Kerala tackled the COVID-19 pandemic through its strong public health system and proactive measures. It implemented a three tier public health system and decentralized governance. When cases emerged in January, Kerala conducted aggressive testing, intensive contact tracing, and established quarantine facilities. The government issued clear guidelines, recruited additional health workers, and implemented social welfare measures. As a result, Kerala was able to flatten the curve with only a few new cases reported in May. However, the pandemic has negatively impacted Kerala's economy which relies on tourism and remittances. A new low-cost COVID-19 diagnostic test kit developed in Kerala could help scale up testing if approved.

1. HOW KERALA
TACKLED COVID-19
Submitted by
Balagopal Aiswarya (roll no:
1)
Tarson Teena(roll no: 2)
Pereira Emima (roll no: 3)
Nazir Sana (roll no: 4)
Nimmy Cleetus (roll no: 6)

2. INTRODUCTION
 Kerala, a southwestern state of 33.3 million people has consistently been a
prominent outlier with better health outcomes in a number of areas
compared to most states in India.
In 2011, Kerala attained the highest Human Development Index of all Indian
states based on its performance in key measures
The health gains made in Kerala can be attributed to several factors,
including
strong emphasis from the state government on public health and primary
health care (PHC),
health infrastructure,
decentralized governance,
financial planning,
girls’ education,
community participation and a
willingness to improve systems in response to identified gaps

4. KERALA AND ITS
MULTILAYERED HEALTH
SYSTEM
3 TIER SYSTEM
14 DISTRICTS
900 VILLAGES
152 BLOCKS
23,940 PHC
DISTRICT
HOSPITALS
1,278 HOSPITALS

5. PROBLEM

6. KERALA AND COVID-19
Kerala was the first state to report a case of Covid-19 in India on 30
January 2020.
As of 6 May 2020, there have been 502 confirmed cases with 469
recoveries and 3 deaths in the state.
Kerala has the lowest mortality rate of 0.6% among all states in India.

7. TIMELINE OF EVENTS
January
The first positive cases of coronavirus in India were reported from
three students of Kerala origin, travelling from the Wuhan province of
China
February
The three positive individuals later recovered from the infection
following hospital care. The 'state calamity' warning was withdrawn
after 4 days, when no further cases were reported.
March
Reported second wave of cases

8. PROBLEMS FACED
Since then, Kerala has reported 503 cases.
Cases increased day by day from March and the state wasn’t
expecting this increasing number of cases.
Kerala faced many challenges during this time:
Improper screening at the airports in the initial stage
Cases increasing day by day due to contacts
Limited number of testing labs
Decreased availability of masks and other medical supplies.

9. TIMELINE
30 January First confirmed case
20 February All positive individuals recovered.
9 March Reported second wave of cases
10 March shut down all colleges and schools up to grade 7
22 March Janata Curfew - Nation wide
23 March Announced statewide lockdown
24 March 100 confirmed cases
25 March Nationwide lockdown imposed till 14 April
28 March First death reported
14 April Nationwide lockdown extended till 3 May
10 April 100 reported recoveries
13 April Reported recoveries surpassed active cases
3 May Nationwide lockdown extended till 17 May
5 May 500 confirmed cases

11. SOLUTIO
N

12. STEPS TAKEN
The Kerala government issued clear guidelines for every step in
the state’s COVID-19 action plan.
The clinical guidelines for dealing with suspected cases and
treating confirmed cases have been issued as a “living document”—it
is updated regularly depending on “newer discovery and current
research.”
Each district has been brought under the charge of a minister
while the collectors and district medical officers, or DMOs, coordinate
activities at the district level.
Treatment provided to COVID-19 patients has been categorized
into three groups based on the symptoms.

13. STEPS
Every people under surveillance are contacted daily by the
medical students and staff with the health department, over phone
calls.
The state’s action plan has also focused on strengthening and
managing human resources.
Appointment has been given to 276 doctors, who were in the
rank list of the Kerala Public Service Commission.”

14. STEPS
Three-tier system has been put in place, which divides doctors
into three groups, two active and one on standby. No group works for
more than one week and none come back to work for two weeks after
that.
Extensive social-welfare measures. To ensure food and social
security during the 21-day lockdown period, the government opened
4,503 relief camps for migrant workers, set up 500 community
kitchens across the state, and provided doorstep delivery of food and
essentials.
They made provisions to recharge mobile phones.

15. STEPS
The government has roped in the manpower associated with
various state programmes like Kudumbasree, a women-
empowerment initiative; ASHA, a community-health organization; and
the Integrated Child Development Services, a government scheme for
children.
The state has further decided to recruit 235,000 people from
between the ages of 22 and 40 as volunteers, through online
registration, to support its COVID-19 action plan. Apart from this, by
mid March the state announced a revival package of Rs 20,000 crore
for health packages, free food-grains, subsidized meals, loan
assistance, welfare pensions, tax relief and arrear clearances.

16. PLANS
A robust response team was put together comprising of 30000 health
workers and the state has a very sound health care system.
1. Aggressive testing- Put up testing points across the state at
district level. Thus Kerala had the most number of tests conducted in
the country.

