At half-past 10 in the night, Dr Adeela Abdulla does not sound tired at all. It’s been another long day of work for the Wayanad Collector; the doctor-turned-IAS officer who has been lauded for keeping this Kerala district free of the dreaded COVID-19 for more than two weeks. It’s had only three positive cases so far, all of whom have recovered.
Wayanad, along with Kottayam, are among the 25 districts which have not reported a single COVID-19 case in the past 14 days, as was stated by Joint Secretary of Union Health Ministry Lav Agarwal two days ago.
Quarantine is the key, Dr Adeela says, vehemently in an interview with TNM. “Quarantine is an all-or-none phenomenon. Either you strictly enforce quarantine or you don’t have it at all. There’s nothing like partial quarantine. You have to quarantine everyone that’s vulnerable.”
Being a doctor, she realised very early on how much it’d help.
Even though Wayanad has only a population of 8 lakh, the district has quarantined 12,500 people, as many as the thickly-populated Malappuram did. This is because Wayanad has a vulnerable population, including several indigenous tribes and relatively poor health facilities, Adeela says.
Geofencing to track people breaking quarantine
Adeela’s team also made sure the quarantine was strictly followed. “
We used a technique called delayed geofencing (a location-based service surveilling phones) in which we studied people in the 20 to 40 age group. We took a sample to study their behaviour – if they ventured out while they were in quarantine. We found that 20 out of the 50 people we observed stepped out of their home. We took a case against all 20 of them and gave a lot of publicity to it. So people understood that this was serious, and that we would put their phone under surveillance,” Adeela says.
Random sampling has been used for cyber-surveillance of people in quarantine not only to ensure strict adherence to isolation but also to understand tendencies.
People’s movement was strictly restricted, with the district being surrounded by hotspots like Mysuru, Neelagiri, Malappuram, Kannur, Kozhikode. Within the district, only health workers, truck drivers and essential commodities were allowed to move. If anyone came from another district, they too would be put in quarantine for 14 days.
The Arogya Jagratha Samithi (health force led by the Health Department and Local Self Government) would make calls every day to the people in quarantine. A team called the ‘Golden 5’ would work at the ward level and make visits to the houses of those in quarantine. The team includes one Asha worker, an anganwadi worker, Kudumbashree ADS (Area Development Societies) member, ward member and health worker.
Registering cases
Registering cases is another measure the district administration used to make it clear that the consequences of violating quarantine shall be very serious.
“From around March 15, after the second wave of the coronavirus had come to the state, we began registering a lot of cases. This was before the lockdown had begun. On March 13, a festival at Valliyoorkavu Temple was postponed. Soon, Section 144 of the Criminal Procedure Code (prohibiting assembly of five or more people) was declared. On March 20, a Friday, we registered a case after a mosque gathering. Churches stopped opening from the next Sunday. By the time the first infected cases came to the district on March 21 and 22, we already had strict measures in place,” Adeela says.
Passing information to people is also equally important, says the Collector. There are press meets everyday or else Facebook Lives.
Border management
There have only been three positive cases in the district so far and no new ones in the last 15 days. Apart from putting all vulnerable sections – and this includes the large tribal settlements that Wayanad is proud of – in quarantine, the district administration ensured all the borders were properly monitored.
“District level surveillance was put in place in all 14 borders, under a Tahsildar, who would act as incidental commander. They would manage the people who come and go through the borders, they would decide who to let pass. If we had the police on duty, people would argue with them and there would be provocations. When it is revenue staff, there is no policing mode, there is no provocation,” Adeela says.
In Wayanad, the opening of the state’s border with Karnataka for people from Bairakuppe in the neighbouring state to come for their treatment had become news. It had happened at the time Karnataka had closed its borders to patients from Kasaragod who were trying to reach the nearby hospital in Mangaluru for urgent health issues. The authorities had refused to open borders even after many levels of intervention until finally it was agreed that for emergency treatment, patients with certificates proving they do not have COVID-19 would be allowed to pass.
“There was a question at the time if the Wayanad border would be open. People of Karnataka had doubts since they had not opened borders for patients from Kasaragod. But we maintained that those who needed treatment can come and have it, and they’d be taken in a special ambulance,” Dr Adeela says.
However, they put restrictions on routine hospital visits from places like Neelagiri. “We take emergency cases but routine cases can be checked in Neelagiri.”
They didn’t, however, tolerate people from other districts coming secretly to hide in resorts of Wayanad. They were pulled up and sent back in ambulances, Adeela says.
Taking care of tribal settlements
Tribal settlements were one of the first areas they focused on. Helpdesks working 24 hours were put in place from March 15. Food, medicine, and transport were made available for the tribal people. COVID Care Centres were opened. “For those who didn’t have ration cards, we would buy ration,” Adeela says.
Awareness was given much earlier with the help of ‘ooru mithram’, who are the Asha workers from each of the tribal communities, who would communicate to the people of their respective community.
“They are so aware that when we make random field visits to check they have all the essentials, children come and tell us, ‘corona undu, varalle’ (don’t come, there’s corona).”
The random visits are made either by Adeela, sub-collector, the Superintendent of Police or the local MLA, to understand field reality.