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The coronavirus slayer! How Kerala’s rock star health minister helped save it from Covid-19

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The coronavirus slayer! How Kerala's rock star health minister helped save it from Covid-19

KK Shailaja has been hailed as the reason a state of 35 million people has only lost four to the virus. Here’s how the former teacher did it

 ‘Our clinics for respiratory disease meant we could look out for community transmission’: KK Shailaja, health minister.

On 20 January, KK Shailaja phoned one of her medically trained deputies. She had read online about a dangerous new virus spreading in China. “Will it come to us?” she asked. “Definitely, Madam,” he replied. And so the health minister of the Indian state of Kerala began her preparations.

Four months later, Kerala has reported only 524 cases of Covid-19, four deaths and – according to Shailaja – no community transmission. The state has a population of about 35 million and a GDP per capita of only £2,200. By contrast, the UK (double the population, GDP per capita of £33,100) has reported more than 40,000 deaths, while the US (10 times the population, GDP per capita of £51,000) has reported more than 82,000 deaths; both countries have rampant community transmission.

As such, Shailaja Teacher, as the 63-year-old minister is affectionately known, has attracted some new nicknames in recent weeks – Coronavirus Slayer and Rockstar Health Minister among them. The names sit oddly with the merry, bespectacled former secondary school science teacher, but they reflect the widespread admiration she has drawn for demonstrating that effective disease containment is possible not only in a democracy, but in a poor one.


How has this been achieved? Three days after reading about the new virus in China, and before Kerala had its first case of Covid-19, Shailaja held the first meeting of her rapid response team. The next day, 24 January, the team set up a control room and instructed the medical officers in Kerala’s 14 districts to do the same at their level. By the time the first case arrived, on 27 January, via a plane from Wuhan, the state had already adopted the World Health Organization’s protocol of test, trace, isolate and support.

As the passengers filed off the Chinese flight, they had their temperatures checked. Three who were found to be running a fever were isolated in a nearby hospital. The remaining passengers were placed in home quarantine – sent there with information pamphlets about Covid-19 that had already been printed in the local language, Malayalam. The hospitalised patients tested positive for Covid-19, but the disease had been contained. “The first part was a victory,” says Shailaja. “But the virus continued to spread beyond China and soon it was everywhere.”

In late February, encountering one of Shailaja’s surveillance teams at the airport, a Malayali family returning from Venice was evasive about its travel history and went home without submitting to the now-standard controls. By the time medical personnel detected a case of Covid-19 and traced it back to them, their contacts were in the hundreds. Contact tracers tracked them all down, with the help of advertisements and social media, and they were placed in quarantine. Six developed Covid-19.

Another cluster had been contained, but by now large numbers of overseas workers were heading home to Kerala from infected Gulf states, some of them carrying the virus. On 23 March, all flights into the state’s four international airports were stopped. Two days later, India entered a nationwide lockdown.

Indian citizens arriving from the Gulf states are bussed to a quarantine centre. Photograph: Arunchandra Bose/AFP via Getty Images

At the height of the virus in Kerala, 170,000 people were quarantined and placed under strict surveillance by visiting health workers, with those who lacked an inside bathroom housed in improvised isolation units at the state government’s expense. That number has shrunk to 21,000. “We have also been accommodating and feeding 150,000 migrant workers from neighbouring states who were trapped here by the lockdown,” she says. “We fed them properly – three meals a day for six weeks.” Those workers are now being sent home on charter trains.

Shailaja was already a celebrity of sorts in India before Covid-19. Last year, a movie called Virus was released, inspired by her handling of an outbreak of an even deadlier viral disease, Nipah, in 2018. (She found the character who played her a little too worried-looking; in reality, she has said, she couldn’t afford to show fear.) She was praised not only for her proactive response, but also for visiting the village at the centre of the outbreak.

