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Yes.There is no doubt about the fact that India has a shortage of doctors and that the doctor patient ratio is one of the lowest in the world, but more important than that is the quality of health care.Let's have a look at some figures:Now I am sure we all know that the WHO minimum prescribed limit for doctor-patient ratio is 1:1000. In India the current ratio is around 1:1700, but it is much worse in the government sector and many rural areas where it may be as low as 1:10000.These figures are quite commonly flashed by our media and also used by many of us in regular conversations as they serve as a simple means of communicating the point. But would bringing the number to the WHO standards help solve our issues?No, it won’t. And here is why:The concept of threshold of health workers was developed as part of the Joint Learning Initiative in 2004.[1] At that time, it was calculated that densities of 1.5 and 2.5 health work-force per 1000 population were associated with 80% coverage of measles immunization and 80% births attended by skilled health workers respectively; these two health related issues considered being the major hurdles for achieving the United Nations Millennium Development Goals.[2]And according to the WHO data, globally the ratio of doctors to other health workers was about 1:1.5. Based on that and keeping a ratio of 2.5:1000 for health work force, a doctor to population ratio of 1:1000 was derived and endorsed by WHO.One of the major issues with this figure is that it clubs together all doctors, whether basic (MBBS), specialists (MD,MS) or super-specialists (DM/MCh/Fellows) which is a highly flawed way of representation of the required work-force. Another issue is that we are now shifting from malnutrition and infectious diseases to non-communicable ones, courtesy Epidemiological transition. The contribution of doctors in the former category is much less than that in the latter.As an example, both measles immunization and births conducted by skilled attendants (objectives used for formulating the above ratio) are modest clinical skills and are done worldwide by nurses, midwives and paramedics.Non-communicable diseases (NCDs) (like heart disease, stroke, hypertension, diabetes, etc) are now the cause of 70% of deaths globally, ranging from 37% in low-income countries to 88% in high-income countries.[3] And tackling these would require more doctors, specifically specialists and super-specialists.Even the ratio of 1:1000 that we so desperately want to achieve may not be sufficient. For example, there are about 1 million fresh cancer cases diagnosed every year in India, but there are only 1500 oncologists making a ratio of 1 oncologist per 1600 patients. In the US, the ratio is 1 per 100 cancer patients and even that is considered inadequate by the American Society of Clinical Oncologists.In India, although infectious & communicable diseases and malnutrition still remain a major health issue, we are currently witnessing an epidemic of obesity, diabetes and cardiovascular disease and the projected rates show a further rapid rise in the numbers. And in my knowledge, we are not well prepared for that.Have a look at the changing trends:(Source: Institute for Health Metrics and Evaluation)You see where I am trying to get here. We need more MD/MS and DM/Mch seats than MBBS seats. Blindly increasing the number of MBBS seats, something like this (IIT-KGP medical college to offer first MBBS course by 2020-21 ) is not what we need right now. You tell me, someone in your family has diabetes; who would you rather consult for that: an MBBS doctor or a super-specialist (endocrinologist or a DM)?We don’t need more MBBS graduates who unable to get PG seats either end up buying seats or leave the country. Around 50000 MBBS doctors are produced every year in India. But only one third have the opportunity of doing a post-graduation in clinical disciplines.[4] If the Government does not employ resources to employ them, the chaos would continue and the profession would soon lose it’s charm.Recent opening up of AIIMS in various states, with two more upcoming is a good move by the government. Initially there were only undergraduate seats, now even post-graduation courses have been started. What is important is that the progress should continue at a reasonably fast pace without compromising on the quality of education and health care facilities.Now coming to other most important aspect: Rural India.Roughly two-thirds of our population still lives in Rural areas. According to a WHO report published in 2016, although the data is a decade older, at the national level the density of doctors of all types (allopathic, ayurvedic, unani and homeopathic) in 2001 was 80 doctors per 100,000 of the population and the density of nurses was 61 per 100,000, with the density in urban areas was 4 times the rural areas.[5]Quoting some direct facts from the above report:Of a total population of 1,028,610,328 in 2001, there were 2,069,540 health workers of which 819,475 (or 39.6%) were doctors, 630,406 (or 30.5%) were nurses and midwives, and 24,403 (or 1.2%) were dentists. Of all doctors, 77.2% were allopathic and 22.8% were ayurvedic, homeopathic or unani. Other categories of health workers were pharmacists, ancillary health professionals, and traditional and faith healers, who comprised 28.8% of the total health workforce.The national density of doctors was 79.7 per lakh population, of nurses and midwives 61.3 per lakh, and of dentists just 2.4 per lakh.Of all health workers, 59.2% were in urban areas, where 27.8% of the population resides, and 40.8% were in rural areas, where 72.2% of the population resides. The ratio of urban density to rural density for doctors was 3.8, for nurses and midwives 4.0, and for dentists 9.9.Among allopathic doctors, as many as 31.4% were educated only up to secondary school level – and as many as 57.3% did not have a medical qualification. Among nurses and midwives, 67.1% had education only up to secondary school level.The education level and medical qualification of urban doctors were much higher than those of rural doctors. Among allopathic doctors, 83.4% of urban doctors had higher than secondary schooling compared to 45.9% of rural doctors. Of urban allopathic doctors 58.4% had a medical qualification, whereas only 18.8% of rural allopathic doctors had one.Nationally, a greater fraction of ayurvedic doctors than allopathic doctors had more than secondary schooling: 74.8% compared to 68.6%. Homeopathic and unani doctors were slightly less well educated than allopathic doctors. Compared to 68.6% of allopathic doctors with more than secondary schooling, 66.9% of homeopathic doctors and 60.9% of unani doctors had more than secondary schooling.So what I