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INFECTIOUS DISEASES AND MICROBIOLOGY

PANDEMICS AND GLOBAL HEALTH

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INFECTIOUS DISEASES AND MICROBIOLOGY

PANDEMICS AND GLOBAL HEALTH

NITHA BALAN AND

MANUEL THOMAS EDITORS

Copyright © 2022 by Nova Science Publishers, Inc. DOI: https://doi.org/10.52305/ZHSY1605 All rights reserved. No part of this book may be reproduced, stored in a retrieval system or transmitted in any form or by any means: electronic, electrostatic, magnetic, tape, mechanical photocopying, recording or otherwise without the written permission of the Publisher. We have partnered with Copyright Clearance Center to make it easy for you to obtain permissions to reuse content from this publication. Simply navigate to this publication’s page on Nova’s website and locate the “Get Permission” button below the title description. This button is linked directly to the title’s permission page on copyright.com. Alternatively, you can visit copyright.com and search by title, ISBN, or ISSN. For further questions about using the service on copyright.com, please contact: Copyright Clearance Center Phone: +1-(978) 750-8400 Fax: +1-(978) 750-4470

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NOTICE TO THE READER The Publisher has taken reasonable care in the preparation of this book, but makes no expressed or implied warranty of any kind and assumes no responsibility for any errors or omissions. No liability is assumed for incidental or consequential damages in connection with or arising out of information contained in this book. The Publisher shall not be liable for any special, consequential, or exemplary damages resulting, in whole or in part, from the readers’ use of, or reliance upon, this material. Any parts of this book based on government reports are so indicated and copyright is claimed for those parts to the extent applicable to compilations of such works. Independent verification should be sought for any data, advice or recommendations contained in this book. In addition, no responsibility is assumed by the Publisher for any injury and/or damage to persons or property arising from any methods, products, instructions, ideas or otherwise contained in this publication. This publication is designed to provide accurate and authoritative information with regard to the subject matter covered herein. It is sold with the clear understanding that the Publisher is not engaged in rendering legal or any other professional services. If legal or any other expert assistance is required, the services of a competent person should be sought. FROM A DECLARATION OF PARTICIPANTS JOINTLY ADOPTED BY A COMMITTEE OF THE AMERICAN BAR ASSOCIATION AND A COMMITTEE OF PUBLISHERS. Additional color graphics may be available in the e-book version of this book.

Library of Congress Cataloging-in-Publication Data Names: Balan, Nitha, editor. | Thomas, Manuel (Research consultant), editor. Title: Pandemics and global health / Nitha Balan, PhD, Assistant Professor, Department of Microbiology, Sree Ayyappa College, Eramallikkara, Chengannur, Kerala, India, Manuel Thomas, PhD, Research Consultant, UniBiosys Biotech Research Labs, Kerala, India, editors. Description: New York : Nova Science Publishers, [2022] | Series: Infectious diseases and microbiology | Includes bibliographical references and index. | Identifiers: LCCN 2021050244 (print) | LCCN 2021050245 (ebook) | ISBN 9781685072285 (hardcover) | ISBN 9781685072612 (adobe pdf) Subjects: LCSH: Epidemics--History. | Communicable diseases--History. | World health--Diseases--History. Classification: LCC RA649 .P363 2022 (print) | LCC RA649 (ebook) | DDC 614.4--dc23/eng/20211013 LC record available at https://lccn.loc.gov/2021050244 LC ebook record available at https://lccn.loc.gov/2021050245

Published by Nova Science Publishers, Inc. † New York

Contents

Preface

........................................................................................ ix

Chapter 1

Pandemics and Global Health in the 21st Century ......................................................... 1 Nitha Balan and Manuel Thomas

Chapter 2

Epidemics and Pandemics: The Kerala Model ........ 11 Rogimon P. Thomas, Sreeja Raj, V. Vinod and Kannan V. Manian

Chapter 3

Human Diaspora and Pandemics: A Review in the Context of COVID-19 ..................... 31 Shaibu Jacob, P. S. Ajith, M. B. Arya, David Abin, Rogimon P. Thomas and Joby Paul

Chapter 4

The Role of Vaccines in Public Health ...................... 73 Ann Susan Mathew, Shelmi Antony and Jayesh Antony

Chapter 5

A Review on COVID-19 Vaccines ........................... 107 Lakshmi Bhaskaran

Chapter 6

Vaccination and Public Health ................................ 119 Geena George and Hema Vijayan

Chapter 7

Pandemics: A Travel through Historic Times ........ 127 C. Mamatha

vi

Contents

Chapter 8

Tumultuous Epidemics in India: A Historic Overview.................................................. 143 Nisha Pallath

