Corona Control in Kerala

How did the state of Kerala manage to control the

spread of Covid -19

13 April 2020

The Kerala state has been able to control the spread of Corona since its spread started. The
first case was reported on 30 January 2020 in Kerala and since then the numbers have
increased to 375 as on 12 April 2020. It is important to note that since mid March, Kerala
and Maharashtra had been the states having the highest number of cases. On 31st March
2020, the number of cases in Kerala were 267 while in Maharashtra were 343. By 10th
April, the cases in Kerala were just 365 while there were 9 states ahead of Kerala in terms
of cases.

The increase in the cases of other

states clearly imply that Kerala
has been able to control and
‘Flatten the Curve’. The growth
trajectory has been worrying for
some states such as Maharashtra
and Tamil Nadu.
It is important to note that every
state has their own challenges in
terms of dealing with the spread.
In this context, it is important to
discuss the factors behind the
success of Kerala for flattening the
curve.
This article discuses the various
administrative and social factors
which led to control of Corona
spread in the state of Kerala.

Source : covid19india.org

1
 Learning from the Past

The state of Kerala in the recent past has dealt with peculiar challenges which stretched
the resources of state and acted as a great learning for the officials.
• The 2018 floods was a time of great distress when the state had to ensure that the Kerala
State Disaster management Authority (KSDMA) is functioning smoothly. During this
process the KSDMA improved its protocols and was activated to its fullest. The floods
also trained the Revenue officials (Village Offices) and Local self governments to run
camps for people who lost their homes. The logistical training of arranging food,
healthcare to more than 10000 people is something which can not be arranged without
practical knowledge.
• The 2018 Nipah Crisis in Kozhikode - A crisis which was unique its own sense. The
Nipah virus claimed 17 lives. This was the Health crisis in which the Health
Department and other officials learned about the Public Health crisis. Strict protocols
were made for contact tracing and surveillance of the cases. The Nipah virus oiled the
machinery of surveillance and Quarantine. Over 2000 people were under Quarantine,
during this crisis.
• The 2019 Nipah crisis in Cochin - A single case of Nipah virus was found which
ensured that the entire Health department of the State was active and n high alert from
initial day itself. The protocols established for the contact tracing and other health
protocols were revised and further improved. The State government gave timely
guidelines on the management of the crisis.

Source - dashboard.kerala.gov.in

2
 Effective State government interventions

The State Government of Kerala has been proactive since the starting of the Covid-19
crisis. The Department of Health and Family welfare had started to issue the detailed
guidelines from as early as 26 January 2020. The first case in Kerala was reported on 30
January 2020. There have been 53 guidelines issued by the Department of Health and
Family welfare till now. The guidelines were of different nature such as Definitions,
testing guidelines, contact tracing, tourists, Treatment etc.
There are multiple practical benefits when such guidelines are issued timely, such as:
• The District administration is aware and at the same page with the state government.
The decisions taken locally will be more guided and uniform.
• The Medical officials - District Medical Officer and the other Medical institutions get
specific and uniform directions and are kept under command with these guidelines.
On the contrary imagining a situation where the guidelines are not given, the District
Administration would have to take their own calls and would be exposed to wrong
procedures and mistakes which might be catastrophic in an issue like Covid-19.
The daily briefing done by the top political executives was the highlight which ensured
that the entire government machinery is under command. The information flow to the
officials and the public, helped to keep everyone aware of what is happening. This also
gave confidence to the public in the preparedness of the government.

Testing

The impetus on testing of the cases was recognised early on and it was tried to have
maximum testing centres within the state. The samples earlier were sent to National
Institute of Virology - Pune, which added further to the time for sending the sample to the
institute. Subsequently, the state had ensured multiple testing centres. At present there are
10 testing centres in state of Kerala. Kerala has in total 14 districts.

Aggressive stepping up of testing is crucial in understanding the spread of disease.

Source - dashboard.kerala.gov.in
As of 13 April 2020, 15683 samples have been tested with 14829 turning to be negative.
The higher testing and the governments priority on testing the maximum has been the
most crucial aspect in controlling the spread of Covid-19.

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 Contact Tracing and surveillance

The contact tracing and surveillance was done by each district using a very strict routine
which was communicated by the health department multiple times. Multiple methods of
contact tracing were used by the health officials - be it google time line tracking,
elimination of contacts, and using AI based technologies for making a simple but perfect
list of contacts. The people under quarantine were very high and the following data table
shows the people under quarantine in the state of Kerala.