understand from the above is that there should be much more stringent regulations for preventing our health care system from quacks. Keeping the medical registration system online updated regularly may help. People can at least check whether the doctor has a license to practice or not. I recently searched my name and I couldn't find it. (I am a licensed medical practitioner under the Delhi Medical Council)Apart from this, there is a need for better supervision of the existing colleges providing MBBS and PG degrees. How many private colleges sell seats for lakhs and crores is a fact unknown to none, but there are a lot of Government colleges and hospitals in peripheries providing dismal quality education and health-care facilities.In India, shortage of basic doctors (MBBS) is exaggerated as only 12% Primary Health Centers, the corner stone of rural health services, are without doctors. On the other hand, the rural sector is facing acute shortage of specialists with 80% per cent posts of specialists (surgeons, physicians, pediatrics, gynecologists, etc.) at the Community Health Centers, the first contact point of a villager with specialists, are lying vacant.[6]So there is no doubt about the fact that doctors are required to work in the rural areas. But forcing a MBBS or MD/MS graduate to work in a rural setup without any proper facilities and pay is neither justified nor would it be of any great help. The government needs to provide good infrastructure and facilities, proper living and sanitary conditions and a decent salary to doctors. An option of providing employment to the spouse (if also a doctor) in the same district or area may also be helpful. There needs to some incentive for the doctors to serve in the rural sector rather than using their education and skills to earn money and have a decent life otherwise. Also, their should be an option of taking voluntary rural postings with added incentives or pay. (Read more about this in Asher Nitin's answer to Do you think today’s young Indian doctors have chosen this profession to serve mankind or to make money? If they really wanted to serve the poor, wouldn't they accept rural postings?)In addition, there is a need to train and recruit a large number of para-medical staff (nurses, mid-wives, etc). Primary and health care workers can help in bridging the gap between our rural population without access to health-care and medical professionals. Referral system needs to be further strengthened.But the contribution of government sector to overall health care is hardly a third, while the rest two-thirds is contributed by the private setup and therefore most of the expenditure has to be borne by the public. Unfortunately the government’s way of taking care of this is putting a cap on the prices set up by the private hospitals. Dr Raghuraj S. Hegde has very well explained in his answer as to why this is not the solution.As per 2014 statistics, our Health expenditure per capita is currently 75 USD. Take a wild guess of this figure in the US. Let me tell you, it is 9403 USD. Forget US, let us compare it with a country which is at present, almost as populated as ours; China has more than five times our figure with 420 USD per capita. And not just that, while China went from 21 to 420 USD in one decade, we struggled from 16 to 75 USD in the same time.Doesn’t this make you angry? Why is our government not willing to spend more on healthcare? Or do you just plan to take out this frustration on some poor over-worked and under-paid resident doctor struggling to make ends meet in an over-burdened and under-staffed government hospital?Anyhow, in my opinion:What would help?Increase the number of post graduate seatsIncrease the number of faculty postsStringent rules to ensure that doctors work for the stipulated time in government hospitalsBuild up infrastructureBetter working environment for doctors, ensuring their safetyRecruit more paramedical staffLimit caste based reservation to only once in the family and once in the careerStrengthen the medical registry systemWhat would not help?Blindly increasing the number of MBBS seatsForcing doctors (post MBBS and post MD) to serve in rural areas.I think it's high time that our government stop romanticizing AYUSH and start focusing on the real stuff that needs to be taken care of.Thanks for the A2A User-12672574652859658938Footnotes[1] http://www.who.int/hrh/documents/JLi_hrh_report.pdf[2] http://www.japi.org/october_2016/11_pov_time_to_revisit_recommendations.pdf[3] The top 10 causes of death[4] http://www.deccanchronicle.com/141115/ nation-current-affairs/article/pg-medicalseat-crunch-ails-doctors.[5] http://www.who.int/hrh/resources/16058health_workforce_India.pdf[6] https://nrhm-mis.nic.in/Pages/RHS2015.aspx?RootFolder=%2FRURAL%20HEALTH%20STATISTICS%2F(A)RHS%20-%202015&FolderCTID=&View=%7BC50BC181-07BB-4F78-BE6F-FCE916B64253%7D

There will be more patient centric care as the senior population are well educated in many areas of health promotion as indicated by reduction in tobacco and alcohol use and use of genetic tests.The future seniors will be proactive since their children live in different parts of the world. Seniors will either live with their families or congregate in senior communities using the latest technologies in health monitoring and care. The future American seniors will still be bombarded with expensive medications, overly medicated, as most of them will ask their doctor to prescribe them narcotics even when not warranted as addiction to many neuro meds will remain. Only those who have savings and long term care insurance can afford personalized in home senior caregiving when needed for 24/7 care (cheaper than staying in the hospital) for chronic health care. Married senior couples live longer than singles.A robotic kitchen is being launched although most seniors dislike new technologies like direct TV remote control. Use of new technologies (mobile health concierge/monitoring/tools/devices) will be driven by their children who are caring for them.Connie-------The reach of technological innovation continues to grow, changing all industries as it evolves. In healthcare, technology is increasingly playing a role in almost all processes, from patient registration to data monitoring, from lab tests to self-care tools.Devices like smartphones and tablets are starting to replace conventional monitoring and recording systems, and people are now given the option of undergoing a full consultation in the privacy of their own homes. Technological advancements in healthcare have contributed to services being taken out of the confines of hospital walls and integrating them with user-friendly, accessible devices.The following are ten technological advancements in healthcare that have emerged over the last ten years.1. The electronic health record. In 2009, only 16 percent of U.S. hospitals were using an EHR. By 2013, about 80 percent of hospitals eligible for CMS' meaningful use incentives program had incorporated an EHR into their organizations. "For such a long time we had such disparate systems, meaning you had one system that did pharmacy, one did orders, one that did documentation," says Jeff Sturman, partner at Franklin, Tenn.