Jesbin Skariah Thomas
 |
| Kerala Covid19 |
Why Kerala, a small state in
India, is getting so much attention in the context of
Covid Management? We know Kerala leads all
other states with regards to human development and any given demographic indicator. The state has the best health care
system with state of the art infrastructure and doctors
accessible to people at the primary level. The doctor-to-patient ratio in Kerala is 25 to 10,000, much, better than the 10:10,000 recommended by the World
Health Organization. Nevertheless, Covid cases in Kerala are on the rise,
though the state’s health department is handling it quite efficiently.
Here, we need to discuss some of the challenges unique to Kerala, not faced by the other Indian states.
- The state's old-age population is
more than any other state in the country -- at 14%, it is 5% above the national
average living over 60 years. Thus, the
elderly with less immunity and high disease
burden is undoubtedly the major contributing factor to fatality.
- The state has the highest
morbidity burden of lifestyle diseases, with one in every four adults having diabetes and nearly one-third of the adult
population suffering from blood pressure.
- Every third household in Kerala has a migrant, and also another 2.5 million guest labourers
residing within the state. The steady inflow of
international and national migrants poses a serious
challenge in containing the virus. During the
first wave, the state had achieved ‘zero’ cases reported as the after-effect of
lockdown imposed. But since then, it has opened up borders, the consequences of
which are reflected in the surge of Covid-positive patients.
- Owing to its high population density (859 per sq km), the probability of any contagious disease spreading rapidly in the state, remains at the upper end of the spectrum.
Despite all these adversities, the
state has proven its mettle in containing the virus and bringing down the
fatality numbers. Therefore, not much chaos, panic or confusion is visible, though
persistent and strenuous efforts are underway at all the levels of the Covid
management system. District-level control cells connect every healthcare
facility to the available logistic resources. These control-cells monitor daily
activities to ensure that there is no shortage of bed, oxygen, ventilators and
the likes. The state has also ramped up its Covid care infrastructure by adding
more hospital beds, ventilators, ICUs etc., in addition to its already existing
notable investment in public health. Expecting the second wave, the state had
put in extensive efforts to boost its oxygen production from 73 metric tons to
219 metric tons a day. Besides all these, the most crucial practice Kerala has
been following is to report the actual data which helps in an accurate forecast
of expected cases and estimation of resources required to tackle the situation.
The priority is to control the number of deaths regardless of the positivity
rate, which even if spiraling is not something to worry about unless the healthcare
system collapses, running out of beds, oxygen and ventilators. So far, the
healthcare system in Kerala has succeeded in extending necessary medical services
to all those who got infected with the novel Corona virus and thereby kept the
death rate at its minimum.
Unlike the first lockdown (which
was sudden and unplanned, leading to unexpected loss of livelihoods for many
and the grave migrant crisis), the Center did not take any initiative in the
second wave to restrict people's movements but left the same at the liberty of
the state governments! If the first lockdown worked as a preparatory phase,
Kerala’s motto in the second wave is to slow down the spread of the virus so
that the system does not fall apart by an overwhelming number of cases.
Vaccination: As per the Covid dashboard of the
Kerala government, nearly one-third of the state’s 18+ population has received
at least one dose of the vaccine so far. Like many other states in India,
paucity of vaccine is still a matter of concern for Kerala. However, the proficient
handling and optimum use of vaccines by the nurses could help give more vaccine
to the people than the allotted amount. Kerala is the only state to have
reported zero wastage of vaccines.
Role of Local government bodies in Covid care: Local government bodies with their task force are at the front
line to deal with the pandemic situation at the micro-level. Ward level Rapid
Risk force has been constituted in all wards with respective ward members, ASHA
workers and ANM and SHG personnel. They are the first to reach out to for
families having a Covid patient or a migrant member. The ASHA workers after
checking on their health status arrange for quarantine facilities, if needed,
to avoid further spread of the virus in the family and the community, at large.
If, however, the household does not have a separate room with attached
washroom, the person is sent to a quarantine facility arranged by the local government.
Community Participation: The state government’s
coordination with local governments ensures that no person is left hungry in
the state. Data suggests that food prepared in the community kitchens run by women
from the SHG served around 8.6 million individuals, till May 17, 2021.
Quarantined people, guest workers (migrants), and destitute had extensively
availed these services, especially during lockdown. Not only the government
officials and health workers, but social volunteers are also working shoulder
to shoulder in the fight against this raging pandemic, supporting local
governments in arranging quarantine facilities for the isolation of Covid
positive patients. As per the Kerala Covid dashboard, till date around 3.7 lakh
volunteers have registered themselves. Nearly 3700 destitute have been
rehabilitated as of 25th April, 2021 and about 340,000 migrant
labourers served in labour camps.
The Kerala model of Covid
management is nothing but a comprehensive care system for citizens with
planning at the micro-level. In both phases of the Covid outbreak, the
preparation and alertness of the government, well equipped with infrastructure
and expertise is certainly outstanding. This has contributed to Kerala’s low fatality
rates -- less than 0.3%, even amidst a multitude of challenges, which undoubtedly
is a great achievement for the government. Necessary preparations to address the
forthcoming challenges of the pandemic are also continuing at the same time.
Reference
- https://dashboard.kerala.gov.in/
- https://health.kerala.gov.in/pdf/Technical-paper-COVID-19-Sero-Surveillance-Round-3-ICMR.pdf
- https://health.kerala.gov.in/pdf/Technical-paper-COVID-19-Sero-Surveillance-Round-3-ICMR.pdf
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