(Editor's note: This is the third part of a series on how Kerala's Kasaragod district efficiently controlled COVID-19 pandemic. Read previous parts here- Part1 and Part2.)

Fifty-year-old Abdul Raheem never had a muted Ramadan like this before. 

A resident of Talangara in Kasaragod municipality, he has not stepped out of his home since the holy month began last Friday. He eats his pre-dawn meal with his family, offers prayers at his home and breaks the fast at sunset with his family.  He also offers the night prayers - Tarawih - in the company of his children.

"I am missing both the community Iftar (breaking the fast) and congregational prayers at the mosque. But I have no regrets. Coronavirus is on the prowl and I have to cooperate with the government's containment measures. I have to stay at home during lockdown," says Raheem.

Raheem's neighbourhood is a COVID hotspot. Thirty-four persons have contracted the disease in his municipality till April 25, accounting for 20 per cent of the total 172 infections reported in Kasaragod district, which lies 550 km north of Kerala's capital Thiruvananthapuram.  Of them, 157 have been cured of the disease and the remaining 15 are being treated in various hospitals.

Coronavirus, which causes COVID-19, had entered Kasaragod on February 3 with a medical student from Wuhan, the epicentre of the virus outbreak in China. The student was discharged from the hospital on February 15 after being cured of the disease. 

The virus re-appeared exactly a month later, on March 16, with a person who came back from Dubai in the United Arab Emirates.  On March 21, the government shut down the district to control infections. This was three days before Kerala announced the shutdown (on March 24) and four days before the centre's lockdown announcement (on March 25).

In Kasaragod, the virus had infected 155 persons at its peak on April 9. The number began to dwindle from April 10 with the decrease in fresh cases and increase in recoveries.  The positive trend continues even now.

It was the result of a multi-pronged strategy involving government departments and voluntary organisations. 

Grass-root health workers kept close vigil on the ground, tracked people who come from other parts of the world and monitor potential virus carriers. 

The health department meticulously traced contacts of infected people, quarantined symptomatic and asymptomatic persons, built infrastructure, mobilised resources and effectively treated infected persons.

The combined efforts notwithstanding, the threat of community spread loomed large over the district. (Community spread refers to the third stage of virus spread when infections cannot be tracked back to a certain person. The disease spreads in such a way that people don't know how they are exposed to the virus). 

The situation was too scary and the officers leading the COVID fight decided to  test a unique containment strategy - triple lock - which, in fact, saved Kasaragod from a pandemic.

Tough situations, tough decisions

On March 24, the Kerala government appointed senior IAS officer and principal secretary with the industries department Alkesh Kumar Sharma as special officer to lead Kasaragod's fight against COVID.

Sharma reinvigorated the government machinery. He travelled to COVID-19 affected gram panchayats, held discussions with people's representatives, brought all government departments together, formed a core committee of seven senior government officials - known as Incident Commanders - to co-ordinate all COVID-related activities and prepared a district-specific action plan to fight the disease.

"We identified COVID hotspots and formulated containment plans. The thrust was on restricting people's movement. So we decided to lock the district with the help of the police department," Sharma said.

"The situation warranted  a tough decision. We went for that to save the  district from a pandemic," he said.

The idea of closing the district with three locks was mooted by Inspector General of Police and Kochi City Police Commissioner Vijay Sakhare, who reached Kasaragod on March 24 to enforce the lockdown.

"The triple lock was a targeted strategy. It is a step-by-step process," Sakhare said.

The police first locked the district borders and ensured that no one from other districts entered Kasargod and no one moved out of it. They enforced travel restrictions, barred pillion riding, limited the number of car passengers to just two and  asked people not to go out of their homes if there was no emergency.

The second lock was put on the clusters (places) from where COVID cases have been reported.

"Chances of spreading the disease were higher in these places because of the presence of primary and secondary contacts of the infected persons. So police cordoned off these areas from the rest of the district and no one was allowed to enter or exit these areas. Roads were blocked with barricades with a police person monitoring 10 houses," Sakhare said.

The third lock was on the houses of the infected persons. "It ensured that infected persons and their contacts stayed inside their homes. It was crucial in checking the community spread," Sakhare said.

Harping on technology

As if the human surveillance is not enough, the police are depending on mobile tracking application to ensure that the lock remains intact.

The police have asked people under quarantine to install an application, CovidSafety, on their mobile phones. If the persons flout quarantine norms like moving from one place to another, the app will send out an alert to the police control room. A team from the nearby police station will reach the location immediately and shift the persons to health department-run quarantine facilities. "The app detects the movement using mobile tower locations. We have shifted many persons from their homes to health department's facilities based on the app alert. Those people have flouted the norms," Sakhare said.

However, a few quarantined persons have raised doubts about the accuracy of the app. They say the app contains many bugs and, hence, it sends out wrong location alerts. Police use these wrong messages to harass people in isolation, they allege.

Supply delivery

People would have broken the triple lock  and stepped out of their homes had they run out of essential supplies. Such a scenario did not emerge in Kasargod thanks to the police initiative to ensure free door delivery of food and medicines.

Around 2.5 lakh people living in the containment zones have utilised the home delivery service so far, said Special Officer Alkesh Kumar Sharma.

The project has been named Amrutham scheme. To avail the service, consumers have to just send  their list of food and medicine to designated numbers through WhatsApp. The supplies will reach their doorsteps at the earliest.

Another important police initiative was the  'Swaraksha' telemedicine service to ensure medical advice for people suffering from diseases other than COVID. Free doctor consultation in text, audio and video platforms will be provided when the patients dial a designated number.

"Around 25,000 people have utilised the telemedicine service and it is still counting," Sakhare said.

Praise from health officials

The triple lock has earned tremendous praise from health department officials. They said that the foolproof surveillance system played a crucial role in checking the community spread. 

Dr C M Kayinhi, medical officer at heavily COVID-hit Chemnad gram panchayat, said the positive confinement of the people helped reduce fresh infections. "COVID infections would have gone above 37 in our gram panchayat if there was no triple lock," he said. 

District Medical Officer Dr A V Ramdas echoed him. 

"Triple lock has been very effective. It saved us from a huge scare. We thank the police department," he said.

Back in Talangara, Raheem believes that triple lock has saved his neighbourhood. “We used to live in fear, but the triple lock worked wonders here. Now we are confident of containing the virus. We are ready to sacrifice anything to drive the virus away as early as possible," he said.

"Till then, we will stay at home," Raheem said.

Read part 4 here: Chemnad gram panchayat's success story