-based Cumberland Consulting Group. "Integrating these systems into a single platform, or at least a more structured platform, has allowed more integrated and efficient care for patients," he says.While the EHR has already created big strides in the centralization and efficiency of patient information, it can also be used as a data and population health tool for the future. "There's going to be a big cultural shift over the next several years of data-driven medicine," says Waco Hoover, CEO of the Institute for Health Technology Transformation in New York. "Historically, that hasn't been a big part of how medicine is practiced. Physicians go to medical school and residencies, but each organization has its own unique ways they do things. That's one of the reasons we see varied care all over the country. When data is what we're making decisions off of, that's going to change and improve outcomes of the consistency of medicine delivered."2. mHealth. Mobile health is freeing healthcare devices of wires and cords and enabling physicians and patients alike to check on healthcare processes on-the-go. An R&R Market Research report estimates the global mHealth market will reach $20.7 billion by 2019, indicating it is only becoming bigger and more prevalent. Smartphones and tablets allow healthcare providers to more freely access and send information. Physicians and service providers can use mHealth tools for orders, documentation and simply to reach more information when with patients, Mr. Sturman says.However, mHealth is not only about wireless connectivity. It has also become a tool that allows patients to become active players in their treatment by connecting communication with biometrics, says Gopal Chopra, MD, CEO of PINGMD, and associate professor at Duke University Fuqua School of Business in Durham, N.C. "Now I can make my bathroom scale wireless. I can make my blood pressure mount wireless. I can take an EKG and put it to my smartphone and transfer that wirelessly," he says. "mHealth has the opportunity to take healthcare monitoring out of the office, out of the lab and basically as a part of your life."3. Telemedicine/telehealth. Studies consistently show the benefit of telehealth, especially in rural settings that do not have access to the same resources metropolitan areas may have. A large-scale study published in CHEST Journal shows patients in an intensive care unit equipped with telehealth services were discharged from the ICU 20 percent more quickly and saw a 26 percent lower mortality rate than patients in a regular ICU. Adam Higman, vice president of Soyring Consulting in St. Petersburg, Fla., says while telemedicine is not necessarily a new development, it is a growing field, and its scope of possibility is expanding.The cost benefits of telehealth can't be ignored either, Mr. Hoover says. For example, Indianapolis-based health insurer WellPoint rolled out a video consultation program in February 2013 where patients can receive a full assessment through a video chat with a physician. Claims are automatically generated, but the fees are reduced to factor out traditional office costs. Setting the actual healthcare cost aside, Mr. Hoover says these telemedicine clinics will also reduce time out of office costs for employees and employers by eliminating the need to leave work to go to a primary care office.4. Portal technology. Patients are increasingly becoming active players in their own healthcare, and portal technology is one tool helping them to do so. Portal technology allows physicians and patients to access medical records and interact online. Mr. Sturman says this type of technology allows patients to become more closely involved and better educated about their care. In addition to increasing access and availability of medical information, Mr. Hoover adds that portal technology can be a source of empowerment and responsibility for patients. "It's powerful because a patient can be an extraordinary ally in their care. They catch errors," he says. "It empowers the patient and adds a degree of power in care where they can become an active participant."5. Self-service kiosks. Similar to portal technology, self-service kiosks can help expedite processes like hospital registration. "Patients can increasingly do everything related to registration without having to talk to anyone," Mr. Higman says. "This can help with staffing savings, and some patients are more comfortable with it." Automated kiosks can assist patients with paying co-pays, checking identification, signing paperwork and other registration requirements. Mr. Higman says there are also tablet variations that allow the same technology to be used in outpatient and bedside settings. However, hospitals need to be cautious when integrating it to ensure human to human communication is not entirely eliminated. "If a person wants to speak to a person, they should be able to speak with a person," he says.6. Remote monitoring tools. At the end of 2012, 2.8 million patients worldwide were using a home monitoring system, according to a Research and Markets report. Monitoring patients' health at home can reduce costs and unnecessary visits to a physician's office. Mr. Higman offers the example of a cardiac cast with a pacemaker automatically transmitting data to a remote center. "If there's something wrong for a patient, they can be contacted," he says. "It's basically allowing other people to monitor your health for you. It may sound invasive but is great for patients with serious and chronic illnesses."An article by Kaiser Health News, National Public Radio and Minnesota Public Radio discussed the effects a home monitoring system had on readmission rates for heart disease patients at Duluth, Minn.