Tuesday, June 23, 2020

The Coronavirus Slayer


KK Shailaja (Teacher) - Kerala's Rock Star Health Minister

In a pandemic of the nature of Covid 19 of 2019-20, a highly contagious respiratory impairment disease, containment of community transmission is directly linked to containment of the disease.

While the whole world struggled and still struggles with containment, the little state of Kerala in India with 35 million people (half of UK and tenth of US population with 7 and 4 percent per capita income of the two countries, respectively) did it successfully, going by the book: following the WHO protocol to the ‘T’ ‘I’ and ‘S’: test, trace, isolate and support.

The architect behind the successful containment is a kindly, cheerful, bespectacled former secondary school science teacher, KK Shailaja (Teacher), who has acquired many nicknames including one promoted by The Guardian, ‘The coronavirus slayer!’ in an article published on Thurs 14 May 2020 titled ‘The coronavirus slayer! How Kerala’s rock star health minister helped save it from Covid-19’.

There are many media vehicles that have covered the minister’s achievements in effective disease containment, including the Malayalam film ‘Virus’ which essayed her story battling the ‘Nipah’ virus.

What lessons can we derive from the Health Minister's proactive response to the pandemic, who succeeded twice over, battling community transmitted infectious diseases that potentially could affect 35 million in her state?

1.   Belief: that the virus can be contained, strengthened by her earlier experience combating the Nipah virus successfully
2.   Foresight: that such epidemics can occur again
3.   Proactivity: created enabling infrastructure for containment based on the Nipah experience
4.   Response: with alacrity and speed based on news of the virus which she read online (serendipity?) when WHO had yet to wake up to the deathly scourge, definitively
5.   Mobilization: of Kerala health care team to act expeditiously
6.   Empowering: the team down the line to take judgment calls
7.   Authority: Used the government machinery and resources effectively to build confidence in the care takers to do the job that had to be done
8.   Collaboration: pressing the law and order department to enforce rules on quarantine
9.   Leading: from the front – visiting infected areas – educating and calming nerves – and dealing with issues as they came up: when ambulance drivers feared infection, she gave them the necessary accoutrements to protect themselves, offered pay hikes, and also medical insurance for treatment in case of infection
10. Empathy: did all of above with infectious serenity and deep empathy that built profound confidence in her frontline team
Some extracts from The Guardian article fleshes out the lessons for better appreciation of the minister’s her day-to-day manoeuvring, decision-making and leadership chops.

“On 20 January, KK Shailaja made a phone call to one of her medically trained deputies who confirmed that the Covid-19 virus was indeed serious.

“Four months later, Kerala has reported only 524 cases of Covid-19, four deaths and – according to Shailaja – no community transmission. By contrast, the UK has reported 40,000 deaths and the US has reported more than 82,000 deaths. Both countries have rampant community transmission.

“How has this been achieved? Three days after reading about the new virus in China, and before Kerala had its first case of Covid-19, Shailaja held the first meeting of her rapid response team. The next day, 24 January, the team set up a control room and instructed the medical officers in Kerala’s 14 districts to do the same at their level. By the time the first case arrived, on 27 January, via a plane from Wuhan, the state had already adopted the World Health Organization’s protocol of test, trace, isolate and support.

“At the height of the virus in Kerala, 170,000 people were quarantined and placed under strict surveillance by visiting health workers, with those who lacked an inside bathroom housed in improvised isolation units at the state government’s expense.

“That number has shrunk to 21,000. “We have also been accommodating and feeding 150,000 migrant workers from neighbouring states who were trapped here by the lockdown,” she says. “We fed them properly – three meals a day for six weeks.” Those workers are now being sent home on charter trains.

“When Shailaja’s party came to power in 2016, it undertook a modernisation programme. One pre-pandemic innovation was to create clinics and a registry for respiratory disease – a big problem in India. “That meant we could spot conversion to Covid-19 and look out for community transmission,” Shailaja says. “It helped us very much.”

“When the outbreak started, each district was asked to dedicate two hospitals to Covid-19, while each medical college set aside 500 beds. Separate entrances and exits were designated. Diagnostic tests were in short supply, especially after the disease reached wealthier western countries, so they were reserved for patients with symptoms and their close contacts, as well as for random sampling of asymptomatic people and those in the most exposed groups: health workers, police and volunteers.

The successful containment by the Health Minister KK Shailaja and the Kerala government headed by Chief Minister Pinarayi Vijayan, stands in stark contrast to how some of the most powerful world leaders of the Western world responded to the Covid 19 pandemic.

Notably, the US White House and the President of the United States of America, Donald J Trump, the most powerful man in the world, who stayed in denial for too long to effectively administer containment of the virus – and the same could be said of some of the European Heads of State where the virus has taken its unpardonable toll.

The leadership of the Kerala State and the governments of the Western world had the same notice period to the deadly nature of the disease. Only one took it seriously. The others hoped wistfully that the virus will die from jetlag. President Trump was unequivocal that the virus will vaporise with the heat when it touches American shores. ‘The sun never sets on America’. Oops! That was Britain. We know where such hubris leads to – rising death toll and collapse of a whole empire. 

In God's Own Country the literacy rate according to one report is 90.90%; the response to the Covid-19 pandemic is 100%.


No comments: