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The coronavirus slayer! How Kerala's rock star health minister helped save it from Covid-19

Laura Spinney

KK Shailaja has been hailed as the reason a state of 35 million people has only lost four to the virus. Here’s how the former teacher did it

Thu 14 May 2020 08.00 BSTLast modified on Sun 17 May 2020 21.04 BST

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On 20 January, KK Shailaja phoned one of her medically trained deputies. She had read online about a dangerous new virus spreading in China. “Will it come to us?” she asked. “Definitely, Madam,” he replied. And so the health minister of the Indian state of Kerala began her preparations.

Four months later, Kerala has reported only 524 cases of Covid-19, four deaths and – according to Shailaja – no community transmission. The state has a population of about 35 million and a GDP per capita of only £2,200. By contrast, the UK (double the population, GDP per capita of £33,100) has reported more than 40,000 deaths, while the US (10 times the population, GDP per capita of £51,000) has reported more than 82,000 deaths; both countries have rampant community transmission.

As such, Shailaja Teacher, as the 63-year-old minister is affectionately known, has attracted some new nicknames in recent weeks – Coronavirus Slayer and Rockstar Health Minister among them. The names sit oddly with the merry, bespectacled former secondary school science teacher, but they reflect the widespread admiration she has drawn for demonstrating that effective disease containment is possible not only in a democracy, but in a poor one.

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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.

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As the passengers filed off the Chinese flight, they had their temperatures checked. Three who were found to be running a fever were isolated in a nearby hospital. The remaining passengers were placed in home quarantine – sent there with information pamphlets about Covid-19 that had already been printed in the local language, Malayalam. The hospitalised patients tested positive for Covid-19, but the disease had been contained. “The first part was a victory,” says Shailaja. “But the virus continued to spread beyond China and soon it was everywhere.”

In late February, encountering one of Shailaja’s surveillance teams at the airport, a Malayali family returning from Venice was evasive about its travel history and went home without submitting to the now-standard controls. By the time medical personnel detected a case of Covid-19 and traced it back to them, their contacts were in the hundreds. Contact tracers tracked them all down, with the help of advertisements and social media, and they were placed in quarantine. Six developed Covid-19.

Another cluster had been contained, but by now large numbers of overseas workers were heading home to Kerala from infected Gulf states, some of them carrying the virus. On 23 March, all flights into the state’s four international airports were stopped. Two days later, India entered a nationwide lockdown.

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Indian citizens arriving from the Gulf states are bussed to a quarantine centre. Photograph: Arunchandra Bose/AFP via Getty Images

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.

Shailaja was already a celebrity of sorts in India before Covid-19. Last year, a movie called Virus was released, inspired by her handling of an outbreak of an even deadlier viral disease, Nipah, in 2018. (She found the character who played her a little too worried-looking; in reality, she has said, she couldn’t afford to show fear.) She was praised not only for her proactive response, but also for visiting the village at the centre of the outbreak.

The villagers were terrified and ready to flee, because they did not understand how the disease was spreading. “I rushed there with my doctors, we organised a meeting in the panchayat [village council] office and I explained that there was no need to leave, because the virus could only spread through direct contact,” she says. “If you kept at least a metre from a coughing person, it couldn’t travel. When we explained that, they became calm – and stayed.”

Nipah prepared Shailaja for Covid-19, she says, because it taught her that a highly contagious disease for which there is no treatment or vaccine should be taken seriously. In a way, though, she had been preparing for both outbreaks all her life.

The Communist Party of India (Marxist), of which she is a member, has been prominent in Kerala’s governments since 1957, the year after her birth. (It was part of the Communist Party of India until 1964, when it broke away.) Born into a family of activists and freedom fighters – her grandmother campaigned against untouchability – she watched the so-called “Kerala model” be assembled from the ground up; when we speak, this is what she wants to talk about.

The foundations of the model are land reform – enacted via legislation that capped how much land a family could own and increased land ownership among tenant farmers – a decentralised public health system and investment in public education. Every village has a primary health centre and there are hospitals at each level of its administration, as well as 10 medical colleges.