The villagers were terrified and ready to flee, because they did not understand how the disease was spreading. “I rushed there with my doctors, we organised a meeting in the panchayat [village council] office and I explained that there was no need to leave, because the virus could only spread through direct contact,” she says. “If you kept at least a metre from a coughing person, it couldn’t travel. When we explained that, they became calm – and stayed.”

Nipah prepared Shailaja for Covid-19, she says, because it taught her that a highly contagious disease for which there is no treatment or vaccine should be taken seriously. In a way, though, she had been preparing for both outbreaks all her life.

The Communist Party of India (Marxist), of which she is a member, has been prominent in Kerala’s governments since 1957, the year after her birth. (It was part of the Communist Party of India until 1964, when it broke away.) Born into a family of activists and freedom fighters – her grandmother campaigned against untouchability – she watched the so-called “Kerala model” be assembled from the ground up; when we speak, this is what she wants to talk about.

The foundations of the model are land reform – enacted via legislation that capped how much land a family could own and increased land ownership among tenant farmers – a decentralised public health system and investment in public education. Every village has a primary health centre and there are hospitals at each level of its administration, as well as 10 medical colleges.

This is true of other states, too, says MP Cariappa, a public health expert based in Pune, Maharashtra state, but nowhere else are people so invested in their primary health system. Kerala enjoys the highest life expectancy and the lowest infant mortality of any state in India; it is also the most literate state. “With widespread access to education, there is a definite understanding of health being important to the wellbeing of people,” says Cariappa.

Shailaja says: “I heard about those struggles – the agricultural movement and the freedom fight – from my grandma. She was a very good storyteller.” Although emergency measures such as the lockdown are the preserve of the national government, each Indian state sets its own health policy. If the Kerala model had not been in place, she insists, her government’s response to Covid-19 would not have been possible.

 A walk-in test centre in Ernakulam, Kerala. Photograph: Reuters

That said, the state’s primary health centres had started to show signs of age. When Shailaja’s party came to power in 2016, it undertook a modernisation programme. One pre-pandemic innovation was to create clinics and a registry for respiratory disease – a big problem in India. “That meant we could spot conversion to Covid-19 and look out for community transmission,” Shailaja says. “It helped us very much.”

When the outbreak started, each district was asked to dedicate two hospitals to Covid-19, while each medical college set aside 500 beds. Separate entrances and exits were designated. Diagnostic tests were in short supply, especially after the disease reached wealthier western countries, so they were reserved for patients with symptoms and their close contacts, as well as for random sampling of asymptomatic people and those in the most exposed groups: health workers, police and volunteers.

Shailaja says a test in Kerala produces a result within 48 hours. “In the Gulf, as in the US and UK – all technologically fit countries – they are having to wait seven days,” she says. “What is happening there?” She doesn’t want to judge, she says, but she has been mystified by the large death tolls in those countries: “I think testing is very important – also quarantining and hospital surveillance – and people in those countries are not getting that.” She knows, because Malayalis living in those countries have phoned her to say so.

Places of worship were closed under the rules of lockdown, resulting in protests in some Indian states, but resistance has been noticeably absent in Kerala – in part, perhaps, because its chief minister, Pinarayi Vijayan, consulted with local faith leaders about the closures. Shailaja says Kerala’s high literacy level is another factor: “People understand why they must stay at home. You can explain it to them.”


The Indian government plans to lift the lockdown on 17 May (the date has been extended twice). After that, she predicts, there will be a huge influx of Malayalis to Kerala from the heavily infected Gulf region. “It will be a great challenge, but we are preparing for it,” she says. There are plans A, B and C, with plan C – the worst-case scenario – involving the requisitioning of hotels, hostels and conference centres to provide 165,000 beds. If they need more than 5,000 ventilators, they will struggle – although more are on order – but the real limiting factor will be manpower, especially when it comes to contact tracing. “We are training up schoolteachers,” Shailaja says.

