HOW KERALA DEFEATED CORONAVIRUS

            HOW KERALA DEFEATED CORONAVIRUS  

  

Hey, friends! It has been more than one and a half month since the lockdown was implemented in India Yet, the corona virus shows no sign of stopping You can see the massive rise in the total number of cases in the country in this graph The graph depicts an exponential growth rate Despite this situation, there is one state in India where the trend is reverse where the number of active cases are actually declining And that state is Kerala The Kerala model is appearing to be extremely successful in the fight against COVID 19 Although, there are a lot of states in India where not a lot of cases were reported, for example, the north eastern states But the Kerala model is so successful because at one point of time it was the worst affected state in India But today, it is being counted in one of the most successful states As of 9th May, the growth rate of new infections in Kerala is a mere 0.1% Compared to all the states that have reported more than 500 cases, then Kerala has the lowest figure So the question is what unique things did Kerala do to become so successful in the fight against COVID19 And what can the rest of India and the other Indian states learn from Kerala in the field of healthcare? We will find out about all of this in today's  article. Come, let us see. Talking about the existing healthcare systems, then the healthcare of Kerala has always been viewed at the top NITI Ayog has released a health index to measure the performance of the different states in India from the aspect of healthcare This health index measures 23 different indicators For example, the infant mortality rate the extent of full vaccination coverage in a state the out of pocket expenditure that the people have to spend the extent of the occupancy of hospitals beds the number of vacancies in the position of doctors in public healthcare facilities This health index measures 23 such indicators And Kerala stands at number 1 in the 2019 health index Kerala is the best state in India from the aspect of healthcare There are clear cut reasons behind this Most of the states in India do not spend sufficient money to improve their healthcare facilities Where India, as a country, has spent only 1.29% of its GDP on healthcare Kerala devotes as much as 5% of its GDP towards healthcare Look at the comparison with the rest of the developed countries Most of the developed countries spend around 4-9% of their GDP on healthcare Also, there is a lack of availability of doctors across the entire country As per the recommendation of the World Heath Organization , a ratio of 1 doctor per 1,000 citizens should be maintained in every country in order to maintain a good system According to the government, this ratio in India is 1 doctor per 1,445 citizens But ratio is quite good in states like Kerala- Kerala is the fourth best state in terms of doctor availability after Tamil Nadu, Delhi and Karnataka The ratio here is 1 doctor per 535 citizens So due to the already faulty healthcare system, when COVID 19 broke out and lockdowns were implemented there was a deleterious effect on the rest of the medical facilities Data shows us that the tuberculosis treatment, cardiac emergencies, the ongoing immunization drives All of these faced a steep decline during the lockdown That is, the people who were in need of these facilities for heartattacks, kidney or tuberculosis treatments, were unable to go to hospitals due to the lockdowns, or because the hospitals were either shut or overcrowded These things have been observed in the data from across the country Coming back to Kerala, what were the successful actions that it took to stop the spread of COVID19? I talked to Dr. Abhay Shukla ji to understand this in depth He is a public health specialist, activist and the national co convener of the Jan Swasthya Abhiyaan Hear him out When the travellers were returning to several states from abroad in the month of March Back then, Kerala commenced their testing and screening on a very large scale and then from the month of March... what we can essentially call a "Panchsutra" It is a set of 5 activities That is, all of the travellers or infected people were tested on a very large scale and isolate them if they are found positive upon testing This is number 1 Number 2- contact tracing of the positive people as much as possible Hundreds of contacts of each person were dug out Whether he met someone at the tea stall or interacted with someone at his work place All of these contacts were traced and put under home quarantine The fact of the matter is, the suspected COVID 19 cases were isolated very swiftly and effectively in Kerala Hundreds of people were isolated and home quarantined for every active case so all the people that came in contact with the infected person stayed isolated and did not spread the infection So, Kerala basically sent people for contact tracing Would not that have required a lot of manpower to do? They involved the local panchayats on a large scale as well as volunteers 100-200 volunteers were involved in every panchayat So if when exhort people to become active and if they help and work together with the public healthcare system then anything is possible This is the third important point And home quarantine means staying at home for 14 days without stepping out Fourth- The home quarantined people were extended full support Food and medicines were delivered to their houses and they were supported socially in other ways No kind of discrimination was meted out to anybody Although, a lot of people were home quarantined in a lot of states, but the Kerala government went a step ahead and declared that they would take care of the quarantined people More than 16,000 teams were made by them to help the more than 1 lakh quarantined people These teams were stationed