This week came the remarkable news from Kerala: the southern state had managed to “flatten the curve” of the COVID-19 pandemic. For the first time the number of people who had recovered from the virus exceeded the number of active cases in the state.
Applause for this development was widespread, especially since Kerala was the first state in the country to report a coronavirus case—a medical student who had arrived in Kerala from Wuhan, China, at the end of January. When Prime Minister Narendra Modi announced a nationwide lockdown on March 24, Kerala was the state with the most COVID-19 cases. Today, it is slipping well down the list.
Kerala has managed to “flatten the curve” of the COVID-19 pandemic.
Insistence on human development from early on is what I called the Malayali Miracle.
Due to its high social indicators, Kerala was prepared to cope when COVID-19 struck India.
Kerala’s preparedness is a bipartisan political legacy attributable to all governments, Congress and Communist, in the state, as well as its predecessor royal regimes.
Though I am a political opponent of the state government, I am pleased to acknowledge their good work.
Kerala Model is Nothing But Focus on Education and Welfare
How has Kerala pulled this off? Observers are agog with talk of “the Kerala model” – something I had written about nearly a quarter of a century ago as “the Malayali Miracle” in my book India From Midnight to the Millennium. The Malayali Miracle was that of a state that had successfully emphasised what we were just beginning to call “human development” – spending large proportions of its resources on health care and public education, promoting literacy and women’s empowerment, and ensuring not just the highest literacy rate in India (94%) but a high level of welfare support for the indigent and the marginalized. People didn’t beg or starve in Kerala.
Despite the highest population density of any state in India, and a per capita income one-seventieth of the United States, Kerala had social development indicators comparable to that of the most advanced developed countries.
What Kerala Did Right in Fighting Coronavirus?
So when COVID-19 struck India, there was one state that was prepared to cope. Kerala—which had dealt successfully with the Nipah virus outbreak in 2018, losing just 17 lives to a virus against which no vaccine had been discovered and was defeated by containment—was able to deploy more than 30,000 health workers in response to the coronavirus pandemic.
It was quick and aggressive to conduct widespread testing (450 people per million as of 14 April, in striking contrast to Bengal, which had tested 32 per million), thorough and painstaking tracing of any person the afflicted had come into contact with, and compassionate treatment of the stricken. The state was the first to institute a three-week quarantine for suspected cases, the first to make provision for migrant workers stranded by the sudden nationwide shutdown (who needed shelter and food) and the first to arrange lakhs of cooked meals for the hungry through community kitchens it set up.
For a densely-populated state that receives more than 1 million foreign tourists a year, sends out the largest proportion of its people abroad of any state (an estimated 17% of its population work or live outside Kerala), and has hundreds of its students studying abroad, including in China, Kerala was more vulnerable than most. But it came through with flying colours.
Kerala Model: Left, Right and Centre
Many have hailed the state. The Washington Post, in a widely-noticed piece, praised “Kerala’s proactive measures, such as early detection and broad social support,” and declared the state “could serve as a model for the rest of the country.” Experts who spoke to the Post commended the state’s approach as both strict and humane.
Though the article became politically controversial for seeming to give all the credit to the state’s Communist government, it did cite Henk Bekedam, the World Health Organization (WHO)’s representative in India, as rightly attributing Kerala’s “prompt response” to its past “experience and investment” in health emergency preparedness.
These are a bipartisan political legacy attributable to all governments, Congress and Communist, in the state, as well as its predecessor royal regimes. While the Communists, in power now, deserve credit for managing the current crisis well, it was Congress governments that greatly expanded public-sector health care facilities in Kerala, taking the state from 13,000 government hospital beds in 1961 to 36,000 by 1985, setting up a dozen medical colleges, promoting universal health coverage and subsidised medicines for the poor.
Kerala’s public health system is arguably India’s best-performing, on such indices as neonatal mortality, birth immunizations and life expectancy; its world-class nurses work around the world. It has a well-developed network of primary-care centres at the village levels, supported by Taluk and District hospitals – and these facilities don’t merely exist on paper, they are adequately staffed with doctors and nurses, and medical supplies are not scarce, as they often are in the rest of India.
Kerala Sticks to WHO Guidelines & Executes Them efficiently
The WHO’s mantra to tackle COVID is “test, trace, isolate, treat”. Kerala has followed this to the letter, with exemplary efficiency. It has excelled at district-level monitoring, proactive communication to the public (and counselling of sufferers) and community engagement.
In contrast to the bedlam that prevailed at many Indian airports in the days prior to the lockdown, Kerala conducted airport screening ably and professionally, traced contacts, required home quarantine (and supplied assistance to those who needed help) two weeks before the Government of India thought of doing so. Where temporary quarantine shelters were needed for those without homes, these were rapidly established. Kerala’s migrant workers received food, water and assurance of security at a time that migrant workers elsewhere in the country were seeking to trudge back desperately to their homes.
No Time for Political One-Upmanship
Chief minister Pinarayi Vijayan and Health Minister Shailaja have been hands-on in leading the state’s response, though Opposition leader Ramesh Chennithala has been as visible. The CM’s daily media briefings and an efficient administration, well covered by the vibrant local media, have helped build public confidence. Kerala also announced economic relief measures worth Rs 20,000 crores to buffer the state’s fight against the pandemic at a time when the central government has been dithering on a similar approach across the nation. It was the first state to deploy RT-PCR rapid testing kits, which I was able to source and deliver to my constituency, Thiruvananthapuram, out of my MP funds before the Centre cut off that source of support.
Though I am a political opponent of the state government, I am pleased to acknowledge their good work and support my state’s efforts to overcome this deadly contagion. I hope that, in this spirit, Kerala can put political one-upmanship behind it. There’s no doubt in my mind about who should get the credit for this seeming victory over COVID. It’s Kerala.
(Former UN under-secretary-general, Shashi Tharoor is a Congress MP and an author. He can be reached @ShashiTharoor. This is an opinion piece and the views expressed above are the author’s own. The Quint neither endorses nor is responsible for the same.)
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