Once the second wave has passed – if, indeed, there is a second wave – these teachers will return to schools. She hopes to do the same, eventually, because her ministerial term will finish with the state elections a year from now. Since she does not think the threat of Covid-19 will subside any time soon, what secret would she like to pass on to her successor? She laughs her infectious laugh, because the secret is no secret: “Proper planning.”

Reprinted from TheGuardian

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Health

May is Mental Health Month

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mental health

May is Mental Health Month, an important opportunity to raise awareness and promote understanding of mental health issues. This year, the theme of Mental Health Month is “Tools 2 Thrive,” which focuses on practical tools and resources that can help individuals improve their mental health and well-being.

Mental health is a critical component of our overall health and well-being, but it is often overlooked or stigmatized. According to the National Alliance on Mental Illness (NAMI), one in five adults in the United States experiences a mental health condition in any given year. Despite the prevalence of these conditions, many people still face barriers to accessing the care and support they need.

One of the key messages of Mental Health Month is that mental health is essential to everyone’s overall health and well-being, and that we all have a role to play in promoting mental health and reducing stigma. This year’s “Tools 2 Thrive” theme focuses on a range of practical tools and resources that individuals can use to improve their mental health and well-being.

Some of the key tools and resources highlighted by NAMI this year include:

  1. Accepting and acknowledging your emotions – This involves recognizing and accepting your feelings, rather than trying to push them away or suppress them. This can help you develop a greater sense of self-awareness and improve your ability to cope with stress and difficult situations.
  2. Connecting with others – Social connections and relationships are important for our mental health and well-being. This can involve reaching out to friends and family, joining a support group, or participating in a community activity.
  3. Creating healthy routines – Developing healthy habits and routines can help promote mental health and well-being. This can include getting enough sleep, eating a balanced diet, and engaging in regular physical activity.
  4. Finding purpose and meaning – Having a sense of purpose and meaning in life can help promote mental health and well-being. This can involve identifying your values and goals, pursuing hobbies and interests, or volunteering in your community.
  5. Seeking professional help – If you are struggling with a mental health condition, it’s important to seek professional help. This can involve talking to your primary care provider, seeking out a mental health professional, or accessing community resources.

In conclusion, Mental Health Month is an important opportunity to raise awareness and promote understanding of mental health issues. By focusing on practical tools and resources that individuals can use to improve their mental health and well-being, we can help reduce stigma and promote a more supportive and inclusive society. Let’s all take steps to prioritize our mental health and support those around us who may be struggling.

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Health

Bill Gates’ Foundation Promise $750M For COVID-19 Vaccine Developed By Oxford Scientists

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Bill Gates' Foundation Promise $750M For COVID-19

Bill Gates has one again ventured up to help the world battle against COVID-19, this time through his philanthropic endeavor Bill and Melinda Gates Foundation. The tech billionare has poured in $750 million to guarantee the worldwide gracefully of a potential coronavirus immunization being created by British medication creator AstraZeneca.

AstraZeneca is working with scientists from Oxford University for the potential antibody. In spite of the fact that the vaccine is still in the improvement stage, the organization has just dedicated to its large scale manufacturing and accessibility. The thought is to abbreviate the long course of events of vaccine creation.

The new funds will be used to increase the supply of the vaccine globally. With this, the total units of the vaccine available for dispense (once developed) will be more than 2 billion.

Representative Image (Credit:GettyImages)

The Charity Foundations

According to a discharge shared by AstraZeneca this week, the understanding has been made with Coalition of Epidemic Preparedness Innovations (CEPI) established by the Bill and Melinda Gates Foundation, and Gavi, the vaccine partnership.

The $750 million agreement will be used to “support the manufacturing, procurement and distribution of 300 million doses of the potential vaccine, with delivery starting by the end of the year.”

In addition to the agreement with CEPI and Gavi, AstraZeneca has also reached a licensing agreement with Serum Institute of India (SII), the world’s largest vaccine manufacturer by volume, to supply one billion doses for low-and-middle-income countries.