This is true of other states, too, says MP Cariappa, a public health expert based in Pune, Maharashtra state, but nowhere else are people so invested in their primary health system. Kerala enjoys the highest life expectancy and the lowest infant mortality of any state in India; it is also the most literate state. “With widespread access to education, there is a definite understanding of health being important to the wellbeing of people,” says Cariappa.

Shailaja says: “I heard about those struggles – the agricultural movement and the freedom fight – from my grandma. She was a very good storyteller.” Although emergency measures such as the lockdown are the preserve of the national government, each Indian state sets its own health policy. If the Kerala model had not been in place, she insists, her government’s response to Covid-19 would not have been possible.

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A walk-in test centre in Ernakulam, Kerala. Photograph: Reuters

That said, the state’s primary health centres had started to show signs of age. 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.

Shailaja says a test in Kerala produces a result within 48 hours. “In the Gulf, as in the US and UK – all technologically fit countries – they are having to wait seven days,” she says. “What is happening there?” She doesn’t want to judge, she says, but she has been mystified by the large death tolls in those countries: “I think testing is very important – also quarantining and hospital surveillance – and people in those countries are not getting that.” She knows, because Malayalis living in those countries have phoned her to say so.

Places of worship were closed under the rules of lockdown, resulting in protests in some Indian states, but resistance has been noticeably absent in Kerala – in part, perhaps, because its chief minister, Pinarayi Vijayan, consulted with local faith leaders about the closures. Shailaja says Kerala’s high literacy level is another factor: “People understand why they must stay at home. You can explain it to them.”

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The Indian government plans to lift the lockdown on 17 May (the date has been extended twice). After that, she predicts, there will be a huge influx of Malayalis to Kerala from the heavily infected Gulf region. “It will be a great challenge, but we are preparing for it,” she says. There are plans A, B and C, with plan C – the worst-case scenario – involving the requisitioning of hotels, hostels and conference centres to provide 165,000 beds. If they need more than 5,000 ventilators, they will struggle – although more are on order – but the real limiting factor will be manpower, especially when it comes to contact tracing. “We are training up schoolteachers,” Shailaja says.

Once the second wave has passed – if, indeed, there is a second wave – these teachers will return to schools. She hopes to do the same, eventually, because her ministerial term will finish with the state elections a year from now. Since she does not think the threat of Covid-19 will subside any time soon, what secret would she like to pass on to her successor? She laughs her infectious laugh, because the secret is no secret: “Proper planning.”

• This article was amended on 14 May 2020 to correct the figure for the UK’s GDP per capita. It was originally given as £40,400, but this is the figure in US dollars.



 
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Coronavirus in India: Shocking video of a hungry man eating a dead dog's carcass on the road sparks outrage

gulfnews.com

May 21, 2020 5:49 PM

A man driving on a highway from Rajasthan to Delhi took the video



Hungry man feeds on dog carcass in India, video sparks outrage online

Indian citizen Pradhuman Singh Naruka, driving on a Rajasthan highway, was in shock as he tilted his camera from his car towards a man on the road devouring a dead dog's carcass. The incident has once again highlighted how hunger and poverty is ravaging India amidst the coronavirus lockdown.

“This man is eating [dog] meat on the road,” he narrates in the video he shared on social media.

“You don’t have food to eat? What are you eating? You will die!” he shouts at the man.

Then he instructs the man to stand at the side of the road where he approaches him with a lunchbox of food and gives him a water bottle, while covering his mouth with a handkerchief.

Without hesitation, the hungry man begins to eat the food as Naruka questions him about his background and tells him that he will give him money.

Then Naruka says to the camera: “I saw this man eating an animal that might have died on the road when I was on my way to Delhi. If you see a person on your way please help them and share this video with the government as much as you can.”

Sharing the clip on his Facebook page, Naruka wrote in Hindi: “Humanity became a shame on Delhi-Jaipur National Highway in Shahpura of Rajasthan when a labourer was forced to eat a dead dog due to hunger. No one has understood it as a big thing to help him by stopping his car. Well. I fed him and gave him money. If you ever see someone hungry, please help.”

The video was posted by social media users, with many tagging government officials in their posts.

