Fighting COVID-19: Trace, quarantine and test key to Kerala’s success, health minister says
Lockdown a blessing, but need to be applied in moderation, Shailaja explains
Dubai: When the first officially reported instances of coronavirus positive cases started emerging out of Wuhan, China, around mid-January this year, K.K. Shailaja, the Minister of Health and Social Welfare in the southern Indian state of Kerala, knew she had a task on her hands. For the Indian state with the largest number of its people working abroad, Shailaja knew it was just a matter of time before the wave of what would eventually turn out to be a pandemic would reach the shores of Kerala.
The result of that early ‘awakening’ of sorts was that by the time Kerala reported its first positive case, in Thrissur, on January 30, the Indian state with the highest literacy rate had a head-start over practically the entire country in dealing with what would soon turn out to be the biggest challenge facing mankind since the two World Wars.
People have also cooperated with us in our containment measures. About 85 per cent of the people in Kerala have followed quarantine measures. Only about 15 per cent did not follow quarantine measures and that is how we got some cases from human-to-human contacts, but those numbers are very few.
Until 5pm (Indian Standard Time) on June 13, Kerala had a total of 2,322 officially confirmed cases of coronavirus, with 19 deaths. In comparison, neighbouring Tamil Nadu had 40,698 cases, with 367 deaths.
K.K. Shailaja responded to queries from Gulf News and shared her thoughts on what has turned out to be a success story worth replicating in not just India but in many other parts of the world. Following are excerpts:
GULF NEWS: Right from the time the World Health Organisation announced the coronavirus outbreak as a pandemic, Kerala is one state that has managed to up its game like no other in India. What do you think has contributed to this?
K.K. SHAILAJA: This has been made possible by strategy, protocol and plan of action. Right from the beginning, we had drawn up a specific plan to deal with the crisis, because we knew this would turn out to be a major crisis in the near future. So we started to follow a strict regimen of trace, quarantine and test. That was our strategy from a very early stage of the pandemic and it still continues to be our strategy in dealing with it.
We screened all those people who were coming in to the state, particularly from foreign destinations, and all those who were found to bear symptoms for the virus were immediately moved to hospitals, while the rest were sent for quarantine – mostly home quarantine. Once they were sent for quarantine, our dedicated team of volunteers in every village panchayat kept visiting these people to check on them, to ensure quarantine measures were being strictly enforced.
Our team of volunteers and plain-clothed police personnel are still running these checks on a regular basis. We have bike patrols for this purpose.
Also, before anyone was allowed to go on home quarantine, we had to make sure there was a separate room and a separate washroom for his or her exclusive use. Otherwise, home quarantine was not allowed and the person would be sent to an institutional quarantine facility.
I must also mention here that people have also cooperated with us in our containment measures. About 85 per cent of the people in Kerala have followed quarantine measures. Only about 15 per cent did not follow quarantine measures and that is how we got some cases from human-to-human contacts, but those numbers are very few. It’s only about 10 per cent of the total number of positive cases. So all that goes to show that our containment measures and quarantine protocol have worked.
Kerala is one of the few states, or perhaps the only one, to allow free treatment to COVID-19 patients. Moreover, the recovery rate (around 92 per cent) is also quite high compared to most other states in India. These are actually huge statements on the state of public health in Kerala. Your comments …
To give you just a couple of examples, right now, there is a far greater number of people under treatment in state-run hospitals than in private hospitals in Kerala. Secondly, a few days back, seven nationals from the United Kingdom, all visitors to the state, had tested positive. They were admitted to state hospitals for treatment. Soon thereafter, our chief minister received a call from the UK Embassy, requesting him to try and explore the possibility of moving the patients to a private hospital. However, when one of the patients was asked whether he would like to be moved to a private hospital, he refused to take the offer, saying that he was very happy with the facilities at the government-run hospital. And the rest of the UK nationals also had a similar opinion, preferring to undergo treatment at the state hospital.
As the nationwide lockdown has been relaxed and domestic flights have been allowed to operate and also given the fact that many repatriation flights have reached Kerala from abroad, do you think these could pose a problem?
This is a challenging scenario for us. We cannot deny people their right to come back to the state, to their homes. But our Chief Minister Pinarayi Vijayan has suggested to the Union Government that there ought to be a priority for people who want to return to the state based on certain criteria. He has recommended that the old and the infirm, pregnant women and those who suddenly find themselves jobless in a foreign country are the ones who should be accorded a higher priority. Much as we would like to welcome all those who want to come to the state, we certainly cannot allow everyone to come in without applying any sort of discretion.
There have been reports of people arriving on these repatriation flights facing difficulties at the airports before being taken for quarantine and even the quarantine facilities are sometimes not up to the mark …
You see the problem is that we cannot be offering five-star facilities to so many people in quarantine. We are dealing with a large number of people and so it is not possible to provide the best facilities to all. Even then we have tried our best. While the Union Government has stipulated 14 days of institutional quarantine for all passengers arriving from abroad, we have tried to make it a little more hospitable for the returning people by making them stay in institutional quarantine for seven days and for the remaining seven days they are being allowed to stay in home quarantine. In fact, there were people who were unhappy with the facilities at institutional quarantine and said that they had bigger, better facilities at their places of residence. Once we were sure that they indeed had houses where quarantine protocols could be followed, we allowed them to go home and consider home quarantine as institutional.
Has the lifting of the nationwide lockdown made things a bit difficult to manage? Would you rather have the lockdown continue for a little longer?
Actually, lockdown is a blessing to contain people. However, having said that, we must also understand that one cannot expect a lockdown to continue indefinitely because it’s not just a question of securing life alone but livelihood as well. A prolonged lockdown is bound to give rise to food shortages. You cannot let people starve. Moreover, for small and medium enterprises also a lockdown that continues for too long can be counter-productive. These measures need to be applied in moderation. For instance, in Kerala, initially, containment zones were panchayat-specific. Within a certain panchayat, if we found positive cases, we would impose a lockdown on that panchayat. Now, the specific ward in which positive cases are being reported, only that ward is being assigned as a containment zone and not the entire panchayat.
So, are you happy with the measures adopted by your department to contain the infection in your state?
Yes, we had actually managed to ‘flatten the curve’ with our containment measures. However, the number of positive cases started rising once the flights started coming in. There have even been cases of patients dying on the very first or second day upon their arrival in Kerala. Some people have travelled even though they knew they were not well. Even some airline crew members have been affected while operating these flights. So we appeal to all concerned to kindly ensure that people who are sick are not allowed to travel because even one sick person in a confined space like that of an aircraft can end up infecting many. I also urge people to follow health protocols in their respective countries of residence.