Chapter 9

Rise of Microbes and Pandemics in Shaping Human Civilization ................................................... 157 M. Hayarnnisa, Ann Mary Jacob and S. M. Merlin

Chapter 10

COVID-19 Pandemic: A Boon or Bane for Nature ...................................... 169 Asha Ramachandran

Chapter 11

Mental Health Issues in COVID-19 ......................... 181 Hridya Vijay and Nitha Balan

Chapter 12

The Impact of COVID-19 on Youngsters ............... 195 Joby Jose and Shaiju K. Sebastian

Chapter 13

The Pandemic and Its Impacts with a Special Focus on COVID-19 Situation in India ................... 207 Prem Jose Vazhacharickal, Jiby John Mathew and N. K. Sajeshkumar

Chapter 14

The Pandemic AIDS.................................................. 243 Tharakupeedikayil Abdul Majeed Sajeena

Chapter 15

The Plague Pandemic................................................ 259 Thushara Balakrishnan

Chapter 16

Future Pandemics: Agents, Potential and Impacts ................................. 287 Sunaina Valappay Cheenatukandy

Chapter 17

SARS-CoV-2 and Diabetics ...................................... 313 Sweety Gopinath

Chapter 18

Pandemics and Ethnomedicine ................................ 327 Tojo Jose and Sebastian Antony

Contents

vii

Chapter 19

Identification of Active Plant Constituents to Inhibit SARS-CoV-2 by Molecular Docking Studies: A Comprehensive Review ........... 341 M. Deepak, C. T. Sulaiman, Indira Balachandran and Subhash Chandran K. Parameswaran

Chapter 20

Pandemics in European Literature: A Review ....... 353 Temina Cyriac

Chapter 21

Impact of COVID-19 and Lockdown on India’s Foreign Trade.......................................... 367 Jinu Joseph

About the Editors ................................................................................ 377 Index

..................................................................................... 379

PREFACE Knowledge of public health and pandemics is pivotal, as the emergence, re-emergence, and outbreak of diseases have plagued mankind from time immemorial. The past few decades have witnessed a deluge of infectious diseases, many of which involve novel pathogens with umimaginable morbidity and mortality. Furthermore, knowledge of public health equips the public with well articulated opinions regarding crucial health issues that appear daily in the media. The COVID-19 pandemic in particular imperils the public health arena globally. This book, Pandemics and Global Health, portrays the history of pandemics, the current realm and future outlooks. Nitha Balan MSc., PhD Manuel Thomas MSc., PhD

In: Pandemics and Global Health ISBN: 978-1-68507-228-5 Editors: N. Balan and M. Thomas © 2022 Nova Science Publishers, Inc.

Chapter 1

PANDEMICS AND GLOBAL HEALTH IN THE 21ST CENTURY Nitha Balan1, PhD and Manuel Thomas2, PhD 1

Department of Microbiology, Sree Ayyappa College Eramallikkara, Chengannur, Kerala, India 2 UniBiosys Biotech Research Labs, South Kalamassery, Kochi, Kerala, India

ABSTRACT Pandemics are disease outbreaks which affect several countries and can cause major health, social and economic risks. In March 2020 World Health Organization declared Covid-19 as a pandemic, which has become a Public Health Emergency of International Concern (PHEIC). The disease has spread throughout the world mainly due to the inadequate preparedness for the global health security. Increased population mobility, rapid urbanization, climate change, weak surveillance and limited laboratory diagnostic capacity and increased human-animal interaction are also contributed to the emergence and rapid spread of pandemics which also exposed the pitfalls in the current 

Corresponding Author’s Email: [email protected].

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Nitha Balan and Manuel Thomas public health global caricature. COVID 19 pandemic revelaed the clear picture of the failure of our global helath infrastructure.The diseases demonastrates that helath security is a collective response which need adequate technical capacity, improve current global security we need a proper authority, responsiveness, expertise, evaluation, finacing etc. The currenr pandemic situation opens an opportunity to combine knowledge and skills together to rejuvenate global public health system.

Keywords: pandemics, global health, epidemics, outbreaks, public health

INTRODUCTION Disease outbreaks and associated drastic aftermaths have wreaked havoc since the beginning of mankind. Throughout the history, poverty, inequality and social determinants of health paves the way for the transmission of infectious diseases and existing health disparities or inequalities can further contribute to unequal burdens of morbidity and mortality irrespective of geographic region (Quinn and Kumar, 2014). The past few decades have witnessed rapid emergence of infectious diseases, creating a serious threat to global public health where Severe Acute Respiratory Syndrome (SARS), Middle East Respiratory Syndrome (MERS) Human Influenza A (H5N1), Pandemic Influenza A (H1N1), Ebola virus and Hanta virus are the major agents (Oswalia and Vasdev 2021). It should be noted that the human and economic toll of these and future agents are quite uncertain and unimaginable and thus a reinforcement of global public health system are pivotal for a better future.

