Q&A: How communist-run India state became model in COVID-19 fight

Kerala Chief Minister Pinarayi Vijayan speaks to Al Jazeera on how the state turned the tide against coronavirus.

Pinarayi Vijayan
Its robust healthcare facilities under the communist party government seems to have helped the state turn the tide against the pandemic [File: Sonu Mehta/Hindustan Times via Getty Images]

The Indian state of Kerala’s strategy to tackle the coronavirus is being held up as a model on containing the pandemic even as other parts of the country struggle to stop its spread.

The state has 691 cases and the highest recovery rate of nearly 90 percent in India while the total infections in the country have crossed 100,000 and nearly 3,000 people have died.

Only three people have died in the state with a mortality rate of about 0.43 percent. 

With a gross domestic product (GDP) per capita of $2,000, it has achieved one of the lowest COVID-19 mortality rates in the world as compared with the global average of just over 3 percent.

The United States with a GDP per capita of $65,000 has seen 94,000 deaths at the rate of 5 percent.

Kerala’s robust healthcare facilities under a communist party government seems to have helped the state turn the tide against the pandemic.

A relatively affluent population of 35 million, the state has the highest overall health index in the country.

In an email interview with Al Jazeera, Pinarayi Vijayan, the state’s chief minister, talks about the steps his government took to handle the world’s biggest global health crisis of our times.

Al Jazeera: Kerala seems to have been able to flatten the curve successfully while rest of India has struggled. How did Kerala contain the virus?

Pinarayi Vijayan: First and foremost, it is the resolute support extended by the people of Kerala in the fight against COVID-19 that has helped the state to emerge on top of the situation. The state’s early preparedness, focused healthcare interventions led by our public health system, effective lockdown measures assisted by law enforcement agencies, special economic package well in advance, timely assistance for migrant labourers, decentralised initiatives through the local self governments especially in taking care of those under quarantine and inter-departmental coordination, and so on have served as the pillars of the Kerala model against this pandemic.

Home quarantining of suspect cases, contact tracing of positive cases, adequate testing and specialised treatment have all ensured that positive cases have been treated effectively and cured. In a nutshell, all these have paved the way for our success in containing the virus.

Corona Kerala
Medical staff collect samples from people at a newly set up Walk-In Sample Kiosk to test for the coronavirus at Ernakulam Medical College in Kerala [File: Arun Chandrabose/AFP] 

Al Jazeera: Kerala has the lowest COVID-19 mortality rates and has the highest recovery rate in the country. How did it achieve it?

Pinarayi Vijayan: We have lost three precious lives. Kerala has been able to tackle the health emergency effectively because of our robust public healthcare system. COVID-19 has proved to the world that public health systems are absolutely essential. The synergy between our health services, forces and local governments have ensured that measures for both prevention and cure have been in tandem with one another. All these together, ensured that by the time we flattened the curve, Kerala had the highest recovery rate and one of the lowest death rates in the world.

As of May 19, there are 142 positive cases in Kerala. So far, out of the 642 infected people, 497 have been cured. Still, as you have pointed out, our numbers are far better than even the most advanced and resourceful countries.

Al Jazeera: Did Kerala’s experience in fighting the 2018 Nipah virus outbreak help in handling the coronavirus outbreak?

Pinarayi Vijayan: Certainly, the wide range of experiences our state has had in fighting communicable diseases has in some senses given us a head start in the battle against COVID-19. It was during the Nipah virus outbreak that we had to focus on contact tracing of positive cases.

That experience enabled us to set up specialised teams comprising public healthcare experts, police officers, representatives in local self governments and officials in district administrations, to trace the contacts of positive cases this time around. That had a ripple effect in terms of quarantining, identifying suspect cases, conducting tests and so on.

Al Jazeera: The strict lockdown imposed by the government of Prime Minister Narendra Modi has created a migrant crisis. How did Kerala handle the crisis?

Pinarayi Vijayan: The lockdown is a means to limit interaction between people so that the transmission of the virus can be curtailed. However, it is not a magic wand that can be waved to address the health emergency at hand. We will have to supplement it with identifying suspect cases, quarantining them, conducting adequate tests, treating positive cases and tracing their contacts. This is a cyclical exercise that has to be continued till all those under treatment are cured and all those under quarantine are ascertained to be negative.

Under a lockdown, people are forced to give up their livelihoods and the most adversely affected ones would be the daily wage labourers. Almost all of the guest workers in Kerala are wage labourers. To ensure that they strictly adhere to the lockdown protocols, their needs will have to be met. It is the duty of the state to ensure that their needs are met. Kerala did that. We arranged relief camps for them, with adequate healthcare support and supplies for personal hygiene. Based on their preference, we provided cooked food or essential materials to cook with. When travel was allowed by the central government, we even arranged for their travel back to their home states. Over 300,000 guest workers have been assisted through around 20,000 camps during this period.