-based Essentia Health. The national average rate of readmissions for patients with heart disease is 25 percent, but after Essentia Health implemented a home monitoring system, the rates of readmission for their heart disease patients fell to a mere two percent. And now that hospitals are being financially penalized for readmissions, home monitoring systems may offer a solution to avoid those penalties.7. Sensors and wearable technology. The wearable medical device market is growing at a compound annual growth rate of 16.4 percent a year, according to a Transparency Market Research report. Wearable medical devices and sensors are simply another way to collect data, which Dr. Chopra says is one of the aims and purposes of healthcare. He says sensors and wearable technology could be as simple as an alert sent to a care provider when a patient falls down or a bandage that can detect skin pH levels to tell if a cut is getting infected. "Anything we are currently using where a smart sensor could be is part of that solution," Dr. Chopra says. "We're able to take a lot of these data points to see if something abnormal is happening."8. Wireless communication. While instant messaging and walkie-talkies aren't new technologies themselves, they have only recently been introduced into the hospital setting, replacing devices like beepers and overhead pagers. "Hospitals are catching up to the 21st century with staff communicating to one another," Mr. Higman says, adding that internal communication advancements in hospitals followed a slower development timeline since they had to account for security and HIPAA concerns.Systems like Vocera Messaging offer platforms for users to send secure messages like lab tests and alerts to one another using smartphones, web-based consoles or third-party clinical systems. These messaging systems can expedite the communication process while still tracking and logging sent and received information in a secure manner.9. Real-time locating services. Another growing data monitoring tool, real-time locating services, are helping hospitals focus on efficiency and instantly identify problem areas. Hospitals can implement tracking systems for instruments, devices and even clinical staff. Mr. Higman says these services gather data on areas and departments that previously were difficult to track. "Retrospective analysis can only go so far, particularly in places constantly changing like emergency departments," he says, but tracking movement with a real-time locating service can highlight potential issues in efficiency and utilization.These tools also allow flexibility for last minute changes. "If [a physician has] an add-on case today, do they have instruments on hand, and where are [the instruments]?" he asks. At the most basic level, these services can ensure equipment and supplies aren't leaving the building, and for high-cost equipment and supplies of which hospitals may only have one or a few, being able to track their location can help verify its utilization, he says.10. Pharmacogenomics/genome sequencing. Personalized medicine continues to edge closer to the forefront of the healthcare industry. Tailoring treatment plans to individuals and anticipating the onset of certain diseases offers promising benefits for healthcare efficiency and diagnostic accuracy. Pharmacogenomics in particular could help reduce the billions of dollars in excess healthcare spending due to adverse drug events, misdiagnoses, readmissions and other unnecessary costs.Before a full-fledged system of pharmacogenomics comes to fruition, the healthcare industry needs a tool that can aggregate and analyze all the big data and digital health information, Mr. Hoover says. "When we really start to have the ability to study a lot of that data, it's going to transfer how we match up that information at the population, individual and macro levels," he says. "The ability to actually compare that information is going to be valuable as we move forward, making sure medications we are taking are going to work for us."Tools for big data analysis for pharmacogenomics are still being developed, but data analytics and data aggregation for the purpose of population health may be the next big advancement on the horizon. "Understanding and connecting all these variables is going to be profound as it relates to moving forward in healthcare and designing interventions and analyzing patient populations and ultimately improving the lives and health of the American population," Mr. Hoover says.http://www.beckershospitalreview.com/healthcare-information-technology/10-biggest-technological-advancements-for-healthcare-in-the-last-decade.html

I can’t compare to all states of India with Kerala and its not fair too at this stage to make any comparisons. We are in the middle of a crisis and this is not just applicable to Kerala or South India or India as whole… Rather it's applicable to the entire world.Every government in this world is trying their level best to serve their citizens in the crisis. We can’t claim, ONLY we are doing the best. Everywhere, govts are trying to do best for their people. Maybe in some areas, we might be standing slightly better, some areas we may be lacking too.So I am not into any comparison at all. But since I write about Kerala in Quora, I feel I will write what all Kerala State has done in its fight against Corona Virus. I am talking only in specific to Kerala, not in comparison with any others.And please note, this is an evolving crisis and every day something new is being added to the fight. So sticking to things as of yesterday- 28/03/2020Contact trackingFor me personally, I consider this job done by Kerala’s DHS (Directorate of Health Services) as something the best they could do for us. Learning from Nipah outbreak experience, Kerala has used its resources to track contacts and people who been associated with the index patient (first patient in a cluster) to identify a cluster and isolate from the community. This includes detailed tracking of patient’s route from the moment he/she landed in Kerala until the moment he/she been quarantined into the hospital. Most of the tracking is done thro’ inputs made by the patient which are cross verified by officials of Public Health Inspectorate and Community Medicine Department, apart from using Police’s intelligence sources like Cyber cell to track down the mobile tower locations of the patient, special branch reports, phone records, CCTV camera recordings etc. By this manner, DHS able to identify a cluster comprising of potential secondary and tertiary contacts made by the index patient who will be either home or hospital quarantined and if any symptoms are shown, their blood samples will be tested.The DHS frequently makes regular route maps of patients and publishes in public to let people know about the time and place where the patient was and ask the public to declare to DHS, if they were in at that place at the specified time, to be declared as part of a cluster.Route Map of Patient 1 of Pathanamthitta which resulted in the start of second wave since March 2020This kind of tracking helped Kerala as of now to contain the disease to cluster level, though some have jumped out of quarantine and their actions created more clusters and patients.How Kerala's flowchart model is helping effective coronavirus contact tracingKerala launches contact-tracing programme to neutralise coronavirus threat2. TestingI have written answers