Development of a district level multifaceted first-response strategy to COVID–19 in a resource limited setting in Kerala, India

Raman Swathy Vaman, Mathew J. Valamparambil, Ramdas A. V., Manoj A. T., Basil Varghese, Flory Joseph


The SARS-CoV-2 pandemic that began in Wuhan in China has spread rapidly with cases currently confirmed in more than 200 countries worldwide. The first case of the outbreak in India was reported on 31st January 2020 in three medical students who returned to Kerala from Wuhan. We report the district level preparedness and response to the first case of COVID-19 infection confirmed in the district of Kasaragod, Kerala. The identification, diagnosis, clinical course and management of the case including surveillance and contact tracing are described. The district level actions before and after the identification of the first case provide a guidance to other resource limited settings regarding the preparedness and mitigation measures to be adopted in times of a pandemic. The evolution of strategies highlights the importance of coordination between district and state health authorities, district administration and line departments; rapid dissemination of health information, disaster preparedness and engagement of the community for surveillance support and home quarantine.


Covid-19, Emergency preparedness, Low-income population, India

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