It was in 2011 that Kerala first felt the heat of a global epidemic called swine flu and successfully tackled it. Nine years later, the state is battling novel Coronavirus (nCoV) with all its might and till now it has succeeded in halting the virus' spread without causing any panic among the people.

Swine flu, caused by H1N1, a variant of pig influenza virus, took a toll on the morale of the citizens in 2011 when more people fell ill and several of them succumbed to the respiratory disease. Preventive steps were soon in place with isolation wards opening in all district hospitals, quarantine measures, awareness campaigns, helpline numbers and round-the-clock vigilance. After quarantining thousands, the disease was finally controlled much to the relief of panicked people.

Three years later, an avian influenza, known as bird flu, gripped Alappuzha district, leaving several dead and health officials culling hens and ducks. Poultry business almost shut down and the infected were treated with special care. That phase too ended after the state health department beat the disease successfully.

2018 saw a more disastrous outbreak – Nipah, which was completely unheard of till the affected and those who came in contact with them, including a nurse, succumbed to the viral infection, which was later found to be caused by fruit-consuming bats. In a historic show of grit and determination, the Kerala health department left no stone unturned to contain the epidemic. Every single person who came in contact with the carriers was traced, identified, isolated and monitored during the incubation period. Over 2000 people were quarantined during the Nipah spell, which claimed 17 lives. In one month, the epidemic was contained and the state was officially declared Nipah-free. The World Health Organisation (WHO) had also hailed Kerala for its successful measures to stop the spread of Nipah virus in the state.

Coronavirus after Nipah

Year 2020, however, started with a new breed of virus. Less than a week before the outbreak of novel Coronavirus (nCoV) was reported in the Chinese city of Wuhan, where the death toll increased day by day, the first case of coronavirus infection was detected in Kerala in a medical student who returned from Wuhan, followed by two more Wuhan returnees. Even before the infected Keralite was identified, the state government has been screening everyone returning from China at the airport itself, and anyone who was suspected was quarantined in hospital; the rest of the co-passengers were advised home quarantine. As of now, 2,528 are quarantined across Kerala, 93 of them at hospitals and 2,435 at homes.

Control rooms were opened, awareness programmes were initiated, and the disease was declared as a state calamity. With surveillance protocol in place, health officials led by minister K K Shailaja have been working round-the-clock to ensure that all of them and their families follow the instructions responsibly throughout the incubation period of 28 days, offering them telephonic counselling, watching out for signs and medical teams checking on the suspected carriers to rule out infection.

No need to panic

In the meantime, there have been a panic-like situation in many parts of the state. Since the epicentre of nCoV was known as the unhygienic market in Wuhan, a few markets in Kerala shut down, tours were cancelled and crowds lessened. Several schools cancelled picnic programmes organised for students following directives from district collectors to avoid such travel.

Fake messages doing the rounds on social media too did their part to add fuel to the fire. People almost relived the scare of Nipah days. Caution was understandable but is there a situation to panic?

The health minister herself had made it clear that there is no need of unnecessary scare. “None of the infected is in a life-threatening situation. Home quarantines have been effective in containing the spread of the disease. A team of 191 are checking on the home quarantined individuals,” she said. She added that there was no need to panic and that the government would overcome the challenges like it did with the Nipah virus two years ago.

All the three cases identified in Kerala directly came from Wuhan, which is the epicentre. During Nipah, Perambra was the epicentre of the disease and there were reasons to be scared. This time, there’s no such situation as only those who returned from China had to be monitored and isolated.

“Caution is necessary, but panic is unwanted,” stresses Dr Shimna Azeez, lecturer in community medicine, Government Medical College, Manjeri. But she feels that precaution is of utmost importance as the virus itself is new and there are no vaccines or medication to cure the infection. “Coronavirus is not new but novel coronavirus is a mutant virus. Researches are ongoing and home quarantine is the wisest method to contain the condition at present. Since the carriers are asymptomatic, infection will be detected only after the incubation period. Till then, it’s better to stay isolated and practise quarantine measures sensibly. Both the suspected carriers and their families have to practise safe methods to avoid possibilities of spreading the disease,” she said.

Tourism hopes for the best

The scare has taken a toll on tourism. Bejoy Koshy, director of Dakshindia Destination Management, says he got a record number of cancellations this time. “We faced this during the Nipah season. February is usually the peak time for bookings. And this was our busiest season in seven years. Since Nipah recovery, bookings have been picking up through November and December. Almost all the hotels were full. Now travel agents are calling us saying we have flight and stay cancellations, especially from Japanese tourists.”

And he explains why, “Since their country too has reports of nCoV outbreak, they themselves stay quarantined to avoid calamity. What’s the point in leisure with risk?” Given the circumstances, that’s a very responsible act. And Bejoy is very hopeful, “Like Nipah, we will beat coronavirus too. It’s difficult to convince tourists of safety at this point. Everything will soon be back on track. I am waiting for the season to pick up after all this.”

Even though the authorities cancelled Munnar marathon, the hill station is getting regular tourist flow in February also. According to tourist guides in the region, there may be a slight fall in foreign tourists' numbers but otherwise things are back to normal in the Munnar tea gardens. Sabu Mathew, a part-time tourist guide and a resident of Devikulam, says the tourist flow is normal for January and February this year and the mystic mountains expect it to go up around Valentine's Day.

No effect on malls

It seems business hasn’t been affected much due to the corona virus threat. The weekend rush at Lulu Mall in Kochi was a clear indication for that. Compare this with the pictures of desolated streets in Wuhan, you will get a clear picture of how Kerala is keeping panic at bay despite the coronavirus threat.

Upscale malls in Kochi see the same sales and weekend crowds. “Only with a slight difference, more people are sporting masks,” says N B Swaraj, media coordinator of Lulu Mall, Kochi. He also notes that most of the overcautious customers are foreigners.

Medicos stay safe at home

A medical student, who returned from China and stays quarantined at her home in Malappuram, observes that the practices, though appears a little difficult, are the safest method to contain the virus. “Staying indoors lessens the scare of people around. I stay at my room and never let in any of my family members. It’s not a very serious epidemic if we stress on safe practices. The medical facilities here are excellent. Though I have no symptoms yet, the minister personally contacted me over phone and explained the quarantine situations and assured of all mental and health support.”

Her family too have been receiving WhatsApp forward messages with lot of fake treatments, bogus medicines and misinformation. “But they are not worried. They believe the proper sources more than unknown messages,” she adds.

Be cautious

Those who returned from foreign countries, not just China, (as nCoV outbreak has reported in 28 countries so far), have to stay cautious to protect the health of themselves and everyone around them. Shimna elaborates, “Safe practices include staying indoors, washing hands often, using hand rub (sanitizers), sneezing into tissues, avoiding journeys and public areas. The quarantined and those who are in direct contact with them should use N-95 masks. The others can wear surgical masks. Remember the protocol: Do not touch the front part of the mask, dispose any mask after six hours of use. Not matter what, no one should come into direct contact with the body fluids of the suspected carrier. If you have any queries or suspect that you are infected, call Disha toll-free 1056 or control room and visit a lesser crowded OP of any hospital.”

Shimna stresses that all these are acts of caution and are never to be mistaken as panic-spreading suggestions. She adds, “In the past instances of Nipah too, caution is what made us survive. This is yet another spell of a new outbreak. Only staying responsible and staying together can help us survive this too. And we will.”