A Look Into How Kerala Managed To Flatten To Curve

After a student from Wuhan tested positive on January 30, Kerala became the first state in India to report a positive case of the novel coronavirus. On April 4, Kerala crossed the 300-mark. Since then, however, the rise in a number of cases started plunging. As on April 14, Kerala has reported 379 cases and 3 deaths. Presently, 181 patients are under treatment across various hospitals in Kerala while 198 have been cured.

State Finance Minister Thomas Isaac pointed towards the flattening of the curve in a tweet on April 12. According to him, active COVID-19 cases had declined in the previous week. The flattening of the curve points to the slowing of the spread of the disease. Illustrating the graph he had posted along with his tweet, he said that the recovered cases (green curve) will cross the yellow curve of currently active positive cases soon. The red curve indicated total positive cases so far reported in the state.

But, how did Kerala, the state with the highest number of COVID-19 cases after Maharashtra in the early stages of the contagion, manage to tighten its grip on the spread of the deadly contagion?


For starters, the land of coconut realised early the potential morbidity of a curve arcing acerbically upward. As early as January 18, the state health department issued a COVID-19 alert and began to screen passengers arriving from abroad, initially from China, the epicentre of the contagion. A health card was handed out to people arriving from foreign countries in which they had to enlist their travel details and health condition. Any passenger with a fever, cough or sore throat was immediately shifted to a linked hospital and the district medical office was notified.

The administration ordered district hospitals to designate isolation wards. Rapid action was taken in setting up district control rooms, started procuring medicines, masks, gloves, and other personal protection equipment (PPE).

Within weeks, on February 4, it declared the COVID-19 threat a state disaster and screening at airports was tightened, and travellers from nine countries including South Korea and Iran were required to quarantine at home starting Feb. 10, a fortnight prior to India put similar restrictions into place. Temporary quarantine shelters were established to house tourists and other non-residents. Contact tracing was scrupulous. Individual patients were interviewed and their primary and secondary contacts were traced and isolated.

A week into March, after a family of three came but didn’t report their travel to Italy, Kerala introduced spatiotemporal mapping which involved a detailed flowchart that depicted the date, time and movement of each corona-positive person, based on call details and CCTV footage.

Home quarantine was strict. People were home-quarantined, for 28 days instead of the WHO-recommended span of 14. By April 11, as many as 1,22,676 people were under home-quarantine.  Each such person received an average of 2 to 3 calls from the authorities daily.  Around 16,000 teams ensured that in-home quarantine stayed home.

The communist state also announced an economic package worth ₹20,000 crores to fight the pandemic days before the central government imposed an impetuous lockdown that left many states scrambling. It delivered uncooked lunches to schoolchildren. The state collaborated with service providers to increase network capacity for the Internet at homes and pledged two months of advance pension.

On March 28, CM Pinarayi Vijayan announced the state would conduct rapid testing that involved blood samples instead of nasal swabs, and stipulates results within 45 minutes to 2 hoursThese tests can be repeated on a patient in quarantine and can reveal the extent of recovery. Over the first week of April, Kerala had conducted more than 15,000 tests. By April 12, 14,989 samples had been sent for diagnosis, of which 13,802 came out negative.

The fortitude of its health-care system allowed it to follow the WHO’s recommendation on aggressive testing, even as central agencies maintained that mass testing was not conceivable in a country like India. If Kerala continues to keep up the trend, it would soon be able to not just flatten its COVID-19 ambit but also circumnavigate itself from the menace of the novel coronavirus.  Earlier this week, CM Vijayan said that the recovery of more people and a decline in the number of new cases in the state are good signs but it should not let the administration “lower the guard” against COVID-19.

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