JANUARY 30, 2.30AM. It was an odd hour for a media briefing. But, only a few hours earlier, Kerala had confirmed the first-ever case of coronavirus disease 2019 (Covid-19) in India. After a two-hour-long meeting of the rapid response team, Kerala Health Minister K.K. Shailaja told the media that the state was all set to tackle the disease that had caught the world unawares. And, Shailaja teacher (as she is popularly known, thanks to her previous profession) kept her word. Though two more cases were confirmed, the state was declared ‘coronavirus free’ after all three patients tested negative for the virus and were discharged.
The situation, however, was quite different a few weeks ago. There was panic as the government declared Covid-19 a state calamity after the three cases were confirmed in different parts of the state. There were reports that the tourism industry was badly hit, with foreign tourists cancelling hotel bookings. But Shailaja told THE WEEK, “At that point in time, we felt lives were more important than revenue.”
The three Covid-19 patients, who were studying medicine in China and had reached Kerala following the outbreak, were admitted in medical colleges in the state. Those who had been in contact with the trio, too, were quarantined. As were those who had arrived from China and their kin.
At one point in time, the number of those quarantined was more than 4,000. No new cases have been confirmed in the last 26 days, and the number of those under observation is barely 50. Kerala has achieved this at a time when the rest of the world is still grappling with the pandemic, which has claimed 2,595 lives worldwide (as on February 24).
When asked the secret behind the state’s achievement, Shailaja, who had stayed put in Kozhikode, the epicentre of the Nipah outbreak, two years ago, said it was “calculation, planning and coordination”, sounding quite like a teacher. Excerpts from an interview:
At a time when one hears only bad news about Covid-19, you have a positive story to tell.
We have survived a deadly virus once again.... Kerala could achieve this because of the dedication and selfless service of everyone involved in the task. Also, our tryst with Nipah had been a great learning experience. Having survived it, all of us knew the importance of calculation, planning and coordination. It also taught us the importance of being vigilant. Personally, the Nipah experience taught me the importance of leading from the front and giving confidence to those who look up to you. When these experiences are coupled with grit and determination, good results are bound to come.
Please do explain the calculation, planning and coordination aspects.
Nipah had caught us unawares. Many of us were hearing that term for the first time after deaths were reported. But we were prepared to tackle coronavirus the very day China reported it. I called a meeting of senior health officials that day itself and a rapid response team (RRT) was formed as I was sure that coronavirus would find its way to Kerala, thanks to hundreds of medical students who study there. We also ensured that everybody who was coming from abroad, especially China, was tracked from the airport and was under our surveillance. All medical colleges and district hospitals were asked to set up isolation wards, and other logistics were also arranged. We had created 18 expert groups and assigned specific tasks to all of them... So, by the time the first case was reported, we were all prepared to face any eventuality.
What was your reaction when you learnt about the first confirmed case?
I was in Thiruvananthapuram when the news came from Thrissur. The health secretary and I flew to the spot immediately and all the three ministers from that district, too, joined us. There was no panic as the patients were already in isolation. But the possibility of a massive spread did scare us as it became known that some who had come from China had avoided airport [checks] as they did not want to be quarantined. But we could locate all of them, thanks to a few alert minds. Once everyone who had been in touch with the affected ones had been quarantined, we heaved a sigh of relief. Luckily, everyone who had to be quarantined cooperated with us. The entire health department—from our brilliant health secretary, Rajan N. Khobragade, who did not sleep a wink on those days, to ASHA workers on the ground—put in its best to stop coronavirus from spreading. Private hospitals also joined us on a war-footing. We all knew that if three cases were reported, we must be prepared for 300 and we were.
What was the treatment like?
There is no treatment protocol for coronavirus yet. So the only option before us was to give symptomatic treatment. The symptoms were sore throat, fever and headache, so medicines were given accordingly. What was most important was to take adequate rest and plenty of fluids as is the case for any viral attack. We ensured that they all did that.
There was panic all over the state after the third case was confirmed in three days.
Yes. Some people got worked up and started spreading rumours. Even mild sneezing and coughing made people panic and we started getting frantic calls. So, we set up control rooms in every district. Counselling was given over the phone and personally. The media helped us in a big way in passing the right information to the public at the right time. The reporting was well-balanced, and gave the message to the public to not fear but to be alert.
The government had declared Covid-19 a state calamity. Was it necessary? There were reports that it drastically affected the tourism revenue of the state.
Yes, it was necessary. As per the protocol, it is mandatory to declare if two or more districts are affected by a contagious disease. So when I told the chief minister about the third case, he consulted with the officials concerned and the decision was taken. At that point in time, we felt lives were more important than revenue.
What are the lessons you have learnt from tackling coronavirus?
As in the case of Nipah, coronavirus, too, has taught us a few lessons. The most important lesson is that we need to build a permanent RRT as these kinds of viral attacks are more likely to happen thanks to climate change. It has made us realise that the entire staff, and not just a few, should be trained to face any eventuality. The importance of improving hospital hygiene is another lesson learnt. Also, more young professionals need to be in leadership roles. The government is preparing guidelines based on these lessons and we will have it ready by April.