Public Outreach To Doctors' Training: Kerala Is Leading Fight Against Coronavirus

By :  Reethu Ravi  
Published : 6 March 2020 8:38 AM GMT / Updated : 2020-03-06T15:33:18+05:30
Public Outreach To Doctors

Image Credits: Madhyamam, Outlook India

The effective manner in which Kerala tackled COVID-19 earned praise in a talk show featured on BBC News on Wednesday.

The total number of patients infected by the coronavirus or COVID-19 in India now stands at 30 after a man tested positive in Ghaziabad on Thursday. E-commerce portal Paytm informed on Wednesday that one of their Gurugram office employees who had just returned from a vacation in Italy had contracted the virus.

As of Friday, 30 confirmed cases have been registered of which six cases in Agra, one each in Delhi, Telangana, and Gurugram. On Wednesday, samples of 16 of the group of 23 Italian tourists and their Indian driver who had travelled to Rajasthan last month tested positive, Union Health Ministry said. The total cases also include the first three cases reported in Kerala, who have since recovered.

On Wednesday, Kerala's Health Minister KK Shailaja told ANI that the condition of three students are stable at home and are free to mover around as their isolation period is over.

At present, a total of 469 people have been under surveillance. Of this, 438 people are under home quarantine and 31 in isolation wards. The minister also said that the situation in Kerala has stabilised.

The effective manner in which Kerala tackled COVID-19 earned praise in a talk show featured on BBC News on Wednesday.

"Kerala is one state that has developed its health infrastructure really well. And it's not just hospitals, but it's the primary healthcare centres which are the first level of contact of the population. So at one end, they have done that. At the other end, they have developed the very good capability of diagnosing and tracking these viruses and infections," leading virologist Dr Shahid Jameel said.

So, how is Kerala battling the deadly virus?

Early Preparations

With its experience in fighting the Nipah virus outbreak two years ago, Kerala is setting an example to the world in dealing with the novel coronavirus epidemic. In 2018, 17 out of the 18 affected by Nipah had died in the state. However, taking a lesson from the past, during Nipah's second outbreak in 2019, not a single death was reported in the state.

The state was battle-ready as soon as the Union Health Ministry issued an alert against the coronavirus on January 17. As students from Kerala accounted for a large section of the medical students in China's Wuhan, the epicentre of the virus outbreak, the health department officials in Kerala was alert about a possible outbreak in the state.

Moreover, the chances of a higher number of positive cases in the state are high due to its huge population.

"Kerala's density of population is high, and people participate in many group functions. Hence, as the virus is airborne, it can spread easily. Also, the comorbidity in the state is high, that is, diseases like hypertension, diabetes, cancer, and heart diseases are more. People with such diseases have higher chances of getting infected," Dr B Ekbal, former Vice-chancellor of the University of Kerala, a public health activist, and currently a member of the Kerala State Planning Board told The Logical Indian.

Immediately after WHO declared the severity of the virus, strict vigil began at airports in the state to screen passengers flying in from China. At the four international airports, preliminary screening procedures were set up. If anyone showed symptoms during the screening, they were taken to the nearest medical college in a sterilised ambulance.

Isolation wards were prepared in all districts. In addition, private hospitals were also informed about setting up isolation wards in case of an emergency. To decide on treatment, isolation, and quarantine of suspected patients, a Rapid Response Team (RRT), headed by the Health Minister herself, was set up. State and district level control rooms were also set up, that held daily meetings headed by the Principal Secretary of the State health department. Over 40,000 health official and staff have been mobilised in the state.

Adequate training was provided to paramedics, drivers, support staff and measures were taken to spread awareness among the public. The awareness drives focused on minimising the spread of fake news and fear among the public. State-run Kerala Medical Services Corporation (KMSCL) was also prepared to ensure the storage and supply of masks, gloves, medicines, safety suits, protective gears, medicines etc.

Contact Tracing, Quarantine, And Surveillance

After the first case was confirmed, 'contact tracing' was promptly initiated to trace all those who had come in contact with the patient. The second and third case was confirmed n February 2 and February 4, respectively. All the patients were interviewed in detail to contact any individual they may have come in contact with. "Based on all the contacts we received, we quarantined the people and put them under surveillance," said Dr Ekbal.

"The Health Department is identifying those who are coming in from China, and they are monitored. They also check people who come in the close proximity of the affected person. All of them are quarantined for 28 days. If anyone is sick, they are treated in the hospital," said Dr Ekbal.

After the third case was confirmed, Kerala declared a 'state calamity' to strengthen all surveillance measures. This was later withdrawn on February 7 as no new cases were reported. "The announcement is not meant to scare people. It is to help take proactive steps to intensify the steps to contain the spread of the virus," the Health Minister had said.

The health department wasted no time in waiting for more positive cases to turn up to strengthen vigilance across the state. "We are not waiting anymore for positive cases to come. We will be prepared to take containment action and will not have a lag time," health secretary Rajan Khobragade had told media.

KK Shailaja: Leader At Forefront

Soon after the Union Ministry's alert, through PSA's and press conferences, state Health Minister KK Shailaja in her calm and composed voice issued an alert against the spread of coronavirus and asked the listeners in Kerala to maintain caution.
With her exemplary show of strength in dealing with calamities in the state, KK Shailaja, fondly called as Shailaja teacher, has won hearts all over. The 63-year-old former high school teacher's openness and caring nature is also a reason for her popularity.
Many attribute Kerala's continued success in combatting epidemics to the Health Minister.
"(Shailaja)Teacher's leadership is exemplary! What I'd say is that she has an 'infectious enthusiasm'. Just like how there is an index case for any disease, Teacher is the index case for enthusiasm in the entire health department. Her enthusiasm spreads to everyone. Her leadership is such that she can easily enthuse people," Dr Ekbal said with a laugh.
"We are countering the virus with this enthusiasm that Teacher has imparted in all of us," he adds. In the days and weeks that followed, cases of the deadly virus grew, and the three confirmed cases were reported in Kerala.
On January 30, when the first confirmed case of the virus was detected in Thrissur district, a high-level meeting chaired by Shailaja was held at the Thrissur Government Medical College. As two more positive cases get confirmed from the state within the next five days, the Minister leads her team against the deadly virus with gumption.
"We overcame flood and Nipah. We will overcome coronavirus too," the Minister assured the citizens.

Communication From The Health Department

The Kerala Health department regularly communicates with people of state via press conferences, especially by the Health Minister herself.
In addition, bulletins on the status of the quarantined individuals, patients under isolation, new people screened, etc, were shared on an almost daily basis. Through live streaming of the press meets and posts on precautions, social media was widely used by the top officials to reach out to the public.
Furthermore, the health department is providing mental health support to all those under quarantine. Twice daily, a specially designated team of doctors and counsellors call all those who are under quarantine at homes or at hospitals to help them deal with trauma, anxiety, sleeplessness, worry, etc.
"Our health department has done an exceptional job of taking care of us. Every day they would call me to ensure that I was alright," Bharathi E S, a medical student who had returned to Kochi, Kerala, from China, and was under home quarantine, told The Logical Indian.
"When I developed a slight throat pain a couple of days after coming here, they immediately asked me to get admitted to a hospital they mentioned. I was admitted for five days and tested for the virus. After the tests turned negative, they discharged me and asked me to continue home quarantine. All the doctors and nurses there took such good care of me. A doctor would give me counselling every day too. From food to all the health check-ups, everything was free too," she added.

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