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Stunningly effective coronavirus approach: the secret of Kerala and Vietnam

The Indian state of Kerala and Vietnam are two poverty-stricken regions that are also particularly vulnerable to the spread of Covid-19 — yet they managed to control the epidemic in an impressive way. Why do they manage to save so many lives when the West still has thousands of new deaths every day? asks MARC VANDEPITTE

Less than 5 deaths

As a rule, poor countries are very vulnerable to COVID-19. Nevertheless, the fight against the virus was particularly effective in both countries. Kerala was one of the first Indian states affected by the virus. Six weeks after the outbreak, it already had the lowest mortality rate in the country. A total of 690 infections and four deaths were counted. India as a whole, on the other hand, may be heading for millions of corona cases with serious illness.

Vietnam did even better. It managed to nip the outbreak in the bud. A total of 324 infections and zero deaths have been reported to date.

Compared to the countries of the North, these countries have very few resources to fight the virus. Their GDP per capita is about 16 times lower than that of Britain. What, then, is the secret behind their efficient approach? We list its elements. 

1. Nip in the bud

After the discovery of two corona infections, Vietnam declared a state of national emergency. This made it one of the first countries to do this. A steering committee was formed at the highest level, chaired by the Deputy Prime Minister.

Schools were closed across the country, and a week later several villages were quarantined. Two weeks before Wuhan went into lockdown, Vietnam introduced the “social distancing” system and passengers from abroad were systematically screened.

The World Health Organisation praised this rapid approach: “Early detection, early isolation and active treatment [are] extremely important. Vietnam's early actions stopped the further spread of the disease, saving thousands of lives.”

It was the same story in Kerala. Even before the first contamination, the country was brought into a state of readiness on January 23. Returning migrant workers were screened at airports and quarantined if infected.

A strict lockdown was announced from mid-March. At that moment there were 24 infections. Schools and businesses were closed and large gatherings prohibited. A comprehensive system of tracking and tracing was set in motion.

According to infectious-disease expert Todd Pollack, the reason for its success is simple: “Countries that took early, aggressive action, using proven methods, have severely limited the virus. If you reduce it fast enough, you never reach the point of exponential growth. ”

2. Drastic but social

In both countries, safety is paramount and everything is done to save as many human lives as possible, no matter the temporary economic damage that entails.

“While many countries were debating their health and economic choices, Vietnam's government made an unequivocal decision to prioritise health over economic growth,” said World Bank health specialist Sang Minh Le.

Neighbourhoods were completely locked down, with police surveillance. In “suspect zones” everyone was tested. Potential carriers of the virus were quarantined away from their own families.

The elderly were thus protected against possible contamination. Everyone who returned from abroad was quarantined for 14 days.

Kerala set up a lockdown that was much stricter, lasted longer and came much earlier than in the rest of India. The state borders were closed and shelter was provided for the thousands of stranded migrant workers. A system of intensive testing and contact tracing was rolled out.

The strictness went hand in hand with a social approach. In Vietnam, quarantined families were served meals three times a day at very low prices. The unemployed, affected small self-employed and the poor could count on a corona benefit.

In Kerala, the free meals that children normally receive at school were now delivered at home. All families received free food and could count on a cheap consumer loan. The payment of energy bills was postponed for one month and certain benefits were paid earlier.

This social approach alleviates residents' fears and strengthens confidence in the government, which in turn is conducive to strict compliance with the measures.  

3. Raising awareness

The Vietnamese government conducted an intensive awareness campaign through posters and banners in supermarkets, banks and other public spaces.

Every day, the population was flooded with text messages, downloadable apps and dozens of articles on the most popular online news broadcasts. Young people were entertained with informative pop songs or educational video clips.

There were similar awareness campaigns in Kerala. It was an absolute priority for the members of the government. The prime minister spent an hour every evening addressing and citizens about the state of affairs and encouraging them.

In one particular region, when inhabitants fearing infection wanted to flee their village, the health minister came in person to speak to the villagers in order to calm them down.

Such awareness-raising and emotional support also strengthens people's confidence in their government.

4. The great resources

Fighting an epidemic efficiently is very labour-intensive and requires a lot of manpower. Both Vietnam and Kerala mobilised it quickly and en masse.

When the first corona infections were detected in a village, the Vietnamese government sent massive numbers of doctors and health workers there. In order to combat the epidemic in the rest of the country effectively, medical students and retired doctors and nurses were called in.

The government organised mobile units to react quickly. Some 16,000 teams were formed to staff call centres and assist quarantined people with medical assistance, food parcels, or just to chat with.

In Kerala, the mass organisations of the ruling communist party (women, farmers, young people) came to lend a hand. As a result, the government was able to count on many volunteers to carry the campaign.

The local village councils organised communal kitchens to prepare free meals and encouraged local villagers to house people who were isolated or did not have enough space for social distancing at home. Agents were deployed to check that each household respected quarantine.

5. Medicine for the people

The most important element in the fight against the virus of both Kerala and Vietnam is the nature of their health-care systems.
Doctors and health workers are active right down to the smallest and most remote villages in Vietnam.

Healthcare is affordable for everyone, including the poorest. If you fight an epidemic, it is important that everyone is reached and that no one slips through the net.

Another factor is the emphasis on prevention. Vietnam has a strong tradition in this field. Massive efforts were put into testing, contact tracking and placing infected persons in quarantine.

Kerala has invested heavily in its healthcare for many years. In recent years in this state there have been no cuts, unlike in the rest of India. Kerala spends twice as much per capita on health care as the rest of India.

Its health system is considered to be the best in the country. Kerala's nurses are known as world class and are highly sought after in hospitals in the US and Europe. Life expectancy in Kerala is seven years longer than the Indian average and infant mortality 4.5 times lower.

Like Vietnam, Kerala has well-developed public primary health care. Striking in this respect is its decentralised character: each village has a primary-care centre and there are hospitals in each district. Local authorities play a key role.

As a result, care is highly accessible and it is possible to respond quickly to local complaints or needs. This also makes it easier to test and trace infected people.

During the corona crisis, local health workers and numerous volunteers focused on people with special needs and single elderly people. For example, they monitored whether people were taking their medication on time.

The excellent healthcare in Kerala and Vietnam does not come out of the blue: communism has been a strong influence, as the unchallenged state ideology of Vietnam and as a brand touted by the leftist parties that have dominated Kerala since the 1950s.

Jason Hickel, professor at Goldsmiths University of London and working at the UN, agrees: “This is what happens when you have a society that is organised around the welfare of humans rather than around the welfare of capital. … It puts the 'so-called first world' to shame.”

Duly noted.




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