Kerala's strategy helped contain Covid first wave: Ex-health minister

The former Kerala health minister said even days before the Centre issued guidelines and protocols in identifying and containing the disease, the state commenced its preparations to fight the possible outbreak of the disease.

Kerala's former health minister KK Shailaja was leading a 'night walk' of women through a city street as part of a government campaign on the crucial day two years ago, when the alarming message was passed on to her via phone.

One of the medical students from the state, who was in quarantine after arriving from Wuhan in China, the epicenter of the novel coronavirus during the first wave, tested positive for the infection-- a first such case in the entire nation.

Though the message was quite disturbing, the seasoned politician regained her composure and began exploring options to quickly reach Thrissur, over 275 km away from Thiruvananthapuram that night itself somehow as the affected woman was admitted to a hospital there.

Almost two years since the country's first confirmed COVID-19 case reported in Kerala, Shailaja, who won global acclaim for leading the state in effectively managing the disease, said the night of January 30, 2020, was crucial for her as health minister.

From managing to get an air ticket last minute to reach Thrissur and convening an emergency midnight meeting of doctors and health officials there to boosting the confidence level of the team members and briefing the media about the first case-the job was quite hectic, she recalled.

"The outbreak of Nipah virus was actually an eye-opener for all of us...After that we were mentally prepared to fight any such infectious diseases in future. I think we could evolve a good disease management strategy and execute it well, which helped contain the spread of the disease effectively during that stage," she told PTI in an interview.

Shailaja was the face of Kerala's fight against COVID-19 during the initial phase.

A legislator from Mattannur constituency now, the former minister said even days before the Centre issued guidelines and protocols in identifying and containing the disease, the state commenced its preparations to fight the possible outbreak of the disease.

She said the news of the global spread of coronavirus came at a time when the state health department was about to conduct a state-wide mock-drill in all government and private hospitals for gauging preparedness to tackle Nipah.

"When I came to know about the new virus, I directed the drill giving thrust on that infection. Others may laugh at me if I say we even opened a control room in Thiruvananthapuram as we came to know that Wuhan was the epicenter. Because we were aware that several Keralite students were pursuing their higher education in the Chinese province," she said.

An expert group was formed under the control room and team leaders were identified and given distinctive responsibilities to tackle the new virus, if it was reported in the state, she said.

Days before other states came up with an action plan, the Kerala health department deployed trained personnel in all four airports of the state and began checking the temperature of passengers arriving from abroad at their newly set up health desks there.

"We had only some infrared thermometers and other related equipment for the purpose. As no case was reported anywhere in the country, no central guidelines were in place. Thus, three persons, who arrived from Wuhan on January 27, were found to have slight fever," Shailaja said.

Among the trio, who had been put under hospital isolation, that one student was tested positive on January 30, 2020.

After reaching Thrissur by 12.45 am, the minister, who was accompanied by two of her cabinet colleagues and health secretary, conducted an emergency meeting of doctors and senior health officials of the district at the government medical college.

Later, she confirmed to the media, who had gathered at the hospital premises in the wee hours, about the reporting of the first COVID case in the country.

"The following days and weeks were saw countless meetings, relentless planning and efforts to control the spread of the infection. It was really a tough battle but we fought it well through meticulous planning and collective action," the ex-minister said.

All taluk and district hospitals were directed to keep an adequate number of isolation beds ready for COVID emergency and 100 beds in medical colleges in the initial phase.

Decision to buy and stock an adequate amount of PPE kits was taken and training to wear protective gadgets was started immediately.

Several rounds of online meetings of head nurses, ASHA workers and other health workers were conducted every day across the state to coordinate the medical treatment, surveillance, quarantine and also to boost their morale.

On the psychological impact of the disease, Shailaja said the first COVID patient, the woman from Wuhan, was very calm and bold even after knowing that she had contracted the virus.

"As she was a medical student, she was aware of the disease. She was shifted from the district hospital to the medical college in the early hours. When I talked to her over the phone, she said she was feeling ok and had no severe symptoms."

But, there were persons who got thoroughly disturbed due to the mandatory quarantine and isolation like a Ranni-based family that arrived from Italy and tested positive for the virus, she recalled.

Stressing that the fight against the disease was a collective effort in the state, Shailaja said there were hundreds of doctors, nurses and health workers who set aside their personal affairs to take part in the mission to contain the infection.

"I met a nurse at the district hospital in Kasaragod when COVID was at its peak. When I said I was aware of their personal problems as they were unable to take leave, she reassured me and said she had taken permission from her family to work overnight due to the current situation....," she said, lauding the healthcare worker's undying spirit.

The coordination of various government departments under the leadership of Chief Minister Pinarayi Vijayan and the whole-hearted support of the finance department despite the cash crunch played a key role in the battle against the pandemic, the woman leader added.

Noting that the most important thing in checking the spread of an infectious disease was to trace its source and isolate the affected people, she said those persons, put under isolation, should never feel that they are abandoned.

"Trace, quarantine, test, isolate and treat...that was our mantra. Even though the WHO guidelines gave thrust on the test, we thought isolation and quarantine were also important. I feel that helped us contain the infection spread effectively," Shailaja added.

The state adopted a strategy to delay the peak of the first wave and took all possible steps to equip the health system to face any emergency during the gap, she explained.

Kanpur IIT had predicted 50,000 cases during the peak but the collective efforts helped the state to flatten the curve even though a second wave followed it, she said adding that her tenure as minister had ended by the time.

Though 2020 was COVID year, the death rate was 8 per cent less in Kerala as compared to 2019, according to the excess death analysis conducted during the end of the year.

The lesser number of deaths was reported only in 7 places across the world during the period and one among them was Kerala, she said adding that the striking achievement was made possible through the containment strategy adopted during the time.

It was also a reply to the Opposition who had alleged that the state was covering up the actual figures of the COVID death, the ex-minister added.

On the super spread of COVID in the state, she said the testing facilities should be decentralised and the primary healthcare system should be further strengthened to overcome the crisis.

Shailja also said steps should be taken to ensure that every single person displaying symptoms, should undergo a test.

Hailed as 'rockstar health minister' by the global media for her able leadership, effective crisis management and mature intervention in arresting the first wave of COVID-19 in the state, Shailaja's non-inclusion from the present Left government cabinet evoked widespread criticism.