before. Kerala’s strategy in combating this disease is by constant testing of samples. Kerala so far is the state that has done the highest number of testing among Indian states and its testing ratio is somewhat at par with many major affected countries like Japan or similar.Arun Mohan (അരുൺ മോഹൻ)'s answer to Why are no COVID-19 deaths reported in Kerala even though the state has the highest number of cases?States That Are Testing More Are Detecting More Cases, Data Show |If Kerala has done anything good in this sector, its solely because of regular testing and able to identify people quickly.As of yesterday (28/02/2020),Kerala tested 6,067 samples5,270 samples were negative165 are currently on treatment (Confirmed cases)1,34,370 are in isolation/surveillance (not yet confirmed)8 have recovered and still kept in observationand 1 death has been reported (the very first death in the state)This massive Pro-testing approach has helped Kerala to have nearly 10 Testing Virology labs in the state, including an NIV unit that helps faster and regular testing. As of now, Kerala has the highest number of blood sample testing facility in IndiaAs yesterday Kerala announced massive rapid testing after getting in-principle approval from ICMR. Kerala is the first state to announce so and was pressing ICMR for rapid testing permission for every single one in isolation/quarantine for last few days.3. Medical preparednessKerala was expecting to have Corona right soon after China declared its condition way back in Jan 2020. Kerala due to its very high non-resident Malayalee population living in many countries of the world was sure, they will soon get this new disease thro’ them and it was so right its judgement when the first Covid Case of India was reported in Kerala way back in Feb 2020. And it fully contained the first wave of Covid entry in Feb when it could isolate all cases and avoid spread etc.In the second wave, which happened thro’ an irresponsible family’s actions that created multiple clusters and later thro’ various foreign imports (some again were of irresponsible actions), the medical teams were so prepared to deal with emergencyDHS by March mid has already completed setting up various contingency plans, which were titled as PLAN A, PLAN B AND PLAN C. These plans were effectively communicated to entire medical and administrative officials of the states and everything has been well defined. This even includes thresh-holds for initiating each plan. Medical infra audits were carried out as part of this medical contingency plansThe Plan A which is currently ongoing has seen mobilization of resources associated with 50 Govt hospitals and 2 private hospitals on standby with total of 974 isolation beds and 22 ICUs readied for Corona carePlan B which has been initiated last day has mobilized resources for an additional 71 govt hospitals and 55 private hospitals for combating this disease which will add another 1408 beds.Plan C is the next stage (once the diseases spread comes to 3rd stage) which will mobilize 81 govt hospitals and 41 private hospitals with another addition of 3028 beds and 218 ICU bedsThese plans were drawn in March 1st week, which shows the extend of planning of Kerala Govt.The new set of plans (unofficially codenamed as PLAN D) will feature nationalization or semi-nationalization of entire Private hospitals of Kerala featuring a total bed of 69,434 beds and 5507 ICU beds. As of the latest decision, the govt decided to take over unused private hospitals and those medical colleges whose operations were suspended by MCI. 3 hospitals facilities and one Hostel complex were taken over in last 48 hours (PVS Hospital in Kochi, Anjarakady Medical College in Kannur, Shanti Jamaath Islami Hospital in Kozhikode and Sree Sankaracharya University Hostel Complex in Kochi)Collector Ernakulam (Kochi) taking over an unused hospital in Kochi city to be converted into a Covid Care Hospital facility.The Plan D features taking over hotels, hostels, lodges and other commercial units to develop into Isolation centres and Temporary Isolation centres, which shall be more than 2 Million rooms.As of now, Kerala Govt has announced opening Exclusive Covid Hospitals in every district of Kerala (14 Covid Hospitals in the level of tertiary care facility) and the first one is opened in Kochi- CMC (Cochin Medical College) which is a government Medical college and others are expected to open by this weekKerala’s first dedicated Covid Care Hospital centre in Kochi with 500 isolation beds and 70 plus ICU bedsGovt has been in talks with various community organizations and they all pledged their support for the fight. The Catholic Hospitals Association which is the second-largest Medical group after Government hospital network has decided to give all their hospitals to DHS along with their medical Staff (2660 Doctors, 10,300 Nurses, 5,500+ Paramedics and 6800 Admin staff). The Nair Service Society has assured Govt to provide its 2 hospitals and 100 plus educational institutions which they can convert into field hospitals if required. The SNDP Trust also assured Govt to provide its 1000 plus schools to be converted as field medical hospitals or treatment centres. It also assured to give its medical college to the state upon demand. So as Muslim Educational Society and Jammat e Hind Islami also assured to provide all its hospitals, madrasas, schools and colleges to the government for its better use.4. Upgrading Covid Hospital facilitiesOne key factor Kerala Govt focused on improving the facilities at all Covid care hospitals to ensure the public do not hide their medical cases to avoid visiting or isolating themselves.All Govt Covid Isolation rooms and treatment rooms are modernized and sanitized as per WHO protocols. Patients were brought to such isolation wards in dedicated Covid care ambulances and the isolation rooms were all modern and neatThe govt took extra care to ensure the food patients get at these hospitals should be as inviting as possible to shed all bias and prejudices against Govt hospitalsCovid patients gets inviting meals with options like Soups, fruits, eggs, Dosa, Appams, Rice-fish curries, chappatis, curd etc while foreign patients gets continental meals like Toasted breads, cheeses, omelettes/scrambled eggs, roasted chicken, biscuits etc. Patients do get daily milk, tea, coffee, fresh fruit juices, packed mineral water and daily newspapers (courtesy from Hindu).Dosa, eggs, oranges, fish fry: Here's the menu at COVID-19 isolation wards in KeralaThe hospital authorities have taken every wish of patients as much as possible, for example an covid affected Kid from Italy in treatment at Kochi were treated with Italian pasta, Ravoli and pizzas as the kid likes only Italian food which were ordered from an Italian restaurant nearby.5. Medical