How Kerala managed to flatten the Covid chart

Kerala has been reporting new cases of the novel in single digits for the past few days, a flattening of a deadly curve by measures that included early detection, aggressive testing and contact tracing, and a 28-day quarantine period, twice as long. as prescribed by the WHO. And underlying everything and making it possible was a strong public health system.

From an infection on January 30 to 378 on April 13 and two deaths so far, the state has seen 198 people recover. He recorded his highest cases in one day (39) on March 27, and the lowest on March 19 (1). On April 12, there were only two cases. He soon realized the potential lethality of a curve that arched sharply upward.

As early as January 18, the state health department issued a Covid-19 alert and began examining passengers arriving from abroad, initially from the cradle of the virulent spread: China. International arrivals were issued a health card listing their travel details and health status.

The state's five airports were linked to ambulances and emergency response at district hospitals. Any passenger with a fever, cough, or sore throat was immediately rushed to a linked hospital and from there passed a message to the district medical office.

During the following week, he established district control rooms, began acquiring masks, gloves, other personal protective equipment (PPE), and medications. He ordered district hospitals to designate isolation rooms. Within weeks, on February 4, he declared the Covid-19 threat a state disaster. Tracking contacts was meticulous. Manual surveillance, from January 30 to March 8, began with interviewing individual patients and working backwards with people with whom they had been in contact.

Starting March 9, he introduced temporary spatial mapping after a family of three did not report his trip to Italy. This involved a detailed flow chart representing the date, time, and movement of each affected person, based on the details of the call and CCTV images.

House quarantine was strict: 12,470 were in house quarantine on March 16; This increased to 1.22,676 people on April 11. Each person in home quarantine, for 28 days instead of the recommended 14, received an average of 2 to 3 calls a day from the authorities. Some 16,000 teams ensured that those quarantined at home stayed at home.

As of April 12, 14,989 samples had been sent for testing, of which 13,802 were negative. From April 1 to 13, the state conducted 227 tests per million people for its population of 3.4 million rupees.

On March 28, CM Pinarayi Vijayan announced that the state would conduct rapid tests, with blood samples, not samples, and results within 45 minutes to 2 hours. These tests can be repeated in a quarantined patient and can reveal the degree of recovery.

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Kerala also kept its doctors safe. A three-tier system was implemented in all government medical university hospitals. The doctors were divided into three teams. The first worked on Covid-19 cases and in isolation rooms. The second attended outpatient cases and the emergency department. The third stayed at home on leave, prepared to deploy if necessary.

The blockade showed results in Kerala. The state had reported 109 cases on March 24, the day before closing, and at that time it was the most affected. But, as the shutdown progressed, it almost crushed the curve, reducing the increase in cases per day to just around 10% by the end of the first week. Since April 3, it has been between 3% and 4%.