REASONS BEHIND EMERGENCE AND REEMERGENCE OF INFECTIOUS DISEASES An emerging infectious disease (EID) is one that has appeared and affected a population for the first time, or has existed previously but is rapidly increasing, either in terms of the number of new cases within a

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population, or its spread to new geographical areas (WHO, 2005). The reappearance of a previously known infection after a period of disappearance or decline in incidence is known as re-emergence (Ranga et al., 1997). The major predisposing factors in the emergence and reemergence of diseases are human, environmental, ecological and pathogen factors which play a vital role in perpetuating novel emerging pathogens. Moreover, changes in vector populations, human association with reservoir hosts and appearance of new pathogen variants with high potential in transmission are also considered as keyfactors. According to Bedford, et al., (2019) emergence of epidemics will become more tragic, frequent, complex, harder to prevent and contain rapidly changing ecology, urbanization, climate change, increased travel and fragile public health systems prevailing in lion-part of the countries. Microorganisms are talented in infecting and causing diseases among humans facing a significant and concerted threat to public health from time immemorial. These threats are amplified due to an array of factors like climate change, increased international travel, immune host response, changes in vector population etc. Constant mutation and adaptation make the microbial world drug resistant which results in many disease outbreaks. The past few decades have witnessed an overwhelming increase in the incidence of endemic diseases, epidemics, and pandemics.

ENDEMIC (GREEK EN MEANING IN AND DEMOS MEANING PEOPLE) Endemic diseases are diseases present permanently in a region or population. Generally, it is used to describe a disease that is present at an approximately constant level within a society or country. Each country may have a disease that is unique like Caribbean Dengue in Caribbean region (Brandling-Bennett and Penheiro, 1996) and Kyasanur Forest disease (KFD) in Karnataka, India (Murhekar et al., 2015).

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EPIDEMIC (GREEK EPI MEANING UPON OR ABOVE AND DEMOS MEANING PEOPLE) Epidemic disease is an outbreak that affects many people at one time and can spread through one or several communities within a short span of time. When the term epidemic is used in connection with infectious diseases it is due to the sudden rise of cases usually resulting from a new infectious agent or an existing agent with mutation or expansion of geographic range (Chakrabort, 2015). The term epidemic is similar to outbreak but is commonly used to describe an unusual frequency of illness in a group of people that is not explained by expected seasonal increases (TELL ME, 2014). On the other hand, epidemics can follow predictable patterns and these trends among population.

PANDEMIC (GREEK PAN MEANING ALL AND DEMOS MEANING PEOPLE) A pandemic occur when a new infectious agent, or a reemerging one, spreads across multiple continents, or even worldwide. According to the classical epidemiological definition, a pandemic is defined as “an epidemic occurring worldwide, or over a very wide area, crossing international boundaries and usually affecting a large number of people” (Last, 2001). Significant features of a pandemic are given below:     

Affects a wider geographical area, often global Infects a very large number of people Often caused by a new pathogen or a new strain of a pathogen that has been dormant for many years Spreads quickly in humans as there is little to no existing immunity Can cause a high number of deaths

Pandemics and Global Health in the 21st Century 

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Because of the need to control the spread of the disease, there is often social perturbation, tempestuousness, anarchy, and crippling impact on economy

STAGES OF A PANDEMIC WHO has acknowledged six phases that should be followed before declaring a disease as pandemic (WHO 2009). Phase 1 represents a low risk and phase 6 is a full-blown pandemic:   

  

Phase 1 - a virus is seen in animals but has not been shown to infections in humans Phase 2 - a known animal virus has caused an infection in humans Phase 3 - scattered or isolated incidence of cases or small clusters of the disease occurring in humans; possible cases of human-tohuman transmission but not at a level to cause community-level outbreaks Phase 4 - human to human transmission at a rate that causes an outbreak in communities Phase 5 - the spread of the disease between humans is now evident in more than one country Phase 6 - community-level outbreaks are in at least one additional country other than that seen in phase 5

Once Phase 6 is reached preparation should be made for a global pandemic. Each phase has an array of actions needed to be followed to facilitate transparency and awareness among public health professionals and general public.