Twitter user @LavanyaBallal wrote to Indian Prime Minister Narendra Modi and criticised the Bharatiya Janata Party (BJP), the current ruling political party in India: “This is beyond heartbreaking. No one deserves this. He is eating the carcass of a dead dog. @narendramodi India won’t forget this amount of pain and humiliation heaped on the poor #ShamelessBJP”

Twitter user @desaideepali held Piyush Goyal, India’s current minister of Railways and Commerce accountable: “When Piyush Goyal says no one is starved, he must see this. Can't see, can't imagine the pain here.”

Thousands of migrant workers are currently making their way home from cities across India. Numerous stories of the labourers being killed, starved and walking without basic necessities have emerged and the Indian government has been widely criticised for mismanagement during the COVID-19 lockdown.



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Humans became ashamed on the Delhi Jaipur National Highway in Shahpura, Rajasthan when a labourer was forced to eat a dead dog due to hunger.
 
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This Coronavirus was the greatest scam. The death rate was no different from regular Flu. The CDC is now giving its best estimate. Chinese origins are also a scam to ruin Chinese economy.

The CDC also says its "best estimate" is that 0.4% of people who show symptoms and have Covid-19 will die.

It was a political stunt to ruin Trump's reelection chances and now all 50 states are opening. Over 40 million people in US lost jobs and the economy is not going to recover for the next six months.

 

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Intra-state bus services to resume from tomorrow in Andhra Pradesh
1 min read . Updated: 20 May 2020, 08:12 PM ISTANI
  • Madireddy Pratap of APSRTC said that the decision on running buses to neighbouring states will be taken after getting response from them
  • At first, 1,683 buses in all categories will run in 434 routes from tomorrow. Buses will run in all areas except in containment zones

VIJAYAWADA : Andhra Pradesh State Road Transport Corporation (APSRTC) vice chairman and managing director Madireddy Pratap on Wednesday informed that the intra state bus services will start from tomorrow except in the containment zones amid the coronavirus lockdown.
He also said that the decision on running buses to neighbouring states will be taken after getting response from them.
"Intra state services will start from tomorrow. For inter state services, we have written to neighbouring states Telangana, Tamil Nadu and Karnataka. After they respond, we will take decision on it," he said while speaking to reporters.
"City services will be opened in Vijayawada and Visakhapatnam only after lockdown 4. At first, 1,683 buses in all categories will run in 434 routes from tomorrow. Buses will run in all areas except in containment zones," he added.

Talking about the revenue loss to APSRTC, Pratap said: "During the lockdown, it has incurred losses of approximately ₹1,200 crore" and added that "maintenance expenses recurred in these 58 days is approximately ₹700 crore."
He further asked passengers to cover their faces before boarding buses as a precautionary measure to contain coronavirus and informed that "masks will be available at all stalls at the cost of ₹10."
Sanitiser facility is also being made available at all bus stands. "Our engineers have made automatic hand sanitiser dispensers. It will be kept in all bus depots," he added.


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Intra-state bus services to resume in Andhra Pradesh: Here's how to book tickets online
India

Times Now Digital
Times Now Digital

Updated May 21, 2020 | 07:56 IST



Andhra Pradesh: Almost 1683 buses in all categories will run in 434 routes from today except the containment zones. Here's how you can do the bookings.

(Representational Image)

(Representational Image) | Photo Credit: PTI
After Centre eased restrictions for public transportation, Andhra Pradesh State Road Transport Corporation(APSRTC) has decided to resume the intra-state bus services from May 21, 2020. The buses will not operate in the containment zones amid the lockdown.
APSRTC vice-chairman and managing director Madireddy Pratap said that the decision to run buses in the neighbouring states will be taken only after getting a response from them.
According to ANI, Madireddy Pratap said "Intra state services will start from tomorrow. For interstate services, we have written to neighbouring states Telangana, Tamil Nadu and Karnataka. After they respond, we will take a decision on it."
Thus, he made it clear that intra-state services will resume and he has already written to neighbouring states Telangana, Tamil Nadu and Karnataka for inter-state services. Initially, almost 1683 buses in all categories will run in 434 routes from today except in the containment zones.
On the safety front, it is necessary for the passenger to wear masks or cover their faces before boarding the bus to curb the spread of Covid-19 infections. Also, masks will be available in the stalls present there for Rs.10 as well. Also, sanitisers will also be kept at all the bus stands thus passengers must use them as well before starting the journey.
The bus services were suspended from March 21, 2020, till Wednesday due to the coronavirus lockdown. During the lockdown, APSRTC has incurred losses of approximately Rs 1200 crore and maintenance expenses recurred in these 58 days is approximately Rs 700 crore. Booking can only be done through mobile numbers registered on the Spandana portal and which are accepted by the district administration as per the government guidelines
The tickets for all these buses will be available online and there will be no conductors in these buses. The passengers can book the seats in advance and follow social distancing norms. Here's how you can book tickets online