Global Distribution

Representative Image (Credit:GettyImages)

AstraZeneca had just reserved 300 million of the potential vaccine to the US and 100 million to the UK. “The Company is building various gracefully chains in equal over the world to help worldwide access at no benefit during the pandemic,” it says.

With the new deal with SII, AstraZeneca has now promised 1 billion doses of the vaccine for low and middle-income countries. Out of these, 400 million will be provided by the end of 2020, the statement confirms. 

The organization had the option to make 1 billion units of the vaccine a month ago. At present, Phase II/III variants of the vaccine are being tried on around 10,000 grown-ups in the UK according to AstraZeneca. On the off chance that its clinical preliminaries end up being fruitful, the primary portions of the vaccine could be prepared by as ahead of schedule as September.

Credit:IndiaTimes

Why The Humanity Post?

The World Health Organisation has named depression as the greatest cause of suffering worldwide. In the U.S., 1 out of 5 deals with depression or anxiety. For youth, that number increases to 1 in 3.

The good news is that 40% of our happiness can be influenced by intentional thoughts and actions, leading to life changing habits. It’s this 40% that The Humanity Post  help to impact.

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Health

New test technique offers more secure measurements of hydroxychloroquine

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New test technique offers more secure measurements of hydroxychloroquine
Credit:GettyImages

LONDON: Researchers have built up another technique to measure levels of the medication of hydroxychloroquine in patients with the rheumatic infection foundational lupus erythematosus.

The technique developed by specialists at Uppsala University and Uppsala University Hospital in Sweden may likewise be valuable in different regions, for example, in the treatment of Covid-19.

Hydroxychloroquine was originally used to treat malaria but has also proven effective with SLE and rheumatoid arthritis (RA), the researchers said.

Today it is prescribed to all SLE patients since it ensures against flares of the ailment. Tests are currently being led to check whether it can likewise be utilized to treat Covid-19, they said.

A disadvantage of hydroxychloroquine is its side effects which can be avoided, however, if the dosage is adjusted for each patient. To achieve the protective effect against flares in SLE while also minimising the risk of side effects, researchers developed a method that can be used in the medical care system to measure hydroxychloroquine levels in the blood of SLE patients.

The method, described in the journal Arthritis Research and Therapy, is based on high-resolution mass spectrometry.

The researchers went through available data on hydroxychloroquine measurements.

They saw that results from measurements on whole blood, plasma and serum were not comparable with each other.

“It was indicated that there were significant contrasts between various reports, and there appeared to be huge individual contrasts,” said Kim Kultima, Associate Professor at Uppsala University.

They compared the levels of hydroxychloroquine in plasma, serum and whole blood in SLE patients.

The team concluded that the levels in whole blood were about twice as high as in serum and plasma. Whole blood analyses were also the most dependable.

“One striking outcome, and a significant understanding, was that levels in entire blood for patients recommended a similar measurement could vary by up to multiple times between people. This demonstrates a huge individual variety in how the drug is processed,” the specialists said.

One problem pointed out by the study is that the services for electronic information on medicinal products in Sweden (FASS) provides concentrations of hydroxychloroquine in plasma.

The researchers judge that these values provide an inaccurate and inappropriate picture for monitoring medication levels in patients.

“We also have to be very careful about drawing hasty conclusions about whether hydroxychloroquine is effective with Covid-19.

“What we cannot deny is that the examination strategy will ideally prompt better information for giving the correct doses to SLE patients who are endorsed the medicine,” the analysts said.

The team are planning to measure the levels of the medication in the blood of Covid-19 patients if the substance proves effective.

Credit:TimesOfIndia

Why The Humanity Post?

The World Health Organisation has named depression as the greatest cause of suffering worldwide. In the U.S., 1 out of 5 deals with depression or anxiety. For youth, that number increases to 1 in 3.

The good news is that 40% of our happiness can be influenced by intentional thoughts and actions, leading to life changing habits. It’s this 40% that The Humanity Post  help to impact.

Continue Reading

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