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PANDEMICS AND GLOBAL HEALTH The global history of emerging or re-emerging infectious disease pandemics has proclaimed that they have appeared every decade but now, the frequency between epidemics/pandemics are alarmingly shorter as evident with Severe Acute Respiratory Syndrome (SARS) in 2003, Influenza A H1N5 (bird flu) in 2007, H1N1 (swine flu) in 2009, Middle East Respiratory Syndrome (MERS) in 2012 and Ebola in 2014 and the most recent member COVID 19 (Jones et al., 2008; FAO, 2020). Lion part of the developing countries has difficulties in improving public health systems at par with developed countries. Gostin and Friedman (2015) have suggested a new global health framework with vigorous and dynamic national health systems as its cornerstone and a sceptered WHO at its vertex. The establishment of UN Mission for Emergency Ebola Response (UNMEER) in 2014 is the first UN mission to respond to public health emergencies (Ebola Response, 2021). The global health architecture is increasingly under deep strain, largely due to recent, ongoing, and potential global health crises like the COVID 19. The Ebola crisis has revealed serious flaws in the capability of the national and international system to prevent and respond to these junctures. It should be noted that the health, development, and security challenges are tightly interwoven nexus and thus a multilateral system anchored in the United Nations will address these issues without any discrepancy among fellow members.

CLIMATE CHANGE AND DISEASE EMERGENCE Climate is considered as an epitope of health and any climate constrains has resulted in shifts in pattern, range and intensity of infectious diseases, while weather affects the timing and power of outbreaks. Epstein et al., (1998) reported that longterm warming trend boosts geographic expansion of several diseases, while extreme weather events are engendering ‘clusters’ of disease outbreaks. A warming and

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unstable climate paves the way for global emergence, resurgence and redistribution of infectious agents with epidemic proportions (Leaf, 1989). The emergence and re-emergence of neglected tropical diseases are expected in several countries where the lives of millions of people especially in developing countries will be at risk. El-Sayed and Kamel (2020) amalgamated the role of climate change in the spread of infectious agents and their vectors including viral, bacterial and parasitic diseases. Nava et al., (2017) noted that environmental changes have a deluge of impact on the emergence and reemergence of infectious diseases, mostly in countries with high biodiversity and severe dissonant socio-economic and environmental issues.

CONCLUSION Recent COVID 19 pandemic portrayed the hindrances in institutional silos for sound and holistic policymaking, smooth implementation, and operational capacity among national and international public health arena. The national and international developments in managing the pandemic clearly depicted an international system that is insufficiently prepared for an outbreak and reacts sluggishly to an outbreak which steps up to a global health security threat. From the beginning of mankind itself episodes of ailments outraged mankind and COVID 19 is a recent member. Thus, mounting an effective and rapid response mechanism to pandemics is the need of the hour to leapfrog not only local and national efforts but also international cooperation which embodies global solidarity and collective responsibility for forbidding and combating pandemic disease threats.

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REFERENCES Bedford, J., Farrar, J., Ihekweazu, C. Kang, G., Koopmans, M. and Nkengasong, J. (2019). A new twenty-first century science for effective epidemic response. Nature 575:130-136. Brandling-Bennett, A. D., Penheiro, F. (1996). Infectious diseases in Latin America and the Caribbean: are they really emerging and increasing? Emerging infectious diseases. 2(1):59. Chakrabort, R. (2015). Epidemics. Encyclopedia of Global Bioethics. doi 10.1007/978-3-319-05544-2_174-3. Ebola Response. (2021). UN Mission for Ebola Emergency Response (UNMEER). https://ebolaresponse.un.org/un-mission-ebola-emergen cy-response-unmeer. (Accessed on 27.06.2021). El-Sayed, A. and Kamel. (2020). Climatic changes and their role in emergence and re-emergence of diseases. Environmental Science and Pollution Research. 28:1-17. Epstein, P. R., Diaz, H. F., Elias, S., Grabherr, G., Graham, N. E., Martens, W. J. M., Mosley-Thompson, E. and Susskind E. J. (1998). Biological and physical signs of climate change: focus on mosquitoborne disease. Bull. Am. Meteorol. Soc. 78:409-417. FAO. (2020). Global emergence of infectious diseases: links with wild meat consumption, ecosystem disruption, habitat degradation and biodiversity loss. Rome. https://doi.org/10.4060/ca9456en. (Accessed on 27.06.2021). Gostin, L. O., Friedman, E. A. (2015). A retrospective and prospective analysis of the West African Ebola virus disease epidemic: robust national health systems at the foundation and an empowerd WHO at the apex. Lancet. 385:1902-1909. Jones, K. E., Patel, N. G., Levy, M. A., Storeygard, A., Balk, D., Gittleman, J. L. and Daszak, (2008). Global Trends in Emerging Infectious Diseases. Nature. 451(7181):990-3. Last, J. M. (2001). A dictionary of epidemiology. Oxford University Press, Inc., New York, New York.