Industrial PreparednessKerala Govt has taken extra note in preparing itself for a major medical emergency. The state’s Medicine production has gone into full swing. The state-run Kerala State Drugs and Pharmaceutical Corporation has been entrusted with bulk mass production of Hand sanitizers which produced more than 1 Lakh bottles of Sanitizers and increased production targets to 1 million (10 lakh) by end of this week.1 lakh bottles of hand sanitizers in a day: Kerala goes all guns blazing against Covid-19KSDP also entrusted with mass production of 8 critical generic drugs and 2 drugs for which it holds patents to ensure no shortage.The state’s Electricity board has ordered to procure 500 new medical ventilators exclusively for Covid operations (Kerala state holds 5000 ventilators in total which is approx 12% of total available ventilators in the country). The state is going to enter talks with various manufactures for portable ventilatorsIn addition, the industry department has been asked to explore the possibility to produce 1 lakh N95 masks with any tech partnership with companies using facilities available to the department. In the meantime, the state will continue the mass production of cloth and surgical masks.As of today’s (28/03/2020) cabinet decision, Kerala Govt decided to form a medical industry cluster to manufacture indigenous medical equipment supplies at the earliest using existing facilities.The Kochi Superfab Lab, India’s only such facility were given the charge to design equipment required for such a major medical emergency. The state will produce its own Respirators, Ventilators, N95 Masks, Oxygen cylinders, Bio-Medical equipment preparing itself for the worst medical emergency.ISRO’s VSSC facility in Trivandrum and Kochi’s Technology Innovation Zone along with Kerala Start Up Mission will be fully utilized to design and develop newer and practical technologies and existing factories in Palakkad’s Kanjikode Industrial Cluster will be fully converted to produce equipment required for the medical sector. For this, a meeting of industrialists will be called tomorrow and setting the plan in motionThe state has opened a new challenge to all its technocrats and tech student entrepreneurs and start up promoters to come up with ideas for effective tech solutions to deal with a major emergency.A website- http://WWW.BREAKCORONA.IN has been started by Kerala Govt to invite newer ideas that can easily be put into action for which Kerala Govt will support financially and these projects will also generate employment and opportunities in the economy.6. Technology Usage and War RoomOne main feature which Kerala’s DHS used to control Covid spread was its Control Room set up at Kerala State Disaster Management Authority complex in Trivandrum and district headquarters. This was something which I feel, gave real-time updates to DHS on the spread and ways to control and contain it.These multiple data recording and analysis units helped to track patient history, procure data from multiple sources, feed in data and help control room unit officials to analyze patterns of travels and contact detailsIn a way, it was a full-fledged health surveillance facility. Patients route maps were made, their contacts were identified and their movements were tracked from this Hitech facility. These 24 hours of data control rooms, helped to give a clearer picture and understand the extent of spread thro’ interactive maps etc.This also includes geo-surveillance, monitoring those in quarantine with geo-fencing, GPS enabled trackers, electronic anklet monitoring systems etcScreenshot of portal that highlights patients under GPS enabled Geo-fencing to track their movements as used by District Administration- PathanamthittaCoronavirus | GPS-based tracking of all those quarantined in PathanamthittaIn addition, Kerala is using multiple data collection methods to track vulnerable people and develop maps to identify potential hot spots and nearest medical facilities. The disease mapping helps to have a strong information flow for various strategic decision making to control community transmission.Kerala uses open source public utility to fight COVID-19 - Geospatial WorldKerala govt to use ration card data for digital map on COVID-19Disease mapping to stem community transmissionApart from this, the centralized health support centre- DISHA (Direct Intervention System for Health Awareness) played a crucial role in tracking and supporting patients and other suspect cases. DISHA is a centralized call centre of DHS with a toll-free number- 1056 which was started to support patients for telemedicine and tele-support like counselling etc. But during this COVID time, it was fully converted into COVID Support and call centre facility. They notified the patient records, their queries and supported back with real-time updates of their medical conditions, moving ambulance support for them and mental counselling etc to alleviate stress.Disha 1056 call center, the nerve point of Anti-Corona operationsCoronavirus: This team at Kerala helpline desk works round the clock in fight against the pandemicNow, the state is coming up with a sophisticated Hitech War Room in the State Secretariat that has senior Bureaucrats as members to control and coordinate entire Covid operations including logistics movements during lockdown etc. A new secured line has been established- 0471-2517225 for the public to call at War Room directly.War room to coordinate effortsWar room in Kerala to supervise COVID-19 containment activities8. Lockdown SupportThe Lockdown as announced by Central Govt has affected every Indians. Kerala is no exception to this grave situation.During lockdown time, the state has focused on maximizing deliveries of essential supplies at home.The state has partnered with Zomato in Kochi, Trivandrum and Kozhikode to supply essentials from state-run Supermarket chain- Supplyco to public. 