How to book APSRTC tickets online

STEP 1

Login
Login to Andhra Pradesh State Road Transport Corporation website using your credentials. You can also login using the mobile number and OTP will be generated.
STEP 2
Enter details
Now, enter your journey details: From and To where you have to travel.
STEP 3
Enter date
Enter the date when you want to travel. Also, you can check-in for the round trip. Now, click on check availability and book accordingly.
STEP 4
Make payment
Make a payment online and the tickets will be sent to your registered mobile numbers.




Intra-state bus services to resume in Andhra Pradesh: Here's how to book tickets online
 

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Ticket booking counters to open from today, people gather outside ‘Rail Reservation Centre’ in Delhi
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New Delhi, May 22 (ANI): Indian Railways on May 21 announced that ticket reservation counters and Common Service Centers will be opened in a phased manner across the country from today onwards. People were seen standing outside ‘Rail Reservation Centre’ in Delhi on May 22. “We got information yesterday that railway counter will open today. I came here at 3:30 am to take the ticket,” Khurshid said. “We got information yesterday that railway counter will open today. I came here at 4 am in the morning but we haven’t got any information about the opening of the counter till now,” Mohammad Zafar said who was waiting to buy the ticket. Earlier, Indian Railways had also announced that 200 trains will start services from June 01.
 

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Ticket reservation counters at railway stations to open from May 22

Booking of train tickets will resume at around 1.7 lakh common service centres across the country from Friday onward, union railway minister Piyush Goyal also said on Thursday.

INDIA Updated: May 21, 2020 21:20 IST
Anisha Dutta | Edited by Kanishka Sarkar

Anisha Dutta | Edited by Kanishka Sarkar
Hindustan Times, New Delhi

Migrants who arrived on Shramik Special trains from various states seen at Danapur Railway station in Patna.


Migrants who arrived on Shramik Special trains from various states seen at Danapur Railway station in Patna. (Santosh Kumar /HT Photo )

Ticket reservation counters at railway stations will re-open in a phased manner beginning Friday, the railway ministry said on Thursday.
The ministry has also allowed the booking of train tickets through Common Service Centers (CSCs) and agents.
“ Opening of all these booking facilities once again will mark an important step in the graded restoration of passenger railway services and making the task of ticket booking easy for all prospective travelers from all parts of India in reserved trains. Zonal railways may adhere to standard social distancing guidelines and observe the hygiene protocols in view of the ongoing COVID-19 pandemic,” the ministry said.
Zonal Railways have been instructed to decide and notify the opening of reservation counters in a phased manner tomorrow along with dissemination of information about their locations and timings as per local needs and conditions.

Booking of train tickets will resume at around 1.7 lakh common service centres across the country from Friday onward, union railway minister Piyush Goyal also said on Thursday.
Railways will also allow booking at counters across the station soon, he said. This will make the service accessible to those in remote locations. The minister said bookings will also resume at counters at specific railway stations over the next two to three days.
“ We will announce resumption of more trains. It is time to take India towards normalcy. We are developing a protocol to identify the stations where counters can be opened. We have to ensure that there are no large crowds gathering at counters to book tickets, so we are studying the situation and devising a protocol towards it,” Goyal said.

Goyal was speaking at an interaction with BJP spokesperson Sambit Patra on Thursday.
Railways on Tuesday announced it will run 200 special passenger trains a day from June 1 and online ticket booking was scheduled to open Thursday.
Goyal said within 2.5 hours of opening bookings for the 100 pairs of special trains on Thursday, four lakh passengers had booked tickets.


Ticket reservation counters at railway stations to open from May 22
 

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Thanks to Centre's Corona Mismanagement, We Are Staring at a Catastrophe I The Wire I Arfa Khanum
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