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Leaf, A. 1989. Potential health effects of global climate and environmental changes. N. Engl. J. Med. 321:1577-1583. Murhekar, M. V., Kasabi, G. S., Mehendale, S. M., Mourya, D. T., Yadav, P. D. and Tandale, B. V. (2015). On the transmission pattern of Kyasanur Forest disease (KFD) in India. Infectious Diseases of Poverty. 4:37. Nava, A., Shimabukuro, J. S., Chmura, A. A., Luz, S. L. B. (2017). The Impact of Global Environmental Changes on Infectious Disease Emergence with a Focus on Risks for Brazil. ILAR Journal. 58(3):393-400. Oswalia J. and Vasdev K. (2021). Emerging and re-emerging infectious diseases - Past, present and beyond. MOJ Biol. Med. 6(1):5-8. Quinn, S. C. and Kumar, S. (2014). Health inequalities and infectious disease epidemics: A challenge for global health security. Biosecurity and Bioterrorism: Biodefense Strategy, Practice and Science. 12(5):263-273. Ranga.S., Trivedi.N., Khuranan, S. K., Thergaonkar, A., Talib, V. H. (1997). Emerging and reemerging infections. Indain Journal of Pathology & Microbiology,40(4): 569-81. TELL ME. (2014). Transparent communication in Epidemics: Learning Lessons from experience, delivering effective Messages, providing Evidence. https://www. tellmeproject.eu/sites/default/files/Dossier% 201%20-%20Epidemics%20and%20pand emics%20%20General%20 guidelines.pdf. (Accessed on 27.06.2021). Walton, J., Beeson, P. B., Scott, R. B. (Eds.). (1986). Epidemic. The Oxford companion to medicine, 1, A-M, 351. Oxford: Oxford University Press. World Health Organization, Regional Office for South-East Asia. Combating Emerging Infectious Diseases in the South-East Asia Region. New Delhi: WHO-SEARO; 2005. World Health Organization. (2009). Pandemic influenza preparedness and response: a WHO guidance document. Geneva: World Health Organization. 2009.

In: Pandemics and Global Health ISBN: 978-1-68507-228-5 Editors: N. Balan and M. Thomas © 2022 Nova Science Publishers, Inc.

Chapter 2

EPIDEMICS AND PANDEMICS: THE KERALA MODEL Rogimon P. Thomas1,, PhD, Sreeja Raj2, V. Vinod3, PhD and Kannan V. Manian4, PhD 1

Department of Botany, CMS College Kottayam (Autonomous), Kerala, India 2 Department of Biotechnology, St. Berchmans College (Autonomous), Changanacherry, Kerala, India 3 College of Medicine, University of Florida, Gainesville, Florida, USA 4 University of Rochester Medical Centre, Rochester, New York, USA

ABSTRACT Infectious diseases are always keyed out by either epidemic or a pandemic. These are the words used for describing a disease outbreak. But, an epidemic and a pandemic describe different stages of disease in society. An epidemic is a disease outbreak that affects many individuals 

Corresponding Author’s Email: [email protected].

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Rogimon P. Thomas, Sreeja Raj, V. Vinod et al. in an area, or a population and will affect many people concurrently and spread across different communities within a short period. Epidemic involves not only infectious diseases but all that deteriorates the health of a society and can follow predictable patterns and these trends are often used to monitor, predict, and control the spread of the infection. A pandemic is an epidemic that moves across the borders of different nations. Pandemic affects the wider geographical area and affects people around the world. The causative agent, probably a virus might infect people, spread faster among communities, and may result in a huge global death toll. The world since December 2019 is in the grips of the Covid-19 virus. In this paper, an attempt has been made to pinpoint and highlight the efforts made by the state of Kerala in tackling the pandemic of all times, Covid 19.

Keywords: COVID-19, epidemic, pandemic, Kerala

PANDEMICS AND EPIDEMICS: AN INTRODUCTION Pandemics have always shaped civilizations. An epidemic becomes a pandemic when it moves across the boundaries of a place or a country (Physiopedia, 2020). Starting from the smallpox epidemic, moving through plague, SARS, Ebola, Zika and finally Covid-19 outbreaks, man has always been fighting with the microorganisms. Each epidemic helps mankind redefine the limits of technologies and medical science and develop novel methods of immunisation and treatment strategies. More and more pandemics keep evolving along with the changing lives of human lives. Smallpox and the Spanish Flu had the most Global death tolls. Each time a pandemic outbreak occurs; mankind finds a way to beat the causative organism. Though a pandemic is always disheartening, it brings the world together to fight. Today we have invented vaccines for Covid-19 infections, but still, the battle of mankind and the microbial world will continue forever. This chapter portrays the efficient strategies adopted by the state of Kerala that drew the appreciation of the global community.