Al Jazeera: Do you fear a second wave of coronavirus? What are your plans for that?

Pinarayi Vijayan: Experts are pointing to the possibility of a deadlier second wave. Quarantining is a major part of the fight against this virus. Our home-quarantining method has proved to be very effective and efficient, and our expert committee has also recommended for it to be continued. Yet, sufficient institutional quarantine facilities have been prepared as well. To date, almost 200,000 bath-attached rooms have been readied. All items needed for the personal use of quarantinees will be provided. Food will be arranged through the community kitchens. For those who want to remain in quarantine at their own expense, rooms have been prepared in hotels and resorts too. Till date Rs 13.45 Crore ($1.7m) has been sanctioned from the SDRF (State Disaster Response Fund) for making the necessary arrangements.

If the situation worsens, quarantining alone won’t do, hospitalisation will be required. We have arranged 49,702 beds in the 1,296 government hospitals in the state. They are equipped with 1,369 ICU beds and 800 ventilators as well. 81,904 beds are available in the 866 private hospitals with 6,059 ICU beds and 1,578 ventilators. 207 government hospitals have been prepared to treat those with symptoms. If the number of positive cases increases, 27 hospitals can be converted into exclusive COVID-19 care facilities. 125 private hospitals have also been readied to be utilised, if required. Kerala is geared up to face any eventuality.

Corona Kerala
Indian medical staff wearing full protective suits hold medical waste as they exit from the coronavirus isolated ward of the Ernakulam Government Medical College in Kochi, Kerala [File: Prakash Elamakkara/EPA]

Al Jazeera: What is being done to help the businesses and the poor as the lockdown wipes out businesses and livelihoods?

Pinarayi Vijayan: As far as the poor and vulnerable are concerned, Kerala has given them special attention during these difficult times. We have strived to ensure total social security. Accordingly, 55 lakh [5.5 million] people – elderly, differently abled and widows – in Kerala have been paid ₹ 8,500 ($112) each. We have also provided ₹ 1,000-5,000 ($13-66) to 46 lakh [4.6 million] persons registered in the various labour welfare funds. Fifteen kilogrammes (33 pounds) of rice and a kit of pulses and condiments have been distributed free of cost to every household as well. On top of all this till May 10, 8,226,264 (about eight million) free and subsidised meals have been served through the community kitchens and Kudumbashree hotels that we have set up ever since the lockdown began.

We are implementing two focused schemes in the aftermath of this pandemic. The first is Subhiksha Keralam, which is a programme aimed at ensuring the food security of Kerala. In just one year it will have an expenditure of Rs 3,860 Crore ($509m). The second is Vyavasaya Bhadratha, through which an assistance of Rs 3,434 Crore ($452m) will be granted to MSMEs (Medium, Small and Micro Enterprises).

Till now, the total economic cost due to the lockdown for Kerala is estimated at Rs 80,000 Cr ($10.5bn).

Al Jazeera: Kerala is expecting a huge influx of Malayalis from abroad, particularly Gulf countries. How do you plan to handle that? What will be its economic impact?

Pinarayi Vijayan: As a state government, within our limited means we are already providing assistance through NORKA [Non-resident Keralites scheme]. All COVID-19 positive patients, who are members of the Pravasi Welfare Fund [fund for expatriates], will be provided Rs 10,000 ($132) as emergency aid. Rs 5,000 ($66) will be granted to all those who have returned with a valid passport and work visa. Through NDPREM (NORKA Department Project for Return Migrants), assistance is being given to set up MSMEs and even to take up agriculture. Seed capital funding of up to Rs 3 million [$39,594] is available under this project.

We need to note that financially, it is the government of India that benefits the most from pravasis (expatriates) working in foreign countries. Inward remittances of our pravasis enrich India’s exchequer by way of the foreign currency that is deposited. However, GoI [government] is of the opinion that the responsibility of rehabilitation of returning migrants rests mainly with the states. Fundamentally, this approach needs to change. The Ministry of External Affairs is in charge of the Indian Community Welfare Fund [set up in 2009 to help distressed Indians overseas], which has not been utilised even to bring back our brothers and sisters in this time of distress. It needs to be creatively put to use to constitute a rehabilitation package for return migrants.

Right from the beginning we have been regularly pressurising for the safe return of our migrant brothers and sisters. We handed over the details to the government of India. Over the last one week the first phase of their arrival has been completed. As of May 19, 6,054 pravasis have returned from abroad.

Corona Kerala
People in Kerala wearing masks as a precaution against the coronavirus line up outside a government ration shop in Kochi [R S Iyer/AP Photo]
Source: Al Jazeera