COVID 19: What the world has to learn from the Indian state Kerala 

Kerala was India’s first state to have the deadly coronavirus pandemic in India. The three infected students from Wuhan, however, were cured of it, which was received by everyone. There were rounds of applause for the state’s health minister Mrs Shailaja teacher, the department, medical team and of course the state’s government’s. Nevertheless, the situation toppled when the virus began to spread the globe and again reached Kerala through many of the NRI’s staying abroad.

PB Nooh, the collector from Pathanamthitta district of Kerala had received a call March 7, stating the case of a virus-infected family who came all the way from Italy to their home.

KK Shailaja, an inspiration for Kerala's fight against coronavirus ...Kerala’s health minister Mrs KK Shailaja

The trio skipped a voluntary screening for COVID-19 at the airport and took a taxi 125 miles (200 kilometres) to their home in the town of Ranni. When they started developing symptoms soon afterwards, they didn’t alert the hospital. Now, a whole week after taking off from Venice, all three—a middle-­aged man and woman and their adult son—had tested positive for the virus, and so had two of their elderly relatives.

PB Nooh’ had been expecting a call like this for days. Kerala has a long history of migration and a constant flow of international travellers, and the new coronavirus was spreading everywhere. The first Indian to test positive for COVID-19 was a medical student who had arrived in Kerala from Wuhan, China, at the end of January. At 11:30 that same night, Nooh joined his boss and a team of government doctors on a video call to map out a strategy.

For some, this wasn’t their first time fighting a deadly epidemic. In 2018, the state had dealt with an outbreak of Nipah, a brain-damaging virus that, like the coronavirus, had originated in bats and transferred to humans. And, as with COVID-19, there was no vaccine and no cure. Seventeen people had died, but the World Health Organization (WHO) called Kerala’s handling of the outbreak a “success story” since—despite technical shortfalls—the state’s health system had contained a potential disaster.

That evening, Kerala’s health minister, KK Shailaja, arrived from the state capital. A former science teacher, she’d already gained a reputation for her prompt and efficient handling of the unfolding crisis: the media had nicknamed her the “Coronavirus Slayer.”

While the rest of India, along with countries such as the UK and the US, wouldn’t take stringent steps to limit movement for another two months, Shailaja had ordered Kerala’s four international airports to start screening passengers in January. All those with symptoms were taken to a government facility, where they were tested and isolated; their samples were flown to the National Institute of Virology 700 miles away. By February, she had a 24-member state response team coordinating with the police and public officials across Kerala.

In recent years, as some states have followed the populist lead of India’s Hindu nationalist prime minister, Narendra Modi, Kerala has maintained its focus on social welfare. Its health-care system is ranked the best in India, with world-class nurses who are headhunted for hospitals in Europe and America; the state’s life expectancy figures are among the highest in the country.

The minister’s arrival in the district reassured Nooh. He wasn’t on his own; the machinery of the entire state was at his disposal. “The seriousness of the government was amazing,” he says. Each team on his task force was increased from six people to 15.

On March 11, the who declared the COVID-19 outbreak a pandemic. The next day, India reported its first death.

In Kerala, a different style of leadership was on display. With 15 cases now confirmed across the state, Pinarayi Vijayan, the chief minister, ordered a lockdown, shutting schools, banning large gatherings, and advising against visiting places of worship. He held daily media briefings, got internet service providers to boost capacity to meet the demands of those now working from home, stepped up production of hand sanitizer and face masks, had food delivered to schoolchildren reliant on free meals, and set up a mental health help line. His actions assuaged the public’s fears and built trust.

“There was so much confidence in the state government,” says Latha George Pottenkulam, a clothing designer in the port city of Kochi, “that there was no resistance to modifying one’s behaviour by staying in.”

Manju Sara Rajan, the editor of an online design magazine in the district of Kottayam, told me she felt safer living in Kerala than anywhere else in India. “We have been considering the possibilities for far longer,” she said. Everyone around knew the number to call if they developed symptoms, and they weren’t acting heedlessly by rushing to the hospital at the first sign of a dry cough.

By March 23, the number of confirmed cases in Nooh’s district had risen from five to nine, but the containment efforts were judged successful.

For most of March, India’s prime minister still hadn’t announced a plan to combat the pandemic. He had asked Indians, in a nationally televised speech, to come out on their balconies one Sunday to clap for health workers. Another day, he asked them to stay home for a few hours—a “people’s curfew”—but his messaging was so muddled that large crowds, which included police officers, took to the streets to blow conches, bang utensils, and ring bells as though they were celebrating a festival.

Then, on March 24, without warning, Modi declared that India would go into a 21-day lockdown—and it would start in less than four hours. Keralites were prepared for this national closure since they had already been living in an informal lockdown for weeks. But they also had support: Vijayan, the state’s chief minister, was the first in the country to announce a relief package. He declared a community kitchen scheme to feed the public, and free provisions including rice, oil, and spices. He even moved up the date of state pension payments.

The rest of India wasn’t quite as lucky. With the shutdown just hours away, people rushed out to buy food and supplies: in many areas they quickly dried up.

At the same time, hundreds of thousands of migrant workers who were now out of jobs tried to find their way home, but with State borders sealed and trucks and buses suspended, they had no option but to walk hundreds of miles to their families. By March 29 at least 22 of them had died on the way.

One Saturday in March, Nooh took a long drive to Konni, a town on the edge of a forest that is famous for elephants. One part of the forest is inhabited by an indigenous community of 37 families, separated from the town by a river. There was no bridge, and Nooh had heard that relief supplies hadn’t gotten there. At the water’s edge, he rolled up his sharp blue trousers and hoisted a jute sack full of provisions over his shoulder. It weighed about 35 pounds (16 kilograms). This wasn’t his job, but he wanted to send a message. “In an unprecedented situation, everyone must contribute,” he said.

Twenty-three days earlier, Nooh had been faced with the “biggest ever challenge” of his career. Now, despite being severely overworked, he saw an opportunity. “As a society, we’ve never faced such a situation,” he said. “Let’s see what we can do.”

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