Date People under Quarantine

1-03-2020 206

10-03-2020 1495

15-03-2020 9996

20-03-2020 44390

25-03-2020 76542

30-03-2020 157283

05-04-2020 158617

10-04-2020 129751
Source- dashboard.kerala.gov.in

The other aspect of proper information dissemination in terms of Corona also helped in
keeping people under Quarantine not violate the Quarantine and stay in Home isolation.
As an example, in the district of Ernakulam, the Quarantine was ensured using a team of
- Asha worker, Anganwadi worker and Kudumbashree workers - Ward wise.The same
team was responsible for the people under quarantine under the respective ward. They
had to report to the health inspector in case of any violation. District level surveillance
was also done directly in case of High risk contacts.
Quarantine is something which ensures that the disease might not spread further, in
Kerala, this has been understood early on. A major point for the successful Quarantine in
Kerala is that the people were first aware of the disease and then the lockdown and
quarantine came. The focus was, is and will remain on ‘Corona’ and not on ‘Lockdown’.
In other states, due to lack of information dissemination, the focus among people has
turned towards ‘Lockdown’ rather than ‘Corona’.

4
 Lockdown

The lockdown in Kerala has been effectively done and strictly maintained. The biggest
credit for this goes to the people themselves, who understood the importance of staying
home. The enforcement was also done by the Police and other authorities to ensure that
the people don't go out.

Focus on Ancillary activities during Lock down

Since, the lockdown was in place, a major concern for the state was to ensure that people
who cant go out for food and other items, were fed. These people also included the
migrant labourers who are stranded in the state with no job due to lockdown and also
people who might not have food arrangements due to lockdown. Any kind of unrest
among this group could have led to a situation where the lockdown is violated and which
might have led to further spread of the disease.
The State government started ‘Community Kitchens’. These kitchens are supposed to
provide food to the people needing them. The community kitchen were run under the
local self government of that area. The overall coordination through the Local Self
Government Department, helped greatly in ensuring that these kitchens work smoothly.
To point out historical aspect and learning, our Village officers and Tahsildars did similar
exercise during the floods and were resourceful and prepared to do the same during the
present crisis. The Local Self governments were supported by the Revenue officials at
local level using the Village offices and Taluk offices.

Source - dashboard.kerala.gov.in

5
 Public Health care system

The Kerala has fully functioning public health care system which was adopted to treat the
Corona virus epidemic and cases. It includes the network of Government Medical
Colleges in various district and other Government Hospitals. Sufficient capacity ensured
that even if the hospital was turned into a Covid specific care centre, the other public
health care systems didn't get affect and the system kept running.
It is also important to point out that administratively, sufficient staff was available with
the District Administration to assist in the entire planning of the Corona control measures.
The District Medical Officer, along with District Project Manager(DPM) under National
health Mission (Arogya Keralam) assisted the District Administration to take effective
calls on testing, treatment and quarantine.

Pro-active Screening at International transit terminal

The Kerala government had ensured that the Airports and Seaports were sufficiently
manned, considering the huge volume of traffic coming. The Cochin International Airport
did screening of more than 1 lakh passengers. The screening was done irrespective of the
country the person was coming from. There were mandatory quarantine guidelines being
issued by the Government of India. The Government of Kerala pro-actively increased the
coverage of this and put further more people in quarantine. The airport health department
comes under the Government of India, the same was made strong by giving manpower to
them as doctors and Health workers so that maximum people could be screened.

Conclusion
The reasons for this success are much more complex and are intertwined with the social
and administrative factors. The points mentioned are from a perspective of the official
working in the District. A key factor for success in an epidemic like this is to listen to the
doctors. The bureaucracy doesn't have the expertise or knowledge to understand the
severity of a health crisis. A mutual trust at the top most level to the lowest level is needed
among the doctors and bureaucracy. It is also important to have trained and experienced
doctors assisting the work and entire operations. In a society like Kerala, where the public
is aware and conscious, it might be slightly easier to implement policies once they have
been universally accepted, which in turns become easier if the political dispensation is
pro-active. 

This battle of initial control might have been won, but the War against Corona is still very
much on.

6
- Snehil Kumar Singh IAS

Sub-Collector, Fort Kochi,

Ernakulam

Kerala