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COVID-19 VIRUS: ORIGIN AND CHARACTERISTICS COVID-19 was declared a 'Public Health Emergency of International Concern' by World Health Organization on 30th January 2020 (WHO, 2020). The novel coronavirus infection was first reported in China's Wuhan, the capital city of Hubei Province in the People’s Republic of China on 31st December 2019. After that, the disease started to spread across the globe. Though the government took measures to contain the spread, the disease became a pandemic. The causative agent of this novel coronavirus infection is SARSCov2 (Severe Acute Respiratory Syndrome-Corona virus 2) of genus beta-corona virus. It is characterized as a mild to severe respiratory droplet infection, transmitted chiefly by contact with infectious material (such as respiratory droplets, or with objects or surfaces contaminated by the causative virus). The droplets from the respiratory tract of an infected individual are transmitted onto a mucosal surface (e.g., mouth, nose) or conjunctiva of a susceptible person, or transmitted onto environmental surfaces (Aarathi et al., 2020). The disease spread through person to person transmission. The major symptoms of the disease include severe fever, shortness of breath, cough, sore throat, loss of taste and smell, nausea, vomiting and diarrhoea (Cascellaet al., 2020). The median incubation period was estimated to be 5.1 days (95% CI, 4.5 to 5.8 days), and 97.5% of those who develop symptoms will do so within 11.5 days (CI, 8.2 to 15.6 days) of infection (Huang et al., 2019). The transmission of COVID-19 occurs in four phases, namely first appearance through travellers who tested positive, then local spread, followed by community spread and finally, widespread outbreak of a pandemic (Upadhyay, 2020). Since the first occurrence of COVID-19 outside China in Thailand on 13th January 2020, even nations with effective health care systems and elaborate health care administration like the UK and the USA have quickly slipped from the stage of local spread to community transmission. Analysis of data from many countries shows extremely rapid escalation from the second stage of transmission to the third, often within weeks (Choolayil et al., 2021).

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KERALA: DEMOGRAPHY AND LOCAL SETTING Kerala, God's own country, the land of coconut and spices, is the thirteenth largest state in India in terms of population has 33,387,677 inhabitants as per the 2011 census (Ministry of Home Affairs, 2011; MoHFW, 2017). Simply Population density, affluent non-resident Keralites and thriving tourism all raise the risk for an outbreak in Kerala (Sulaiman et al., 2020). Kerala's airports cater to the travel needs of millions of passengers annually, in and around the world. The situation was crucial for Kerala as it is a small state with a dense population. It homes 35 million people makes it 819 people per square kilometre, eight most densely states in India. Kerala is known for its social development indicators like infant mortality rate, literacy rates, sex ratio and human development indices even though it is having a low per capita income. International travelling is a part of Kerala culture, which is connected to the rest of the world through four airports that serve around 17 million passengers annually.

EPIDEMICS IN KERALA Back in the 1800s appeared one of the most alarming epidemics in Kerala history, Cholera. The then ruler of Travancore, Maharani GouriParvathyBayi started preparing for containment of the disease right when it started wreaking havoc in Bengal in the year 1819. Maharani had managed to distribute preventive medicines among the statesmen before the epidemic came to Kerala. Along with Cholera, the people of Kerala were also fighting Malaria and Smallpox during those days. The rulers of Travancore realized that local treatment methods were ineffective against the combined effects caused by the three epidemics. They then started offering allopathic treatment to the people along with local methods. During Kerala's fight with the Coronavirus, a shigella virus outbreak was reported in Kozhikode district in the third week of December 2020.

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Shigellosis, or more commonly referred to simply as a shigella infection, is an acute invasive enteric infection caused by bacteria belonging to the genus Shigella. It is “clinically manifested by diarrhoea that is frequently bloody,” according to the World Health Organization (WHO). The state had managed to contain the disease even though it created panic among the people.

