Kasaragod, March 28, 2020: Over the last few weeks, Kerala has witnessed a steady rise in the number of novel coronavirus cases in the state. The state’s Chief Minister Pinarayi Vijayan, Health Minister KK Shailaja and the administration had been credited with acting swiftly by testing more people, early contact-tracing of patients and mass quarantining of suspected cases.
But ever since March 17, a lone northern district has caused much disquietude as it has stealthily risen to become the epicentre of the COVID-19 outbreak in Kerala.
With 34 cases reported in a single day on Friday, Kerala’s Kasaragod made an alarming leap in its active count of COVID-19 patients. The Kannada-Malayalam speaking border district has now turned into ground zero of Kerala’s war against SARS-CoV2. The district has 81 cases in a little more than a week - that’s over 49% percent of all of Kerala’s cases. (Out of 81, five patients are admitted in other districts and only 76 are in Kasaragod).
Other towns and cities such as Ernakulam, Kozhikode, Pathanamthitta - which saw the Italy COVID-19 cluster - and Thiruvananthapuram have all recorded less than 30 cases each so far.
On March 22, three days before Prime Minister Narendra Modi declared a pan-India 21 day curfew, Kasaragod entered lockdown to halt itself from entering stage 3 of the pandemic i.e., community transmission.
An order issued by the Kerala government cleared Kasaragod’s beaches, shuttered its theatres, closed down tea shops, malls, temples, mosques and banned all public events. The 13 lakh people of the district were pushed back into their houses and a curfew was declared.
But, the cases continued to rise.
The curious case of Kasaragod
Until the third week of March, Kasaragod seldom assumed centre-stage in the conversations around the COVID-19 outbreak in Kerala. After the recovery of three medical students from Wuhan in late February, the spotlight turned to the southern district of Pathanamthitta, where a potential cluster was identified after a family of three, which had traveled from Italy, tested positive for the virus on March 11.
However, all of this changed on March 19, when one man who had flown in from Dubai, tested positive for SARS-COV2 in Kasaragod. The 47-year-old, an alleged gold smuggler, drove authorities into a frenzy after it was found that he had refused to self quarantine and had instead attended three weddings, a funeral and played carrom and football matches at local clubs and stadiums. The patient had exposed over 1400 people (a consevative number) to the highly contagious virus. Three days later, Kasaragod entered lockdown.
Things went south for the district in the following days. On March 23, Kerala reported 28 fresh cases of the virus. 19 of them were from Kasaragod. On Friday, the district had 34 more cases.
While there have been no confirmed reports of local transmission from the 47-year-old patient, the district has seen an alarming surge of positive cases among people who came back from the Gulf, particularly Dubai, a zone that India arguably did not focus on at the beginning of the outbreak.
97 percent of Kasaragod’s reported cases now consist of Dubai returnees or their primary contacts, including families and friends. Speaking to TNM, Kanhangad municipality chairperson VV Ramesan confirmed that out of 34 cases from Friday, 25 of them had returned from Dubai.
“It is no surprise that we saw 34 cases in a single day. All these 34 people reported positive on Friday had been isolated in hospitals. But the situation is still volatile. People are panicking about what could happen here (a possible community spread). Majority of the people are abiding by the lockdown rules, but still after all this, there are a few who tend not to care about the regulations,” he said.
Another problem that the government faces is lack of good medical facilities in the district. Normally, people in Kasargod depend on hospitals in Kannur or in neighboring Mangaluru. Most of the patients have been shifted to the Kasaragod general hospital which has now been turned into a COVID-19 hospital. As on Friday, over 40 cases were observed here, however the hospital has a reputation of not having good facilities. Many of the women have remained in isolation at the Kannangad district hospital, which is reportedly cleaner and has better facilities. A few patients are also isolated in Kannur’s Pariyaram Medical College Hospital.
The large numbers have even perturbed Chief Minister Pinarayi Vijayan who stated that tighter restrictions would be placed on Kasaragod to contain the outbreak at any cost.
“It has been decided that there should be much stronger interference in Kasaragod district again. The current regulations are not seen to be enough. The situation is very grave. We have to brace ourselves to meet any situation,” he said.
While in the rest of Kerala shops selling non-essential items are allowed to operate from 7 am to 5 pm, in Kasaragod, this window has been shrunk to 6 hours. Drug dispensaries and grocery outlets - which fall in the essential items list - however, are exempted from this rule.
All government offices and workplaces of public and private firms have remained shut since March 22 in the district. None of the employees are allowed to travel out of the district either.
Extreme precautions are being taken down to the ward level. Explaining the home quarantine monitoring process in each ward, Cheruvathur Panchayat Secretary Prabhakan KV said, “So far, we have had 43 Gulf returnees in our tiny panchayat. None of them have violated the home quarantine. In an event that they do, we will immediately inform the police who will book the suspected case under section 188 of the Indian Penal Code.”
Prabhakaran said that a ward level Janakeeya Arogya Jagratha (Public Health alert) committee - comprising the Panchayat member, a Junior Health Inspector (JHI), a Junior Public Health Inspector (JPHI), the local ASHA worker and others - keeps a tab on the movements of the ward’s residents, to ensure that they don’t violate home quarantine.
Inside the Panchayat office too, members, clerks, volunteers and other workers are ‘extremely vigilant’, says Prabhakaran.
“If we step out and return, we wash our hands. We wipe our hands with sanitiser after that. All of us wear masks and gloves when we are out for work and the volunteers maintain safe practices when handing out food for the needy, homeless and elderly in the locality,” he adds.
In spite of all these measures, Prabhakaran says that there is a growing fear among the residents in the district, with the scary leaps in Kasaragod’s cases.
“We are fighting this crisis with every bit of energy. This is a war we are waging against ourselves. And we have to persist till we see the end,” he added.