40 stores of Supplyco will start services of Zomato for home delivering of essentials including the essential kit of basic food items priced at Rs 500 (5 Kg rice, 1 litre coconut oil, 1 kg sugar, half kg of 2 kinds of pulsesSupplyco ties up with Zomato for online delivery of essential items in KochiThe state’s Consumerfed also entered into Online delivery starting from 1st of April and will extend to all districts of Kerala at the earliest. In addition, the state’s milk brand- Milma has aggressively pushed its online delivery- AM Needs more in 2 main cities which shall supply Milk, Milk products and breakfast items like bread, eggs etc. Efforts are made to extend this to other main cities too.Consumerfed’s online delivery from April 1Kerala Govt along with Police Cyberdome and a private company has launched a new Online app- ShopsApp and now asking all shops selling essential goods to mandatorily register in the ShopsApp portal. Once all the shops register, the newly formed volunteer army will be used for home delivery which will be spread across the state, not just cities alone.Shopping from local stores with home deliveryഅവശ്യ സാധനങ്ങളുടെ ലഭ്യത ഉറപ്പാക്കാൻ പൊലീസ് ആപ്The state has assured home-delivery of its essentials kits and ration supplies to the houses of poor (BPL cardholders) across the state, even in rural areas thro’ services of postal personnel as well as its own staff. Right from the day when schools where closed, personnel from Angawadi (kindergarten) and other educational departments were home delivering essentials for kids and children enrolled under each school directly.The state announced ambitious schemes to ensure HUNGER FREE Kerala. The govt clarified, not a single person in the state will starve due to the lockdownEvery family who is currently home quarantined will get Rs 1000 worth Essentials Kit of Food items from the govt for free which shall be home deliveredBPL card holders will get 35 Kg of Rice and APL cardholders will get 15 KG of Rice from Ration shops for free.Covid-19 lockdown: In a first, Kerala to home deliver food kits to the poorIn addition, a mechanism for home-delivering items from nearby shops by volunteers is plannedPolice delivering essentials to houses of elderly people who can’t go out9. Community KitchenThe govt directive is for Hunger-Free Kerala. No one will starve in KeralaFor this, the state has directed every Local Govt bodies to start Community Kitchens to cook food in bulk and provide packed food kits to people who don’t have access to cooked food. This includes homeless people, elderly people, sick people, migrant labour community and those got trapped in hostels or similar facilities overnight. All these shall be delivered to homes for a free or nominal token amount of Rs 20Meals shall be also delivered any needy just thro’ phone calls. The whole scheme has been worked out by Kudumbashree workers and packed meals costs Rs 20 only for veg and extra Rs 30 for a Chicken/Beef/Fish dishhttps://www.thenewsminute.com/article/inside-kerala-community-kitchen-during-coronavirus-lockdown-121325As of now, 748 Community Kitchens have been opened and an additional 300 will be set up soon. This service is available for lunch and dinner.So my parents who are in Kerala tried the community kitchen meal which was home delivered for Rs. 25. Rs. 30 extra if you want fish/beef/chicken. #Kerala #Alappuza @vijayanpinarayi @drthomasisaac @CMOKerala @shailajateacher pic.twitter.com/Ws2snAq5EQ— JF (@Potatodrink) March 27, 2020Kerala's Solution For Food Needs Amid Lockdown: 1,000 Community KitchensAgriculture Minister VS Sunil Kumar inspecting the facilities at Kochi’s Community kitchenKerala’s 43 lakh-strong women self-help network power community kitchens during coronavirus lockdown10. State Volunteer ArmyThe state announced an ambitious idea of forming an army of 2.45 Lakh volunteers to support various volunteering activity under a single command. Ever since the lock-down, multiple organizations are into volunteering activity causing many law & order issues and unauthorized movements. Also, there is a lack of coordination in these activities.To deal with it, the state formed a new directorate- Directorate of Social Service Force under State Youth Commission. The Directorate is to raise an army of trained volunteers to support various activities classified as 18 categories.https://www.quora.com/share/Arun-Mohan-520The key part of Volunteers is to develop emergency Isolation centres as required as movers as well as technicians. Apart from that, they are heavily required for logistics operations across the state, to supply deliveries to home, to work as care-takers and home-sitters for elderly and Covid affected patients etc.The govt announced this day before yesterday and invited online registrations thro’ its new portal- https://sannadham.kerala.gov.in/ (Sannadham in Malayalam means Volunteering) and despite of a technical glitch in registration, by now 30,000 youngsters registered for volunteering. This also includes Kerala Youth Volunteer Action Force- KYVAF (Red Shirts as known locally) designed after 2019 floods to have trained volunteer guards (5000 such trained red shirts are now available). So far only Andhra Pradesh and Kerala have formed such volunteer army.News in Asianet News about huge number of applications and responses to forming Kerala Volunteer ArmyRed Shirts in public sterilization programsKerala to set up Community Volunteer Force to support better deliveryKerala govt to form volunteer army of 2 lakh youngsters for the COVID-19 fightTechies turn volunteers to assist Kerala to contain Covid-1911. Transparency Flow of InformationThe biggest positive thing which Kerala is doing (which some proactive CMs of other states also doing) is effective and transparent flow of information.One of the important lessons learnt after Oockhi crisis of 2017 which Kerala changed since then and effectively used during floods time of 2018 and 2019 and Nipah time, was holding regular press meets and effective passing of all information available and cutting the spread of fake news.The government for the last 56 days were constantly holding daily press briefing both at State Level and district level to pass all information of the day. On the day 1 of first reporting of Covid case, a press conference was held even at an unusual hour of 1:30 AM late night to pass all information to media. Ever since that, media briefing became a mandatory thing at State level which was initially at 8 PM by Health Minister and as the state entered into Stage 2 and probably gearing for Stage 3 where multiple departments need to be involved, the baton moved to CM’s daily press meetings at 6 PM sharp.The daily press meetings of Kerala CM along with Health Minister and Chief Secretary has attracted huge public response, as a clear source of information on Covid situation.Today most of these press meetings are widely watched by entire Malayalee community, where all information of the day, all policies taken by Cabinet, all the government orders and action plan for next day are discussed with mediaPerhaps, one key tool to combat fake news is Transparency. The state issues health bulletins at every 6 hours for all affected people, all collectors are required to hold press meets or press releases on daily basis, district information officers are required to open lines to quell all public queries as well as organize programs to dispel public doubts and help the public in knowing the updates etc.Transparency Has Been Kerala’s Biggest Weapon Against the Coronavirus12. Campaign programs and quick responsesKerala government has realized the importance of massive Public Campaigns