NIPAH OUTBREAKS: A LEARNING EXPERIENCE TO KERALA Kerala survived two Nipah virus outbreaks in the recent past which gave Kerala an upper hand in tackling the situation. The first reports came from the district Kozhikode, of a person with symptoms of encephalitis. Nipah virus infection (NiV), which belongs to Henipavirus, is a pathogenic zoonotic disease. (WHO, 2018). The natural reservoirs of the virus are fruit bats of the genus Pteropus, and the virus has been isolated from bat urine and partially eaten fruits in Malaysia (Chua et al., 2002). Some patients present with acute respiratory distress syndrome and mortality ranges from 40% to 70%. Eighteen cases were confirmed from the districts of Kozhikode and Malappuram. The disease had a high mortality rate and spreads through person-to-person contact. Two outbreaks of the Nipah Virus gave the state a learning experience.It managed to train people to manage an immediate crisis, identify and mitigate threat situations. The skills of tracing and tracking, supportive management of highly infective critical patients, analysis of data to determine how the epidemic is progressing, prevention of healthcare-associated infections, psychosocial support to persons who are under quarantine or on treatment, working with media to avoid panic, and managing misinformation campaigns were picked up by the system during the first outbreak and rehearsed during the second. The results of the hard works of the health care system made people trust them. The ample experience during the Nipah times equipped the authorities to

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manage the first wave of COVID-19 effectively (Sadanandan, 2020). Early identification, isolation of suspected people and laboratory confirmations helped the healthcare system in containing the outbreak.

NOVEL CORONAVIRUS IN KERALA In India, Kerala was the first state affected by Covid-19, and the first coronavirus case was confirmed in the Thrissur district on 30th January 2020 (Jayesh et al., 2020). Two students who returned from China were identified infected. All those infected people recovered and were tested negative by 20th February 2020. Kerala successfully managed to treat the infected efficiently. Six new cases were reported in Kerala by the beginning of March 2020. This became the second wave of Covid-19 infections in Kerala. By the second wave, the number of infections in Kerala began to rise as the authorities expected. The state had already prepared for addressing the situation.

HOW DID KERALA TACKLE THE PANDEMIC? Kerala Government strategized various measures to be adopted including the operating procedures for aggressive testing, contact tracing, quarantining and treatments.

Close Monitoring and Screening Kerala anticipated the threat because of the Keralites living across the world that keeps travelling in and around. Kerala started its preparations when the disease was reported in China and Southeast Asia. A strict system was enforced for close monitoring and screening of people coming into the state by all means from abroad and within India.

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Early Diagnosis of Passengers from Abroad Kerala has around 2.4 million of its people living as emigrants in different countries, especially in Middle Eastern Countries (Economic Review, 2016). Most of the Covid-19 cases reported in Kerala were among those returned from abroad and other states, and the rest were through person-to-person transmission. People coming from abroad were screened for Covid-19 symptoms at the airports as a preliminary step. Those with symptoms were immediately shifted to Covid-19 specialised hospitals for proper treatment. Asymptomatic passengers were advised to remain on home quarantine and avoid travelling until the period of quarantine ends. They were strictly monitored through phone calls. In case they needed immediate attention; they were shifted to appropriate treatment centres, tested for infection and treated if found positive. A ‘sanitised corridor’ protocol was followed for the travellers arriving at the portal of entry to their concerned quarantine destinations with special double-chambered taxis. People found with symptoms were identified and moved to Covid-19 speciality hospitals for further treatment. They were also tested for infection and observed until they are free from the symptoms. The government created a portal call “Covid-19 Jagratha,” a comprehensive solution for real-time surveillance, care and support for people affected/quarantined by Covid-19. Covid-19 Jagratha portal provides all services for the public in case of emergency and provides information related to Covid-19 in a streamlined manner.

Screening at State Borders Once the nationwide lockdown was revoked and cross border movement was initiated, natives of Kerala those who were stranded across the country were asked to register in the Covid-19 Jagratha portal to obtain travel passes. Multiple screening teams were deployed along the state borders to monitor the entry of people. Each team comprised of a

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senior police official, a paramedical staff and a local volunteer. Every vehicle was monitored, details of passengers were collected and their body temperatures were recorded. This was also done at railway stations and airports (Times of India, 2020).

Quarantine System and Testing Along with the world, Kerala started practising social distancing, quarantine, and self-isolation. According to CDC, social distancing also called physical distancing meaning to keep space between yourself and other people outside of your home (at least two metres). Quarantine ensures strict isolation of infected and people suspected of symptoms. Isolation is effectively done either by self-isolation at home or Government authorised Quarantine centres (CDC, 2020).

