infected people here is 37 years old, and the majority of them are Gulf returnees.

“It’s not counter-intuitive. Some 70% of our Covid-19 patients have come from outside the country,” says Dr Ekbal. This in a state where more than 12% of the population are over 60 years old.

Also, worryingly, Kerala has one of the highest rates of communicable diseases – one that spreads from one person to another – in India. A large number of people also suffer from diabetes, heart diseases, respiratory and liver diseases.

The summer monsoon rains, which begin in June, usually trigger a spike in diseases like influenza, dengue and scrub typhus. Fever is a common symptom in many of these diseases. “This can complicate diagnosis. To make sure we don’t end up facing a fresh wave of infections during the rains, we have to very vigilant during the monsoon,” says a doctor.

Such heightened vigilance – controlling inflows of people across the border and isolating suspects – will come at an economic cost. The government has worked out a painstakingly detailed plan for the phased opening up of the state when infections stop.

So far Kerala has stuck to the script and done it well it, say analysts. Cases have slowed down, recoveries are high and the mortality rate is very low. It helped that it had a smaller population (33 million) than many other states and also a highly literate one.

“We have won the quarter-final,” says Sreejith N Kumar, a doctor. “The semi-final would be a staggered easing up without a second wave of infection. And the final would be a return to normal life.”

“Only then we can say we won the game.”

Source: BBC

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