and Public relations to be used to the highest level to ensure its desired objectives reach to the public. The most successful campaign done was BREAK-THE-CHAIN campaign which has been adopted by Central Govt too and listed as a National agenda laterArun Mohan (അരുൺ മോഹൻ)'s answer to How many people participate in the campaign "break the chain" in Kerala?Arun Mohan (അരുൺ മോഹൻ)'s answer to What impact will this bring on the public as the introductory video of Kerala Police doing handwashing dance gone viral?Break The Chain Campaign was to have massive ground level sanitization and handwashing program to ensure the virus don’t spread quickly and break the chain of spread. This campaign helped the public to realize the importance of washing hands frequently and using sanitizers. Public washing kiosks came up and hand-sanitizers at the entrance of any facility became a regular thing. Videos of effective hand washes became common and the handwashing awareness video of Kerala Police became viralThe much viral Handwashing Video awareness dance by Kerala PoliceApart from campaigns, the government ensured, they are into heavy public relations. They are listening to every complaint, every grievance and standing with the public. For this govt machinery are focused on addressing public needs based on complaints reporting.For example, initially, the government didn’t give much thought about migrant labours and workers as the entire attention was over the local population. But when reports started coming in that migrant population have started fleeing to their homes and travelling on foot to their places when the lockdown came, the government machinery immediately set its attention to their problem. The govt started opening migrant workers camps across the state where they can stay and the entire cost of their food and other essentials were taken care of by the state Labour department and local MLAs. Kerala Govt even announced, they won’t use the term- Migrant Workers, rather will address them as GUEST WORKERS (Adithi Thozhilali) to honour their contributions to the state and will care themWhen Bihar’s Opposition leader Tejaswani Yadav highlighted the plight of some Bihari workers in Trivandrum over Twitter, the government quickly addressed to it and even reverted to him personally with an action taken reportI have visited the guest workers' labour camp today and spoke with workers and company representatives. The camp operates with all necessities including food and medicine.Kerala government is paying special attention to guest workers in this #COVID19 crisis. pic.twitter.com/uMsdq2NJQS— Kadakampally Surendran (@kadakampalli) March 27, 2020As of now, Kerala opened 4603 Relief camps to accommodate 1 Lakh migrant workers across the state who lost their work and got stuck in the state with no place to go. More numbers are to be expected as no one actually knows an exact number of workers. Many have fled Kerala before the lockdown came in and some haven’t turned up to government facilities too. The facilities do have all the essentials to survive until an alternative mechanism to help these people reach back to their homes is decided upon. This includes free food and sanitary requirements.Kerala opens 4603 relief camps for over one lakh migrant 'guest' workersAround 35 plus camps are opened for destitute and street dwellers across the state to be accommodated during this period.This decision has prevented a massive exodus as seen in many other North Indian states.13. Welfare schemes and supportThe state has announced a huge economic package of Rs 20,000 Crore to support people during this Covid crisis.One key feature announced was providing 2 Month social security pension (March and April) together by yesterday and today to all registered people, by delivering to their homes and via their coop bank accounts.The Govt kept its word by distributing all pensions by nowMore Photos. pic.twitter.com/H5sckkiCrL— Kadakampally Surendran (@kadakampalli) March 26, 2020How the Kerala government is shaping and implementing its Covid-19 responseKerala to disburse welfare pension for two months from next weekIn addition, the government has decided to support Tribal population by asking all tribal promoters and other officials to supply essential kits at their settlements inside the forest and educate them about the deadly virus spreadThe government announced One Month-long supplies kit per family to be supplied directly to their settlement and instructed forest guards and tribal department officials to ensure they remain insulated.Konni MLA comrade Jenish Kumar & District Collector P. B. Nooh IAS along with volunteers taking food materials to a tribal colony.It is important to work in sync during a crisis, as #Kerala has done in the past.With such common goals, we shall overcome. #KeralaFightsCorona pic.twitter.com/3uJLUW3qVR— Kadakampally Surendran (@kadakampalli) March 28, 2020Collector Pathanamthitta himself taking a load to remote forest interior as part of his personal interaction and awareness campaign among tribals of PathanamthittaThis includes conducting radio shows and public awareness videos/audios in tribal languages etc and holding tribal settlement meetings etc to ensure they listen and understand the implication of the diease.Radio shows, videos in tribal languages: How Kerala is spreading COVID-19 awarenessKerala fighting COVID-19: Awareness videos are made in various tribal languages. Local officials and health workers show these videos going to each tribal colonies.This one here is Oorali language. pic.twitter.com/VuilFvJcm5— Neethu Joseph (@neethujoseph_15) March 23, 2020How these Kerala youngsters are ensuring that the Attappadi's tribal folk are safe from COVID-19These are some measures which Kerala is doing at the moment to ensure the disease doesn’t spread much and prevent Kerala from going into a havoc situation.I am not saying, everything is perfect in Kerala. There are any shortcomings here too. But so far, Kerala is trying the best possible within its strengths, some inherent and some developed, for the betterment of community welfare.I don’t know how much of these are exclusive to Kerala. I don’t think, none of them remains and should remain exclusive to any place as we humans always try various ideas to save our fellow folks in times of mass disasters.The reason I highlighted all these, is to make a larger people aware of what we are doing to combat this virus spread and hopefully, these measures can be a guiding model for others to emulate if required, just like we too adopted many gestures from othersIn times of distress, these kind of positive stories are more of beacon of hope that humanity exists and something must be spread to all…..Let's all work together and may our humanity prevail over every disaster!!!