in call centres and they used to call up the quarantined people to ask if they needed food, rations or medical care, and assured them that they would be provided with these things through home delivery Infact, there were teams for mental care and depression as well If the quarantined people felt alone, trapped and unable to step out then these teams provided mental help through calls And finally- the people under quarantine too, were tested and followed up And the rest of the scarce secondary cases were detected in time as well If most of the cases of travellers and contacts are traced right at the start, the epidemic won't spread And this is what Kerala did Moreover, free meals were provided for the migrants in thousands of homes Speaking of contact tracing, there is an app that has been launched for the same purpose nationwide But no such app was launched in Kerala. Yet the state was so successful So do you think this app is a successful way of contact tracing? Look, if the common public is trusted and they get involved in this process of contact tracing, then it is the best way out And that is what Kerala did Contact tracing isn't rocket science. Who met whom and finding the ones who have the highest chances of infection It is better if this information is given out by the people themselves Rather than spying in them And the Aarogya Setu App is kind of a surveillance system The people download it and then a lot of information reaches the government It is also not clear how this information would be utilized It can be used even beyond the epidemic for surveillance It could also be used to exercise control over the people in this situation of a lockdown Some private players are involved in it as well The health ministry is not centrally involved There is basic tenet of public health If the public itself is involved in the processes of public healthcare, then nothing is impossible If you don't trust the public and don't have enough faith in them and then try to work by exercising control on them, then it is extremely difficult With regard to contact tracing, there is a huge difference between what happened in Kerala and what's happening North India The government told us to install the Aarogya Setu app in North India It was made mandatory to do so if you're travelling by railways and if you fail to comply, then the police would arrest you The people were threatened and intimidated And what effect did it have on the people? Consider it yourself- If you are infected, then you would be more afraid to reveal that you are infected You'd be wary of police action or social boycott If so much fear is inculcated, then the people would themselves not reveal that they are infected But the infected people were not made enemies in Kerala They were viewed as patients They were given treatment and were taken care of There is no stigma or discrimination Is someone is infected (or a contact), then he is like any other person in the society If there is such a belief in people, then they will step forward themselves and they would help in any manner possible for their health as well as the health of the society So these are the steps that Kerala undertook in a swift manner in the case of COVID 19 But the healthcare system of Kerala is believed to be at rank 1 in India anyway So do you think that was a reason that Kerala was able to tackle COVID 19 so easily? That is obvious. Suppose there is an Olympic race And there is an athlete that has been training continuously for several years And there's another who has just woken up from sleep- so who would run faster? There is no doubt in this that the one who has more practice will run more and run faster So the healthcare system of Kerala was ready. There had been an outbreak of the Nipah epidemic earlier Apart from that, the public healthcare system there has already been active to eliminate diseases like Chikungunya Lesser spending, lack of staff and doctors, absence of importance imparted politically- These are the reasons why the private sector is dominating in our country today and the public health system is extremely embittered Why is there a problem if the private sector is dominating but functioning properly? The main aim of the private sector is making profit Giving good facilities to the common public is not the main objective of the private sector And due to this, as we can see in the COVID 19 epidemic as well, that it is the public healthcare system that is doing the job of providing facilities to the public The role of the private sector is too little to be seen And where it is visible, as in cities like Mumbai, the COVID 19 patients are charged 1 lakh rupees perday And a lot of private clinics have been shut and the doctors are sitting in their homes They are not taking up responsibility The private labs are minting huge amounts of money in such a situation in some places Being profit driven, they will not be able to do much in the interest of public health Some governments have taken some steps to regulate the private sector recently For example, the Maharashtra government has decided to set a cap to prevent overcharging from patients The governments of Uttarakhand, Rajasthan, Madhya Pradesh and Andhra Pradesh have overtaken the private hospitals temporarily and brought them under government control so that the government is able to treat more patients if there is a spike in the cases of COVID19 A conclusion from such a situation is that we will have to give priority to issues like healthcare The people devote more attention to frivolous issues Now that a pandemic like situation has arrived, then the people are finally realizing the importance of issues like healthcare We will have to make the public healthcare stronger and we will have to reduce our dependency on the private sector Then only can this system be made better for all of uS.

Thank you!