Kerala, which was the first state in India to report a coronavirus infection in late January 2020, has also prepared a time table for coming out of the lockdown and there would be district-specific strategies to tackle the situation while the number of cases is on the decline and it's also among the best in containing its spread. The state faced a potentially disastrous challenge as a tourist spot such as a disproportionately high number of foreign arrivals. Popular for its tranquil backwaters and health retreats, the coastal state receives more than 1 million foreign tourists a year. One-sixth of its 33 million citizens are expatriates and hundreds of its students study in China.
The reports, in the leading news agencies of the world on the Kerala model, spell out that Kerala had learned valuable lessons from managing the Nipah outbreak and gained the confidence to handle future epidemics from unfamiliar pathogens. The experience also helps in good stead in managing Covid-19. Unlike Nipah, which emerged out of nowhere, the origin of Covid-19 was known. Since there was only one epicentre to begin with, Kerala could focus on returnees from Wuhan.
At the initial level, The Government of Kerala (GoK) on the same day as PM Modi’s lackluster speech announced a relief package worth $270 million. The package includes loans to families through the women’s co-operative Kudumbashree, higher allocations for a rural employment guarantee scheme, two months of pension payments to the elderly, free food grains and restaurants to provide food at subsidised rates. Utility payments for water and electricity as well as interest on debt payments will be suspended.
In Kerala, it stems from a report which was explained in the India Today on March 19, 2020 by a team of experts who warned the government that there is a possibility of novel coronavirus infection spreading to nearly 50 per cent of the state's population. This means that roughly 16.5 million people could test positive for novel coronavirus in the worst case situation, which if reached can potentially lead to crashing down of health care system in the state.
The state government is adopting two-way strategy to minimize the community spread of infection. It is launching Corona Literacy Mission reaching out to all families in an aggressive campaign with Malayalam content. The pamphlets will be distributed to all families by health volunteers and Kudumbashree Mission representatives to create awareness among the public about the dos and don'ts in the time of Covid-19. Secondly, the government has asked the local self-government bodies and police to intensify surveillance and tracking of quarantined persons in the state.
The Washington Post (April 14, 2020) noted that more than 30,000 health workers in the Kerala are working in response to the coronavirus pandemic. The Government of Kerala has also taken other efforts including aggressive testing, intense contact tracing, instituting a longer quarantine, building thousands of shelters for migrant workers stranded by the sudden nationwide shutdown and distributing millions of cooked meals to those in need.
In addition, the State also declared strict travel restrictions and other measures in place, daily hospitalisations of suspected cases have shrunk considerably in Kerala and the number of patients daily discharged after a negative report and subsided symptoms outnumber the former consistently. The Government has used to track the contacts of infected persons. Every contact of each positive case for the 14 days prior to the person showing symptoms is identified, contacted and home quarantined. They are followed up morning and evening for the entire incubation period over the phone by health workers.
Fortunately, timely dissemination of surveillance data was an effective way in which the government of Kerala managed to keep panic under check and gain the confidence of the community. Kerala’s Health Department, using the precedent of the Nipah virus campaign, set up 18 committees to get to work and held daily evening meetings to evaluate their actions. In order to ‘break the chain’, GoK has been conducting rigorous ‘contact tracing’ or studying whom the infected person has been in contact with. Route maps showing the places that, the infected persons have been to, are being published and people who were present at that time at those places are asked to contact the health department so that they can be screened and tested. The route maps are widely disseminated through social media and GoK Direct, the government’s phone app.
For active action, the GoK has also set up call centres with 241 counsellors who thus far have conducted about 23000 counselling sessions for those who are afraid or nervous about the situation. For taking such stringent actions, the number of new cases in the first week of April dropped 30 percent from the previous week. With just two deaths, 52 percent of positive patients have recovered in the state, higher than elsewhere in India.
Till April 19, 2020, India has recorded 16,116 confirmed cases, 519 deaths, 2,302 cured cases, according to the latest update released by the Union Ministry for Health and Family Welfare of India. Interestingly and fortunately, the State of Kerala has confirmed 400 cases infected, 257 cases cured and only 3 cases died in Covid-19 on same time. Not only Kerala but also China, Singapore, South Korea, Taiwan and Germany have shown the roads to be successful in managing Covid-19.
In Bangladesh, the Government has taken huge action plans to mitigate and control pandemic in last four weeks. The Government declared a large economic scheme for the poor and under privileged people, farmers, Industrialists and Business enterprises. The government declared public holiday up to April 25, 2020 and many districts as well as cities have been declared lockdown. The test and collection of samples have been extended across the country and some intensive test units have been set. The government issued official guidelines and notification regarding social distance, doctors and other sectors. There have been taken some eventual steps to accelerate about the information of outbreak. The Government has also specified some hotspots of pandemic and taken action plan to maintain guidelines of WHO.
World Economic Forum stated in a published article that Bangladesh can seek inspiration from other countries' models too, but we should also recognize that many mitigation strategies may be out of our reach. We should also realise soberingly that our public healthcare system is already overburdened and that the curve, as is, very skewed and not flattened. According to World Bank data, Bangaldesh has 8 hospital beds for every 10,000 people; by way of comparison, the US has 29 beds per 10,000 people while China has 42.
Bangladesh is one of the highest densely populated countries of the world. In South Asia, According to pandemic data site worldometer, the density of population in every p/skm is in Bangladesh 1265, India 464, Pakistan 287, Sri Lanka 341, Nepal 203 and Bhutan 20. So there is a possibility to spread out the Covid-19 seriously which is already seen in different districts. Collection of samples and test of the affected people should get highest priority.
According to worldometer, in South Asia the test rating in per million people, Bhutan has tested 10,507 people, followed by Maldives 6,871, Nepal 1,015, Pakistan 472, Sri Lanka 302, India 291 and Bangladesh 162 as of April 20, 2020. Bangladesh is in the lowest position in testing per million people rating.
Till April 20, 2020, Around 150 doctors and healthcare workers, more than 50 police and some other government officials have been infected with coronavirus in discharging duties. Meanwhile, the total number of infected has reached 2,948. The death toll has stood at 101 and 85 people has recovered as according to IEDCR. Bangladesh has collected and tested 26,604 people and 713 persons are kept in isolation while in home quarantine is 15, 5224 persons and in institutional quarantine is 4655 till April 20, 2020. The infected number is almost triple within one week which indicates we are now facing a difficult situation.
COVID-19 is new and different in important ways but we have one of the world’s best networks of community health workers, a rich history of public-private partnerships in emergencies and communities with incredible levels of resilience. We have weathered cyclones, floods and so much more. Let’s not underestimate our own ability to find the best way forward in this crisis to find the best in ourselves and make sure that we help each other survive this crisis. Therefore, the Kerala model can be a way out to control corona outbreak in Bangladesh.
The Writer is a member of Bangladesh Judicial Service & Senior Judicial Magistrate, Feni.