How Kerala responded to COVID-19

It was about a week back that Kerala had the dubiousdistinction of having the highest number of patients in the country with 137confirmed cases of COVID-19 infection. The numbers were accelerating. Now, thescenario appears to be changing. Kerala has slipped to the fourth place (with286 confirmed cases and two deaths as of April 03). While Kerala’s curve hasceased to accelerate, those of many other States have sharply gone up.

The first case of COVID-19 was reported in Kerala onJanuary 29. Today, the total number of confirmed cases is 286,out of which 256 are active patients and two deaths. Countries suchas the USA, Spain, Italy, Philippines, the UK and suchothers, where the virus made its entry around the sametime, a pandemic situation exists today. There are many limitationsin the comparison of COVID-19 data, particularly with regards to testing. Butwhat is incontrovertible is the low mortality rate in the State. The mostcelebrated case of recovery was that of an aged couple, 93-year-old and88-year-old, with multiple complications after being admitted tohospital for more than a month.

   

Is the case of Kerala different? We may not make any rushedconclusions but some simple facts stand out and make the State different fromthe rest of India. The greatest strength of Kerala has been its public healthsystem which has been responsible for remarkable health indicators such as lowinfant mortality, high life expectancy and a sex ratio that is not skewedagainst women, as it is in many other states. This inherent strength, which is built over the years and based on thephilosophy that the health of each and every citizen is a key part ofdevelopment and growth, has stood us in good stead in Kerala in these difficulttimes.

The first wave of Corona virus with the China returneesin January-end was effectively contained. But in March,things went out of hand with the arrival of infected migrantsfrom Europe and the Gulf countries. Some of these returneesdodged health protocols and clusters of the infected emerged in a fewdistricts. There was no choice otherthan quarantining those with COVID-19symptoms at their homes or in isolation wardsunder close observation. A route map of every infected person wasdrawn up and all their contacts were traced.They were also placed under observation and tested. Nearlytwo lakh persons are under observation. The paramount importancein testing anyone with active symptoms is what is missing inIndia’s strategy of fighting COVID-19. There is absolute scarcity oftesting equipment, ventilators, and relevant medical supplies. The country hasto address the need for augmenting the manufacturing of medicalsupplies on a war-footing.

Preparing for the worst

While we are optimistic about preventing the possibilityof a community-wide spread, we are also preparing for the worst-casescenario. Apart from the hospitals, PWD and local governments have identifiedother public institutions, hotels and private buildings that could be usedfor setting up one lakh additional beds. We are hiring temporary doctorsand paramedical professionals and recalling a section of the retiredmedical staff from the public sector. Pharmaceutical factory capacityis being optimised to produce sanitisers, and ensure additionalsupplies of essential medicines.

Since Kerala has many of its residents working in the Gulfnations, we expect another wave of migrants from these areas once theflight connectivity is restored. We are systematicallypreparing for such an eventuality. Chief Minister PinarayiVijayan has taken the lead, collecting inputs from the differentvertical and horizontal agencies and responding to the everyday challengesthrough a daily evening, live televised media interaction. So, thereis no confusion and there is clear direction for action.

But what distinguishes the lockdown in Kerala has been theempathy and concern for the ordinary citizens with which it is beingimplemented. A major weakness of a national lockdown has been the failure toensure social security and food for the migrant workers, which resulted intheir flight to the safety of their villages, disrupting the entire logic oflockdown. In Kerala, along with the lockdown, we havedeclared a Rs.20,000 crore package aimed at transferringmoney into the hands of the people. Given the hard budget constraints ofthe State, this package has been financed by front loading the annual borrowingof the State Government. The welfare payments for 55 lakh personsincluding arrears at Rs.8,500 per person is being disbursed. Free ration, withadditional food grains to non-priority sectors, and Rs.1,000 worth food of”kits”, with three types of pulses, cooking oil, sugar, tea powder andcondiments, are being delivered to all households in the State.

Arrangements are being made to ensure that 55 lakh wagelabourers who are members of Welfare Boards receive sound financialsupport. Consumer loans are being provided from the bank in aidof the poor households through the Kudumbasree self-help groupnetwork. A sum of Rs.2,000 crore has been earmarked for the purpose. Thisis further supplemented by door delivery of cooked food from anganavadis tochildren and other beneficiaries. Another novel programme is the 1,100Community Kitchens set up by the localgovernments for providing free food and 1,000 budget hotels servingmeals at Rs 20 have been opened. Street dwellers would beaccommodated in marriage halls and food will be provided free ofcost. Local governments, in partnership with the contractors, areproviding food and other amenities to migrant workers at their camps.

Unfortunately, the special contribution of the UnionGovernment in such majorefforts of the State Government is virtually nil. GSTcompensation is in arrears, tax devolution has shrunk and no additional marketborrowing has been permitted. All that has been given is pending arrears of theNational Health Mission allocation amounting to around Rs.150 crores andpermission to spend from SDRF for the treatment of COVID-19 patients.The Central Government is pursuing a maverick policy of forcingState Governments to cut expenditure when governments all overthe world are jacking up expenditure, ignoring neoliberal hangovers.

The difference in the response in Kerala is therefore in theinherent strength of the health eco system that works right down to the levelof primary care, supplemented by a war effort to reach help to the pockets andmouths of people, right through all the way to direct feeding where required.Without that effort and leadership and clarity of purpose, COVID-19 cannot befought and defeated.

Dr. TM Thomas Isaac is the Finance minister of Kerala

(Syndicate: The Billion Press editor@thebillionpress.org)

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