Explained: how Kasaragod of Kerala has battled coronavirus

A look at the Kasaragod model, and how it differs from some of the other models across the country that have generated interest. (File photo)

Coronavirus (COVID-19): Kerala has resisted the national trend for new coronavirus disease (COVID-19) with a doubling time of 72.2 days, meaning that the number of cases in the state doubled on those days, against a national average of 7.5 days. . Last week, the Center showed the contact tracking and containment model of Kasaragod of Kerala, one of the first places on the COVID-19 map of India, as one of the success stories of the containment exercise.

A look at Kasaragod modeland how it differs from some of the other models across the country that have generated interest.

Coronavirus: Why show Kasaragod?

Kasaragod reported the third case of COVID-19 in the country: a student airlifted from Wuhan on February 3. District administration mounted a massive exercise to track that student’s 150 contacts.

Read | Fight against COVID-19: behind Kerala’s flattening curve, community involvement

According to figures uploaded by the Kerala government, Kasaragod has had 169 cases and zero deaths as of April 19, a unique achievement in itself, given the fact that a large portion of the district’s population has settled abroad. . Of those infected, 123 people have so far recovered, leaving only 46 active cases among the original 169.

Data source: Government of Kerala

In the first days of the epidemic, almost all the index cases were people who had contracted the virus during their trips abroad (around 15.38%). The second wave in the district occurred after people began to return from the Middle East from March 16.

Kasaragod: Under what circumstances was this containment achieved?

The district is far from the main cities, making the isolation exercise more fluid. Kasaragod is the northernmost district of Kerala, far from the capital Thiruvananthapuram. However, this distance also presented an additional challenge. When expatriates returned in large groups, they landed at various airports and took various public transportation options (railways, highways, etc.) to get home, which had the potential to make contacts all the way.

Health Ministry officials said that while Kasaragod has been on display, the success of Kerala as a whole is essentially a story of the strength of the state’s health system and not one of the immediate steps taken. “It is not for nothing that it leads in all human development indices. The most surprising thing about Kerala is how receptive they are to suggestions for improvement, “said a senior Health Ministry official.

What is the Kasaragod model?

District administration relied on aggressive testing, technology, infallible contact tracking, and an effective public awareness campaign about social alienation to achieve the results it can now show. In Kasaragod, as in other districts, the state government appointed a special officer to coordinate the operation of the district administration and for effective coordination between the line departments at the field and secretariat levels. Section 144 was enforced across the district, with seven drones employed for surveillance. Under the Care for Kasaragod initiative, a detailed action plan, a common coordinated action plan, was developed to combat COVID-19, so that all stakeholders could use it when the situation arose.

And what was this action plan?

All the people in quarantine were tracked by GPS. All essential items were delivered to the home in the containment / pooling areas, regardless of whether they were rich or poor. A campaign on social distancing called “Break the Chain” was carried out to convey the message of social distancing. Core teams with incident commanders were formed to rush to various areas and take quick action.

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The plan was implemented with a very strong social welfare component, which included free food kits for poor and migrant workers, rigorous control over hoarding and black marketing, and alternate day health checks for migrants or the indigent. Community kitchens provided free food. Jana Jagratha Samitis, at the room level, made sure that the message reached everyone.

What was the scale of the exercise?

A total of 17,373 people were quarantined. On average, 100-150 samples were analyzed every day and new testing laboratories were started. The 200-bed Kasaragod medical school with an ICU facility was operational in four days. There is also a 709-bed COVID-19 call center. ASHA and health inspectors conducted household surveys.

All primary and secondary contacts of high-risk cases (those 60 years of age or older) were quarantined in isolation centers. This was done since many houses did not have separate bathrooms.

What are the other successful containment models?

At a recent meeting, the Center asked district magistrates to develop separate crisis plans for COVID-19 management, and shared several models. These include Agra, Bhilwara, Pathanamthitta, etc.

AGRA MODEL: Under the conglomerate containment and outbreak containment plan in Agra, the district administration identified epicenters, outlined the impact of confirmed positive cases on the map, and deployed a special task force based on a micro plan made by district administration. Critical points were managed through an active survey and a containment plan. The “access point” area was identified within a 3 km radius of the epicenter, while a 5 km buffer zone was identified as the containment zone.

BHILWARA MODEL: This involved complete isolation of the city of Bhilwara with the imposition of Section 144 CrPC. In the first phase, essential services were allowed; In the second phase, the closure was complete with the city and district borders sealed and checkpoints at each entry and exit point. Trains, buses, and cars were detained. District magistrates from neighboring districts were also asked to seal their borders. Bhilwara’s message was “ruthless containment”.

PATHANAMTHITTA MODEL: Kerala also implemented technology to a large extent in the Pathanamthitta model. All the people who had entered the district were examined and a database was created so that they could be contacted in the short term. Charts showing the travel route of positive cases were created and publicized. This led to self-report. As people realized from route maps and travel times that they had been in contact with someone positive for COVID-19, many came forward to be examined or treated.

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