Health Minister not resting easy

V.K. SANTOSH KUMAR

Kerala has earned kudos from around the world for its stellar effort in containing the spread of Covid-19. But the state's Health Minister K.K. Shailaja is still not resting easy.

She is concerned that a third phase of the pandemic could undo all the good work.

On May 8, Kerala declared that it had flattened the curve. Thanks to its track, trace and treat methodology, the state then had only 601 coronavirus cases, and three deaths, in a population of 35 million. No wonder Mrs Shailaja, 63, was hailed as the "Coronavirus Slayer" and "Rockstar Health Minister" by the international media.

Mrs Shailaja, who works daily from 7am to 9pm to combat the pandemic, is modest about her achievements.

"It's not just me. We have a solid team in place with officials who know what needs to be done," she said.

"While I appreciate the praise showered on me, they also have played key roles. Thanks to all, we have a well-oiled machinery in place."

But the problem for Mrs Shailaja is far from over, though.

Over the past week, more than 75,000 Malayalees have returned home from overseas and other parts of India.

And their arrival has been marked by a surge of coronavirus cases.

After practically recording zero new cases in the last weeks of April and early May, Kerala on Monday and Tuesday witnessed a big spike: 41 new cases - all but one of them returnees from overseas and other states.

New hotspots have cropped up - Wayanad and Kasaragod in North Kerala - along with two superspreaders: A truck driver who returned from Chennai's Koyembedu vegetable market and infected 10 others and a Communist Party of India (Marxist) leader who infected eight others after sneaking into neighbouring Karnataka to bring back a relative.

"People slacken when restrictions are relaxed," Mrs Shailaja told tabla! with a sigh. "This is not a good sign.

"Now we have to be more vigilant. We managed the first two phases well. Our mortality rate, which is less than one per cent, is the best in the world.

However, we shouldn't lower our guard. The third phase is critical for the state."

The minister calmly explained how Kerala tackled the coronavirus while providing mind-boggling details.

For example, at one point, there were about 170,000 people under surveillance. It is about 72,000 now - a big jump from the 14,750 on May 6.

"It was a huge, complex task," she said. "But we were prepared and worked hard as a team to tackle it."

Even as Covid-19 was rearing its head in Wuhan, China, almost 5,000km away, in tiny, coastal Kerala the authorities were already at work.

"When we heard of the Wuhan outbreak, we figured that it can reach Kerala too due to its rapid human-to-human transfer nature," said Mrs Shailaja.

"There are students from Kerala studying there as well as people who go there on business. When you sense that a danger is looming, the most important thing to do is to prepare for it."

By mid-January, the CPI(M)-led state government had its first meeting and formed a rapid response team.

"By January 24, we had opened a control room and set up 18 expert teams, each assigned specific duties like tracing, quarantine, isolation, treatment and logistics collection," she said.

A protocol to combat the virus was also devised before the first person tested positive. This was followed in every zillah (sub-division).

The state's preparedness level was also high as it had successfully handled the Nipah virus outbreak in 2018.

"It did teach us a few lessons, but it's not just that," said Mrs Shailaja, who also helmed the fight against the Nipah virus.

"In 2018, Kerala started a big campaign to minimise infectious diseases. The state has been able to greatly reduce such deaths."

On Jan 30, India registered its first coronavirus infection in Kerala - a student who had returned from China.

"Saving lives is our priority. No one with the coronavirus should die because of our lack of care. That was our thinking," said Mrs Shailaja, who is affectionately called "Shailaja Teacher" because of her early career as an educator. She quit teaching in 2004 to take up politics as a career.

The Kerala model's success also lies in plugging every loophole - including extending care to even areas like mental health.

About 1,070 trained counsellors have called more than 450,000 people isolated in hospitals or quarantined at home to alleviate their mental distress.

"From the beginning, 'reverse quarantine' was also strictly followed, where the most vulnerable - people aged 60 plus and those with other underlying diseases - were specially taken care of," said Mrs Shailaja.

Given the scarcity of testing materials, Kerala also tested people systematically while other states tested rampantly.

"Since the cases in Kerala were all imported, we implemented a strict quarantine at home or hospital policy," she said.

"Their movements were carefully analysed and only those with symptoms were tested."

Even before the official nationwide lockdown came into effect on March 25, Kerala had started curbing social gatherings.

Malayalees returning from overseas were also strictly quarantined. This helped Kerala successfully handle the second phase.

The cost of implementing such detailed tasks has been prohibitive.

"India's investment in the healthcare system is only around one per cent of the gross domestic product and what Kerala receives is a small percentage of that," said Mrs Shailaja.

"We have somehow managed to adjust with people-centred planning.

"Our chief minister urged us to focus on saving lives instead of mulling over the money involved. Despite the financial challenges we have, the chief minister and the finance minister have been helpful and supportive."

Mrs Shailaja, though, is not sure if the Kerala model can be followed across the country.

"We have shared our expertise with other states, but it may not work everywhere," she said. "Each state has unique requirements and must deal with them in its own way. We have done well in the context of Kerala."

 santosh@sph.com.sg

"People slacken when restrictions are relaxed. This is not a good sign." - Kerala Health Minister K.K. Shailaja in an interview with tabla!