India: Kerala's socialist, ‘people-first’ response to COVID-19 saves lives

May 20, 2020
Kerala's COVID-19 response included public education and support for people's livelihoods. Photo: CPI(M)

The Left Democratic Front (LDF)-governed Indian state of Kerala's reaction to the coronavirus virus outbreak is now hailed as an international example for COVID-19 control.

As of May 18, this state, with a population of 35 million, had only 524 confirmed cases and just four deaths. This contrasts sharply with the gross failure of much of the rest of India under Prime Minister Narendra Modi's right-wing central government, which had 96,169 officially confirmed cases and 3029 deaths.

The biggest party in the LDF government is the Communist Party of India (Marxist), which broke away from the Communist Party of India in 1964. The CPI(M) has been prominent in Kerala's governments since 1957.

All subsequent governments of Kerala invested in the state's primary health system so Kerala now enjoys India's highest life expectancy and lowest infant mortality. It is also the most literate state in India.

Kerala showcases how a massive virus pandemic could be brought under control through planned investment in public health care infrastructure. It was not the result of a single day's effort, but of developments over the past few decades and also the massive trust people have in the CPI(M) and its supporting organisations.

In most countries, especially in the aftermath of the 2008 financial crisis, there has been a rapid erosion of investment in public health systems. By contrast, Kerala's left-wing governments invested large sums in state public health infrastructure between 2006–11.

Kerala also learned from experience dealing with the deadly Nipah virus epidemic in 2018. This experience helped it quickly scale up its response to COVID-19 in a very short period.

Timeline of the pandemic

K K Shailaja is the LDF’s health minister in Kerala. She won widespread praise for her role during the Nipah virus crisis outbreak in 2018. When COVID-19 emerged, Shailaja recognised there was no time to lose. On January 25, she convened a high-level meeting to discuss the outbreak of COVID-19 in Wuhan, China. The next day, her department set up a control room to coordinate its work.

On January 30, a medical student who was studying in Wuhan and contracted the coronavirus, returned home to Kerala and tested positive. Subsequently, two more students came back with the virus.

The system set up by Kerala's Health Department located them, tested them and put them into isolation. They recovered from the virus, and there has been no secondary or community spread.

Kerala has a high proportion of Non-Resident Indians (NRI) – persons of Indian birth, descent or origin who live outside India – so this further increases the chances of virus spread in the community. By March, the numbers of coronavirus positive cases increased, largely as people came to Kerala from Europe and the Gulf states, where many Keralites work.

Break the chain

“Break the chain” is the slogan adopted by the Kerala government to generate awareness among people, to stop the spread of COVID-19.

Since the virus is spread from a positive person to others, it can be controlled if the chain of virus transfer is broken, by following World Health Organization (WHO) guidelines to test people who show symptoms and to quarantine those who are infected.

Kerala has performed the highest number of tests for coronavirus in India, along with developing apps for infected individuals. The apps are used to identify and inform others about the possibility of contracting this disease, if they have been in contact with an infected person.

Local government officials and the Association for Social and Health Advancement (ASHA) health workers are doing the groundwork, finding people who are infected and making sure their contacts are also in isolation.

Nationally, India's healthcare system is in a bad state. It spends just 1.28% of GDP on health, has 7 beds per 10,000 people, and just 20 health care workers per 100,000 people. It has just 30,000 ventilators in the country, making it unprepared for the COVID-19 pandemic.

Social mobilisation

The Centre of Indian Trade Unions, the largest trade union in Kerala, mobilised its supporters to disinfect public spaces and also asked their members to support fellow workers to overcome various problems faced during the lockdown period. The Democratic Youth Federation of India, along with the Kudumbashree (Kerala's Poverty Eradication Mission) women's cooperatives, led a public drive to produce hand sanitisers and masks.

The state government used its power to take over hotels and vacant buildings to convert them into quarantine places for large numbers of people returning to Kerala both nationally and internationally.

Kerala introduced a package to support people's livelihoods during the COVID-19 pandemic that includes increased allocations for rural employment guarantee schemes, loans to families, early access to pension for older people, free foodgrain distribution and suspension of utility payments for two months.

Massive social initiatives and programs were launched to support migrant workers (from other states in India) left jobless due to the sudden lockdown. Food, accommodation and moral support was provided to these migrant workers in Kerala. This is in sharp contrast to the plight of some 45 million migrant workers elsewhere in India, who have suffered starvation, homelessness and police violence, as they attempt to walk hundreds of kilometres back to their home villages, from the big cities where they eked out a living.

'Physical distance, social unity'

Chief Minister Pinarayi Vijayan is a politburo member of the CPI(M) and has provided strong leadership in the face of this pandemic. His main message in the early days of the pandemic was: “Physical distance, social unity — that should be our slogan at this time!”

Vijayan realised that the population first needed to be educated about the severity of the virus and then it would participate in a mass campaign to defeat COVID-19.

By contrast, Modi has given mixed messages to the people and many actions by his government actually created dangerous situations, where desperate migrant workers gathered in large groups to access food and transport back to their home states.

Modi further confused people with his partial curfews and urged people to clap hands and bang pots and pans in public ‒ as if this would scare away the virus. Followers of his right-wing party even circulated messages claiming that the virus would be killed by the noise.

Over the past decade, neoliberal thinkers have sought to define “democracy” as the free market and the right of a small section of the population to make a profit by exploiting the rest. Robust public investment in the betterment of people is considered a hallmark of “authoritarian” or “failed” socialism or communism.

But for Keralites, it is clear from the past three months that in the age of pandemic, it is safer to live in a community operating by the rules of socialism rather than one distorted by capitalism.

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