As of 28 March, there were 182 identified cases of COVID-19 in Kerala, according to the daily status update by the state’s ministry of health. The state also reported its first fatality from the novel coronavirus that day. In the wake of the nationwide lockdown following the pandemic, more of Kerala’s non-residents, who account for almost five percent of the state’s population, returned to the state, driving a surge in new infections. A total of 45 fresh cases were reported in the state in the last two days, according to the ministry. The state has so far tested 6,067 samples, the highest of any state in the country, and a total of 134,370 people are currently under observation. Of these, 133,750 have been isolated at their houses and 620 have been admitted in designated isolation facilities. Out of all the cases under treatment in the state since the outbreak, 16 people have recovered. In a press briefing this evening, the chief minister, Pinarayi Vijayan, announced that four of them recovered today, including one foreign national. The press conference has been a daily feature of the state government’s response to the pandemic since 30 January, when the first case was detected in Kerala.
Kerala’s first three cases also happened to be India’s first recorded cases. Three Malayali students studying in China’s Wuhan province, the origin point of the pandemic, returned to the state and tested positive between 30 January and 3 February. In a measure of the state’s preparedness, the ministry of health already had a draft policy on the outbreak ready by 26 January. In an article in The Hindu on 23 March, Kerala’s minister of health, KK Shailaja, talked about how her ministry had initiated discussions on the outbreak “as early as mid-January.” She added, “When various countries started confirming cases, Kerala was the first State to draft measures for its containment. The measures became more stringent when the State reported its first case on January 30.”
When the third case was reported on 3 February, the state government declared the Covid-19 outbreak a state disaster. An order was issued to constitute a 24-member State Response Team, or SRT, with Shailaja as its chairperson. The team included senior officials from various departments—epidemiology, community medicine, infectious diseases, paediatrics, drug control and food safety, among others. Eighteen state-level teams were constituted to coordinate various functions such as surveillance, call centres, human-resource management, training and infrastructure augmentation. These state-level teams reported back to a state control room, which is coordinated by floor managers. The control room functions round the clock, in shifts.
According to a health official, who did not want to be named, inter-departmental coordination, which is currently being done by the chief minister, plays a huge role in handling the situation efficiently. Effective implementation of the ministry of health’s policies requires important contributions from the departments of police, revenue, electricity, water and public works. “Once the disaster act comes into being, the revenue department gains prominence. Though the health department is leading, all other departments are working together,” the health official told me. The official added that “if any need arises, the concerned department would be prepared to meet it in no time.”
The Kerala government has also issued clear guidelines for every step in the state’s COVID-19 action plan. These guidelines were prepared after consultation with experts in their respective fields and then issued as government orders. And the process is ongoing and evolving. For instance, the state’s 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.” According to these clinical guidelines, treatment provided to COVID-19 patients has been categorised into three groups based on the symptoms. Right from precautionary measures to cremation of patients, these guidelines are meant to be strictly followed.