A Kerala poet was known for his patriotic poems during the freedom struggle once wrote: “When you hear ‘Bharat’, our hearts should be filled with pride; when you hear ‘Kerala’, the blood should boil in our veins.” In these dark, gloomy days of COVID-19, Keralites had the occasion to feel their blood boiling with pride, whenever the world media, which had never even acknowledged the existence of the tiny state in the south-west of India, praised it for the remarkable way in which it flattened the curve of the coronavirus. I have before me 37 reports from nearly 20 countries, as far as Brazil and as close as Bangladesh, declaring in different words that “an overlooked region of India is a beacon to the world for taking on the coronavirus.” Even as my blood boiled in my veins, my reaction so far has been that I am keeping my fingers crossed.

This is not because I did not believe the conclusion reached by many reputed newspapers and agencies, but because these are early days and we should not be complacent about the challenges ahead. It is also because, accustomed as I am to Kerala’s basic strengths, I had not expected anything less in the light of the way in which this southern Indian state tackled two major floods and the deadly Nipah virus in quick succession. Kerala had disregarded warnings of expert committees on the vulnerability of the hilly regions and, consequently, there was hardly any emergency preparedness, but when massive floods hit Kerala after a hundred years, rescue and relief efforts came from most unexpected quarters. Fishermen from the coastal areas navigated themselves to the hills and there were scenes of the fishermen letting people step on their backs to get them to the safety of the boats. By the time the helicopters and rescue agencies came, many lives were saved without any state intervention. 

When the nipah virus arrived, it was a team of doctors of the private Baby Memorial Hospital, Kozhikode, led by Dr. Anoop Kumar and Dr. Arun Kumar, who quietly had the virus tested and alerted the government. The people were ahead of the government, though the credit was given to the authorities. Sadly, however, there are still complaints about the misuse of flood relief funds. 

Kerala was the first state in India to detect coronavirus when three out of 30 Indian students who returned from Wuhan was found infected. Kerala Health Minister  K K Shailaja, who was battle-trained after successfully managing nipah viral outbreak of 2018 and acclaimed as “mother-like” in compassion, swung into action and alerted the health system when the central government was still busy with the visit of US President Donald Trump and the Citizenship Amendment Act. The prompt response to the coronavirus came because of the experience of handling and managing nipah and the investments made in the primary health care system over the years, beginning with the Travancore maharajahs. With low economic growth, Kerala had made wise investments in health and education, which paid off.

Monitoring incoming international passengers began soon when it was detected that some, who had arrived from Italy had spread the virus in central Kerala. Since about one-sixth of Kerala’s 33 million citizens are expatriates, the government sensed great danger in arriving passengers. Public awareness and participation made the measures of the government successful. Prompt tracking of patients and their contacts and hospitalising and quarantining them were responsible for the success in reducing infections and deaths. The Indian Medical Association that advised about the health measures that needed to be implemented played a vital and commendable role.

“Strict, but humane,” said the foreign media. The foreign media reports attributed Kerala’s success to various factors. First, they highlighted that Kerala is the most literate state in India. Some remarked that the long period of Communist rule had made the state disciplined and efficient. When it was pointed out by readers that governments in Kerala changed every five years, the Washington Post issued a correction. The celebrated French newspaper, Le Monde had a more innovative headline, “Marxist state collides with central power”, as though Kerala did not follow the central government’s directives. In fact, the two governments worked closely together throughout, even though there were slight differences in approach because of ideological differences. Serious political differences that had emerged in the weeks before the pandemic were set aside for the common cause of containing the pandemic. The lockdown, imposed on March 25, 2020, has been strictly enforced, modified only by the directions from the Centre. The central government has complimented the state on occasions for its efficiency.

The South China Morning Post called the state Chief Minister Pinarayi Vijayan “Andrew Cuomo of Kerala” as Cuomo, the Governor of New York, had defied President Trump’s orders several times. Like Vijayan, Cuomo also held regular briefings every day about the state of the pandemic. “Vijayan has emerged as a star performer for steering through the coronavirus pandemic with composure,” said the newspaper. “Can Bangladesh follow the Kerala Model?” asked Dhaka Tribune. Gulf News attributed Kerala’s success rightly to the private-public partnership.   

The local media, however, is not unanimous in its praise for the success of the state in its handling of the crisis.  Public opinion is sharply divided into political lines. Since the next elections are scheduled within a year, the opposition is particularly vigilant about the rise in the reputation of the ruling party. Accusations of wasteful expenditure in hard times, “media mania” and corruption and nepotism are hurled at the government virtually every day. A major scandal was about a contract given to an American company to handle the data about the infected patients and their medical history. It was alleged that valuable data would be misused or even sold. The High Court of Kerala shared some of the concerns but did not stay the contract in an interim order. This matter is likely to come up again. Vijayan had countered these criticisms in his press briefings in the early stages, but now he ignores them on the ground that he has other important things to do.

The present state of the pandemic in Kerala is certainly better than the national and international averages. Aggressive testing, isolating, tracing, and treating have succeeded in containing the outbreak. But the big challenge for the state may arise when more than 200,000 Indian nationals return to Kerala from abroad in the next few days, followed by thousands of Keralites from other parts of India. The state’s success is partly an attraction for Keralites to come to a safe haven. Since the flights and trains are regulated, the flow is slow and there are systems in place for testing, quarantines, and treatment.

Kerala’s role in fighting the pandemic is not confined to the state. Health workers from Kerala, particularly nurses and doctors are toiling hard in other parts of India and abroad. Some have lost their lives in the struggle. However, the inadequate living conditions provided in the current situation could result in many of them returning to Kerala after exposure to the virus outside, which may be a challenge. They are in demand in many countries and some of them are resorting to legal restrictions to make them stay. In assessing Kerala’s success, the sterling contribution of the health workers must be recorded with gratitude.

Lockdowns are highly unpopular in the West - particularly seen across the US - as people value their freedoms and want the economy to open up even at the risk of the rapid spread of the pandemic.  Kerala, on the other hand, has a long tradition of closing down cities on account of a large number of public holidays and innumerable strikes. At least in the early days of the lockdown, the mood was of relief rather than bitterness. 

Kerala certainly has reasons to be proud of its record so far and the praise showered on it is well deserved. But we should keep our fingers crossed and hope for the best. The real test is yet to come. “Kerala has won the quarter-finals. We can win the semi-finals if a second wave is prevented. The final victory will come only when life can return to normal,” said Dr. Sreejith Kumar, a highly respected leader of the IMA and a public health activist.

“ The single most commendable feature of Kerala’s success story is the remarkable synergy between state and central governments in striking contrast to what happened in the USA. This needs to be sustained forever in tackling epidemics,”  says Dr M V Pillai, Senior Adviser to Global Virus Network.

“It is like the old saying  'Think Globally but act locally'.  Kerala did think both globally and nationally before it won the battle. Yes, we have won only the battle; the war is still going on. Let us keep the same policy for war victory too .”
 
(The author is a former Indian ambassador and governor for India at the International Atomic Energy Agency (IAEA). The views expressed are personal. He can be contacted at tpsreenivasan@gmail.com)