Kerala has received both national and international recognition for its efforts to contain the coronavirus, in which the police matched a strictly enforced lockdown with extensive community support. This Q&A is based on an interview conducted by the author with Vijay Sakhare––the commissioner of police in Kochi and the chief architect of its triple lock strategy as special officer for COVID-19 in the Kasaragod district.
What was Kerala’s “triple lock” strategy?
The triple lock strategy was made up of three consecutive stages of lockdown, or “locks,” for different groups of people—with each lock more stringent than before.
The first lock, implemented on March 25, was a general lockdown to restrict the movement of the general population and confine them to their homes. Using a system of roadblocks, the district of Kasaragod was cut off from other districts in Kerala and the neighboring state of Karnataka. Villages in Kasaragod were isolated, and larger settlements were divided into zones for easier management.
People were only allowed out of their houses to provide essential services or buy essential goods. Violators were either sent back home or prosecuted. Motorcycle patrols were also deployed to prevent loitering.
To ensure that there were no more than one hundred people in a marketplace at a time, people were given time-stamped vouchers and asked to buy enough goods to last a few days. The police regularly patrolled markets to make sure people stayed apart and to inform people about the importance of social distancing, wearing masks and gloves, and disinfecting their workplaces.
The second lock, on March 28, isolated areas with positive cases from the rest of the district. Using a geographic information system (GIS) to track locations, officials learned that all reported positive cases and their contacts were in just eleven areas. These areas, called “containment zones,” were cordoned off. A single point of entry and exit was left open to allow for the movement of health officials and emergency medical cases. After restricting the flow of people moving in and out of these containment zones, the next step was to limit the spread of the virus inside the zones. The police monitored the areas with drones and on foot to make sure people didn’t leave their homes or congregate outside.
The third lock, on March 30, was an extremely focused containment strategy. It was designed to keep all positive cases and their primary and secondary contacts inside their homes to prevent community spread of the virus.
Motorcycle patrols each covered about a dozen houses, visiting each home twice a day to verify the presence of the quarantined residents and ask about their well-being and needs. District officials also told residents that they were being monitored with surveillance tools, including drones. Every day, the police officers checked footage from nearby security cameras. Neighbors were asked to tell the police if the quarantined people ever left their homes. In one case, where someone reportedly had 121 primary and secondary contacts and infected twenty-one others with the virus, a police guard stood outside the person’s home to ensure they stayed inside.
These three stages of the triple lock strategy allowed officials to focus on individuals who were likely to have a higher risk of spreading the virus.
What led to the formulation of the triple lock strategy?
Kasaragod reported its first positive coronavirus case on February 3, 2020: a student who had been studying in Wuhan, China. Following a spike in cases, the Kerala government ordered a lockdown of the district on March 20. Three days later, nineteen new positive cases were reported, and it was clear that the virus needed to be stopped from spreading further. This led to the triple lock strategy—which the Kasaragod police put in action on March 25, 2020.
Before implementing the triple lock strategy, police officers were trained in social distancing, limiting their risk of contracting and spreading the virus. They were given masks, gloves, and hand sanitizers. Those in high-risk areas, such as busy transport hubs, were provided with personal protective equipment.
District officials played an important role in providing adequate medical infrastructure, resources, and personnel. To increase hospitals’ capacity to accommodate patients, officials identified 1,000 beds in private hospitals and 2,000 rooms in lodges, hotels, and hostels that could be converted into makeshift hospitals. Next, they located 225 doctors and 500 paramedical staff who could work there. The district only had two ventilators, so they also mobilized 600 oxygen cylinders for emergency relief.
What role did technology play?
The strategy used technology very effectively to help the police make sure that the quarantine was maintained.
Thirty police teams traced all the contacts of people who tested positive. As well as conducting inquiries, they used call data records, internet protocol data records, and security camera footage. In doing so, they identified approximately 25,000 people who had been in contact with positive coronavirus cases. This list was about 50 percent larger than the original list the police had been given by the health officials who are usually responsible for contact tracing.
Eighty house-visiting teams collected the geographical coordinates of quarantined homes. The teams also collected information about the occupants, including their names, date of arrival, and the date they tested positive. These details were mapped onto a geographical information system, which was used to create the eleven containment zones as part of the second lock.
Another key part of the strategy was a coronavirus safety app, which was already being developed. The app—installed with the consent of each quarantined person—tracks the person’s location and alerts the police if they move further than 50 meters from their homes. People who did so were given a warning the first time, and if they did it again, they were shifted to institutional quarantine—larger official quarantine centers. Legal action was also taken against them and in some cases, even their families. The app also has an emergency medical assistance call button.
To ensure people stayed at home, it was important that they were supported and had access to essential goods, especially medicine. The police launched a telemedicine platform to field phone calls or messages, called Swaraksha Kasaragode—the word “swaraksha” meaning “secure” or “protect”—on March 25. People in need of medical consultations or emergency services could use the platform to contact the police, who would help them. Over 25,000 people got medical assistance through the platform. Testing and treatment were left to health professionals, while the police handled the rest.
To meet the essential needs of people in the containment zones, the police started a localized home delivery service, Amrutham (the name is based on the word Amrit, which can loosely be translated as “elixir of the gods”). This was launched on March 28 and was extended to the entire district on March 30. To use the service, citizens had to send the police a WhatsApp message with a list of what they needed. The police would then coordinate with local suppliers to ensure that any kind of essential supplies were delivered to them on the same day.
How effective was the strategy?
In the first two weeks following the implementation of the triple lock strategy, sixty-four and forty-seven new cases were reported each week, respectively. The next week, there were only eleven new cases—a 76 percent reduction from the previous week.
In the following three weeks, only five, four, and two new positive cases were reported, respectively. No new cases were reported from May 1 to 11. On May 10, the last coronavirus-positive patient was discharged from the hospital.
How did officials engage with the local community?
Police officials announced that they were controlling the spread of the virus but needed citizens’ cooperation to do so. Using social media and local media channels, they briefed the public about new restrictions, violations, and actions being taken against the perpetrators.
The police also used World Health Organization videos with voice-overs in Malayalam, a prominent local language, to teach proper social distancing practices. Local celebrities were asked to help by making videos to communicate with the public.
How has the strategy dealt with people returning to Kerala?
Anyone returning to Kerala was placed under the tightest restrictions of the third lock. To ensure that they did not infect others, the police met every single returnee at the state border or arrival point and escorted them directly to their homes. People returning to their homes in Kerala from other parts of India were sent home for a two-week quarantine, while those returning from overseas were sent to institutional quarantine centers. Each center was monitored by a police officer.
Since May 4, more than 210,000 people have returned to Kerala. While the number of positive cases in the state has increased, only 10 percent of the new cases were the result of local transmission of the virus. All the other cases arose during the quarantine period within the homes of those who had returned from elsewhere.
How has the model been received?
Following the triple lock strategy’s success within its first three weeks, the government of Kerala adopted it for use throughout the state. Information about the strategy and its implementation was also shared with the central government and officials from other districts across India.
One reason for Kasaragod’s relative success in reducing cases is that the police played a strong role in ensuring discipline. By enforcing the lockdown, they supported health officials, who handled the testing and treatment of patients. The police also adapted to new roles and techniques. They used more technology, traced contacts, encouraged community policing, and ensured that people’s essential needs were provided.
Vijay Sakhare is the inspector general of police and the commissioner of police in Kochi, a major city in Kerala. He was designated as a special officer for COVID-19 to the Kasaragod district. He has served as an Indian Police Service officer since 1996.