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Culture and trade thrive in Kerala's Kochi
01:00 - Source: CNN

Editor’s Note: Dr. Saju Mathew is a CNN medical analyst, primary care physician, and a public health specialist. Follow him on Facebook, Instagram and Twitter, @drsajumathew. The views expressed in this commentary belong to the author. View more opinion at CNN.

CNN  — 

I grew up in West Africa to East Indian parents. Every year, we would spend our summer vacation in Kerala, a state along the southern coast of India.

Saju Mathew

While it is known for beautiful backwaters and ayurvedic centers, today Kerala is making headlines due to its success containing Covid-19. Despite the fact that Kerala confirmed its first case of the coronavirus on January 30, the state, with a population of around 35 million, has 3,726 active cases as of Friday, with 22 deaths — about one death per 1.5 million people — as reported by the Indian government.

Kerala, which is a communist state, has invested in robust public health and education systems. It also has the highest literacy rate (over 92%) of any Indian state and, as of 2016, the highest life expectancy rate of about 75 years of age. All of these factors contribute to creating a population that understands the deadly nature of this virus — and one that has great trust in its leaders.

A key authority in the effort to fight the coronavirus has been the health minister of Kerala, KK Shailaja, also known as Shailaja Teacher or the “coronavirus slayer.” She joins a list of female leaders around the world who have gained respect for their willingness to listen and take action early and aggressively.

While Shailaja is being lauded for her effective health approach in this time of crisis, her claim to fame actually came before the coronavirus pandemic. In 2018 a deadly virus dubbed Nipah was discovered in Kerala. Among its symptoms are headache, confusion and drowsiness. It can rapidly advance to a severe nervous system disease and even result in death.

Shailaja was aggressive in her approach. She stayed in the area where the virus was killing people, mobilized a health care team, and tracked and isolated those exposed to the virus. Though 17 people died, Kerala quickly contained the virus and prevented its spread through the state.

This experience prepared her to lead Kerala through the current pandemic. Long before Kerala had its first Covid case and just three days after reading about the new virus in China, Shailaja began to take action, setting up a control room and instructing 14 other health districts in Kerala to follow suit. The Health Minister’s experience with the Nipah virus seemingly gave her the confidence to be aggressive against the pandemic.

When the first case arrived from Wuhan, China, at the end of January, she followed WHO’s protocol of test, trace, isolate and support. Officials checked the temperatures of incoming travelers from China and those with fevers were isolated in the hospital while other passengers who may have been exposed were allowed to quarantine at home, containing further spread of the virus. Two hospitals were set aside in each district to treat Covid-19 patients and separate entrances and exits were assigned.

Kerala is unique when it comes to this very effective public health strategy of contact tracing due to its grassroots leverages. At one point there were over 150,000 people under strict quarantine.

In addition to employing aggressive testing, contact tracing, and extended quarantines, the state provided a safety net for some of its neediest residents, offering shelter and meals for thousands — including about 150,000 migrant workers who were fed during the quarantine period.

With Kerala easing out of lockdown, and people returning from other countries and states within India, cases have been on the rise. While it remains to be seen whether Kerala can contain the virus, Shailaja said she had planned for a second wave once travel restrictions were lifted. Officials are sticking to the strategy — testing and tracing people at transportation hubs like the airport and railway stations, with additional checkpoints on major roads. For now, the state continues to celebrate low rates of Covid-19 deaths.

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    Kerala’s coronavirus strategy should serve as a model for the both India and the rest of the world. India could suffer a beating should this virus get out of hand. With over 1 billion people living in tight quarters and a health care system that is not equipped for a surge, India should look to Kerala, which has taken aggressive measures against this invisible enemy that’s spreading through the world.