The reason Kerala has managed to come out the other side so quickly is because of its strong public health system, clear risk communication and community participation. Despite its communist rule, Kerala’s healthcare system is, in fact, highly privatised, with a healthy division of labour between the public and private sectors. This very decentralised system has withstood the test of two serious floods and another viral outbreak in recent years, often making good use of the voluntary and active engagement of the public.
Kerala’s efforts to address the pandemic had started as early as January. Indeed, its experience of dealing with the Nipah outbreak in 2018, a virus that had neither treatment nor vaccine available, came in handy. Learning from this episode, which saw a high proportion of hospital-acquired infections, the system had effective protocols in place, and stuck to the time-tested strategy of case isolation and contact-tracing, combined with an alert community surveillance system. Tens of thousands of people were in home quarantine this time, with compliance made possible via a mix of phone-based monitoring and neighbourhood watch initiatives.