17. PLANS
2. Intense Tracing -Route maps of the patients were made and their
contacts were screened.

18. PLANS
3. Quarantine facility- quarantine period was extended from the
normal 2 weeks to 4 weeks as the govt realized that some of the
asymptomatic patients showed symptoms after 2 weeks. Shelters
were put up and public kitchens all over the state for the
quarantined people.

19. PLANS
Deployed convicts in state prison to make face masks, thus ensuring
a steady supply.
State run pharmaceutical companies were asked to make 1000000
sanitizers in 10 days.
24x7 call centers in all 14 districts and an app to provide people
with accurate information and daily updates.

20. KERALA GOVERNMENT DIVIDES THE STATE INTO THREE ZONES
BASED ON ITS ANALYSIS OF THE PANDEMIC SITUATION IN ALL
DISTRICTS.

21. OUTCOMES
Kerala efforts to check the spread of novel coronavirus has won accolades from across
the globe.
For the fifth time in eight days, Kerala has not recorded a fresh COVID-19 case. The
number of fresh cases added in May is 5; May 1,3,4 and 6 were also zero-case days.
MAY 8
The first state in India that was affected by the COVID-19 on his 100th day , there has
been zero new cases. Within these 100 days there were 502 active cases out of which
474 have been cured and only 25 active cases remain.

22. POSITIVES AND NEGATIVES

23. With containment strategies in place even before the first case of
novel coronavirus was detected on January 30,Kerala appears to have
finally hammered the curve flat.
On May 1, for the first time, the State reported zero new cases, and
again on two consecutive days — May 3 and May 4; zero fresh cases
on three days in May.
Since April 22, except on four days, the number of new cases
reported has remained either the same or fewer than the number of
recoveries
Kerala has very good health-care infrastructure in place, down to the
primary health-care Centre's.

24. But what sets it apart from the other States is the manner in which it
followed textbook epidemiology protocols to the tee, and beyond,
and well before the ICMR advocated them, as well as the entire
health-care infrastructure working in tandem despite being
decentralized.
Political leadership, and the close and complete involvement of the
government at all levels with the bureaucracy and local community
have been a huge advantage.
The very different health-seeking behavior and high literacy too
have played a pivotal role in the war against the virus.

25. Tourism is a major contributor to the state's economy. Following
coronavirus confirmation in Kerala, there were waves of cancellations
of hotel bookings and tour packages.
Liquor sales in Kerala is a public sector undertaking, through which
the government earns a significant revenue. However, following the
outbreak, the sales have gone down, directly hitting the economy.
The state's economy is largely dependent on NRI remittances and
the economic slowdown of affected Gulf countries is expected to have
a direct impact.

26. KSRTC, Kerala's state-owned public transport system has reported
losses worth crores due to reduced number of travelers.
 The practice of social distancing has also brought down the numbers
of those who go out on weekends or do shopping, thus affecting local
traders and vendors.
 Nevertheless, the steps taken by the government has helped Kerala
flatten the curve hence proving it to be effective and worthwhile.

28. Kerala has very good health-care infrastructure in place, down to the
primary health-care Centre's.
Political leadership, and the close and complete involvement of the
government at all levels with the bureaucracy and local community have
been a huge advantage.
The very different health-seeking behavior and high literacy too have
played a pivotal role in the war against the virus.
Kerala did not wait for directions from the Centre but instead led from the
front. There was no delay in taking actions.
 With containment strategies in place ,Kerala appears to have finally
hammered the curve flat.

29. PRESENT SITUATION
The northernmost Kasaragod district, where 178 had contracted the virus and where it was
feared the virus spread could spiral out of control, just one more COVID-19 patient remains
to be cured. With 15 cases, Kannur has the highest number of active cases in the state now.
The absence of new cases has not only obviated the declaration of new hotspots (areas
where movements of people and vehicles restricted) but it has also allowed authorities to free
56 regions from their 'hotspot' classification. This has brought down the number of high risk
areas to just 33.
If it keeps true to its recovery rate of 11 per day for the last seven days, and if no new cases
are reported in the coming days, Kerala could become COVID-19 free within three days.

30. oAt present, India is using the RT-PCR (reverse transcription polymerase
chain reaction) method for SARS-CoV-2 test. The time taken from collection
of a swab sample till the final result is over five hours
oRT-PCR is also an expensive test as the machines required are imported and
expensive
oA Kerala-based institute by (Thiruvananthapuram-based Sree Chitra Tirunal
Institute for Medical Sciences ) has developed a diagnostic test for Covid-19
which it claims can furnish results in less than half the time taken by the
method currently being used in the country and for a fraction of its cost —
₹1,000.
oThe test kit, called 'Chitra GeneLAMP-N,' is highly specific for SARS-CoV-2
N-gene or the novel coronavirus and is designed to give accurate results
even after viral gene undergoes mutation during its spread. The test would
not have any false negatives and would be 100% confirmatory
o If the diagnostic test gets approval from the Indian Council of Medical
Research (ICMR), it can help speed up testing for the novel coronavirus in the
country.
o Commercial production of the test kit could begin within the month

31. Vogue India pays tribute to Kerala Health Minister
K.K SHAILAJA in the latest issue for her dedication
and tireless work to bring the state out of the
pandemic.