With 112 persons testing positive in Kerala for COVID-19, the state has been under complete shutdown since Monday, a day before the Central government announced a lockdown across the country.
The southernmost state, which was the first in the country to report positive a COVID-19 case at the end of January, has put various measures into place to tackle the outbreak.
Roads are deserted, while those that venture out are being sent home by the police. Public transport has been shuttered. Shops selling essential items are open from 7 am to 5 pm. Public gatherings, including functions and prayer meetings, have been disallowed.
The government has promised that essential services such as water, electricity, medicine, telecom, food, newspapers, will continue.
More than 72,000 are under observation, with 400 in hospitals and others at home. Kasargod, the state's northernmost district, has the highest number of cases, with 44 testing positive. Strict measures have been imposed in the district with shops open only from 11 am to 5 pm. Cases will be filed against those who go outside their homes, police said.
The state, struggling to recover from the blows to its economy by the 2018 and 2019 floods, announced a special revival package of Rs 20,000 crore, including Rs 500 crore for the health department, Rs 2,000 crore as loans through the Kudumbasree project, Rs 1,320 crore as pension for March and April, Rs 100 crore for food grain for those above and below the poverty line, and one month relief for electricity and water bills.
Strict regulations are in place to avoid community spread of the coronavirus, with ‘physical distancing, social unity’ being the new motto. The health department earlier successfully initiated two campaigns which were taken up by the people: ‘break the chain’ and ‘route map’.
As of now, no community spread has been reported in the state, with all of those infected having come from abroad and their first contacts.
Politicos lead way
KK Shailaja, the minister of health and family welfare, is leading the fight to tackle the coronavirus. The former school teacher hailing from Kannur, popularly known as Shailaja Teacher, earlier led the state in the fight against the 2018 Nipah virus outbreak, which killed 17 of 18 affected, including a nurse.
Keralites had been observing the spread of the virus in Wuhan in January with much worry, given that many students from the state were in the Chinese city. Shailaja called a high-level meeting on 25 January on the matter. A rapid response team headed by the minister was set up to deal with the situation.
The Disha Helpline was activated in the state (1056) and district levels (several numbers), to which calls could be made anytime to clear doubts or to get information. Arrangements were made for home quarantine and counselling services, utilising health care facilities with the cooperation of the local bodies.
Volunteers and counsellors are calling up those in quarantine twice a day to help them deal with stress and trauma.
The first student to return from Wuhan reached Kerala on 30 January was tested immediately and isolated, along with her family, and then sent to hospital.
After two more students returning from Wuhan tested positive and were hospitalised, Kerala declared a ‘state calamity’ on 3 February. It was then lifted on 7 February as no new cases were reported. All three students were cured and returned home, no one else was infected. Kerala announced that the first stage was successfully overcome by 14 February.
All passengers coming from COVID-19 affected countries were asked to undergo screening at airports. Those who had symptoms were moved to hospitals, while others were asked to stay in isolation for 28 days (which was later changed to 14 days) at their homes.
All suspected cases were screened and samples sent to the National Virology Institute in Pune to test initially, later a testing lab was opened by the NVI in Alappuzha.
The health ministry chalked out plans A and B in the initial stage. Eighteen committees were formed, including an infrastructure committee and a private hospitals coordination committee.
Plan A was implemented when the first positive case was reported. A total of 974 isolation beds were arranged in 52 hospitals (50 government and two private) across the state, and an extra 242 were kept ready for use in case of emergency.
Plan B included 1,408 isolation beds in 71 government and 55 private hospitals, with 17 more isolation beds kept ready. The state went with the Plan A till the first week of March, as no more cases were reported after the initial three students were cured.
Things took a sudden turn on 8 March, when a family that had returned from Italy on 29 February tested positive. The family of three did not undergo airport screening and visited friends and family.
Despite their reluctance to be isolated, authorities stood firm. But in the meantime, two of their contacts became infected. The government then prepared a map of the places they'd visited since leaving the airport and asked all those at these spots as well as the fellow passengers in the airplane and at the airport to contact health authorities. Many were placed in home isolation.
Plan C was chalked out after this incident. The plan includes 3,028 isolation beds in 81 government and 41 private hospitals. Areas not deeemed essential at hospitals would be evacuated to make space for new COVID-19 patients. A total of 208 ICU beds were also arranged in the Plans B and C. More private hospitals could be included in the Plan C if needed.
A total of 147 corona care centres have been opened all over the state to facilitate quarantine for those coming from COVID-19 affected countries or other states but have no options.
However, only very few people have been kept in these facilities. These centres, which could accommodate 21,866 people at a time, have been arranged as part of Plan C.
The government has decided to appoint 276 new doctors from those in the rank list of the state Public Service Commission. The selected candidates have been reportedly provided advice memo, and would be appointed after counselling via video conference.
Other paramedical staff also would be appointed similarly. The state would need more staff including nurses, more medicine, precautionary equipment, ventilators. On 22 March, the health minister gave a call for health practitioners to volunteer at the isolation facilities in hospitals/ houses, patient management in wards, screening at airports, seaports, railway stations and bus stations. The message asked interested health practitioners to submit this form.
Food and essential supplies
The Department of Industries would provide bed sheets, towels and other items for hospitals that are burning items used by coronavirus patients. It will also provide medical masks and gloves, hand sanitizer and oxygen cylinders. Masks have also been provided by certain Kudumbasree units and prisons.
Hotels and restaurants have been ordered to only accept orders online and allow takeaway. The Food Safety Department has increased inspections, with 200 of 700 outlets being issued notices instructing them to improve hygiene.
Meanwhile, the cooperation minister informed that pension would reach those eligible by 31 March. Consumer authorities will also provide essential items to those under quarantine via Neethi stores.
Law and order
The police are on the streets to ensure that the lockdown is observed properly, closing down shops after the allowed timings and preventing people from being outside for no serious reason. Strict measures will be taken against hoarders and price gougers and the with the Civil Supplies Department has already begun inspections. Those under quarantine will be arrested if they venture outside, police said.
The passports of two people infected with the virus, who disregarded directions of authorities, were confiscated. Three have been arrested in Ernakulam for keeping their shops open past allotted hours. The police have also registered cases against those spreading fake news and superstition.
Help and information
Chief Minister Pinarayi Vijayan has been giving the public daily updates, except the day of the Janta curfew, since 10 March. Shailaja has also been in constant contact with the media.
Schools and other educational institutions, including anganwadis, have been shut since 8 March and all exams till Class 7, including classes 10 and 12 and university exams cancelled. The Kerala PSC has cancelled all its exams till April 30.
Many have heeded the call of the government and health officials, with several organisations and volunteers stepping forward to serve in this time of need. Many have delivered those finding it hard to get food and essentials. Others provided hand sanitizers to those travelling in buses.
Volunteers have become an essential part of the fight against COVID-19, with many under the auspices of the government like the Kerala Voluntary Youth Action Force. Volunteers have been at the forefront of helping disinfect public places such as schools (which could be used as isolation wards), bus stations and roads.
Kerala, thanks to the coordination between the people and government, is fighting hard to ward off COVID-19.
Updated Date: Mar 26, 2020 13:50:51 IST