Sentinel Surveillance Sentinel surveillance is the monitoring of the rate of occurrence of a disease in a population in collaboration with doctors, laboratories, public health departments etc. A sentinel surveillance system was instituted in Kerala. The population was stratified into 5 categories: Group 1 – Patients in the general population with Acute Respiratory Infection (ARI) but NOT a COVID suspect. Group 2 – Health Care Workers in Non-COVID settings Group 3 – Persons with high social exposure: These persons were further categorized into the following; Food delivery persons, Community Volunteers for COVID, police personnel in enforcement of lockdown, provisions shop vendors ration shop, wholesale fruits or vegetable vendors. Group 4 – Category A COVID -19 Suspects: These categories of persons are those COVID suspects having sore throat or cough or rhinitis

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or diarrhoea and do not require testing unless there is a change in their category. Group 5 – Guest workers: Generally, are those persons from other states who have come to Kerala for labour (Department of Health & Family Welfare, Government of Kerala). Sentinel surveillance included random testing done in the community. It was done using RT-PCR (reverse transcriptase-polymerase chain reaction) test (GoK Dashboard, 2020). Kerala Police and other local bodies were entrusted with this duty.

Incessant Treatment Facilities for the Needy The Government of Kerala took extra efforts to provide treatment facilities to patients suffering from diseases other than Covid-19 infection, like haemophilia, thalassaemia and haemodialysis and so on. A triage system, a method of prioritizing patients' systematically according to how urgent they need care and treatment, was set up at all hospitals. Those patients showing symptoms of Covid-19 were isolated and tested.

Educating the Society The major challenge the government faced was to educate the general public about the epidemic and how to go through it. The government launched a campaign called “Break the Chain” to practice social distancing and maintain personal hygiene to limit the spread of the disease to the community level. All the institutions, ATMs, buses etc were asked to maintain sanitary precautions. People were encouraged to use sanitisers, wash their hands frequently to stop the spread of the virus. The Government of Kerala implemented a lockdown even before the Central government announced the nationwide lockdown. Public gatherings including religious and non-religious gatherings were banned.

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All schools and colleges except for medical colleges were closed. All festival gatherings were banned. Movie theatres and shopping malls were closed down. Only those shops selling essential items were allowed to open within the prescribed time duration, the rest of them were kept closed. All government functions were postponed. All inter-state, interdistrict, international travel was stopped (Anilkumar, 2020). People were compulsorily asked to wear face masks and avoid travel unless otherwise, it is an emergency. Inter-district travel was restricted. Emergency travel was allowed only with authorised travel passes from authorities. All the educational institutions were asked to remain closed. Offices were asked to work with minimal staff and work from home was encouraged wherever possible. The public transport system was stopped across the state.

Print, Visual and Social Media Campaigns The print, visual and social media played a pivotal role in dispersing the messages, instructions, releasing route maps of Covid-19 cases among common people. Relevant and accurate information was shared by the authorities through media to reach the public. Messages regarding the spread and prevention were made caller tune by the Telecom companies so that we would hear a message while we make a call. The Government of Kerala published many training videos for health workers on YouTube and also to promote public awareness about handwashing techniques, social distancing norms, home quarantine etc. The Kerala police also played a crucial role in campaigns and awareness by making and socialising awareness videos to circulate the message “Stay home” via the "Break the chain" campaign. Videos in languages other than Malayalam were also made to provide awareness messages among the guest workers. The government also took measures to counteract the spread of false information.

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Managing Guest Workers Kerala houses about 2.5 million migrant labourers from other states of India. They are officially designated as Guest workers. Several labour camps were set to accommodate all the guest workers of the state. Camps were set up by the Kerala government to accommodate more than 3.5 lakh guest workers. Guards with multilingual knowledge were posted in labour camps for effective communication with migrant labourers. Committees were constituted to take note and address the grievances and make necessary arrangements for all basic amenities and food in collaboration with CSR (Corporate Social Responsibility), LSG (Local Self Government) and other Non-Governmental Organisations. The camps were provided with all basic amenities and recreation facilities. As the guest workers disliked the traditional Kerala food provided by ‘Kudumbashree’, the desired choice of food like chapati, pickle, North Indian Dal curry and Khichdi was provided along with milk supply daily (Economic Times, 2020). A helpline number was also created to address the grievances of the guest workers. Awareness messages in all languages were given to the guest workers to ensure their safety. Timely checking was done to monitor the health of the people by the healthcare workers in collaboration with the labour department. Tele-counselling services were arranged for highly stressed workers by counsellors from TISS (Tata Institute of Social Sciences) (Official Website of Kerala Police, 2020).

INFRASTRUCTURES ENGAGED IN SUPPORTING THE HEALTHCARE SYSTEM COVID Specialised Treatment Centres The State Government had converted most of the government hospitals into Covid hospitals. There were 28 hospitals exclusively dedicated for the treatment of Covid- 19 patients. Hospitals were advised

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to postpone all surgeries unless otherwise they are of utmost importance and people were asked to visit hospitals only in emergencies. Covid-19 isolation wards were separated so that there will be no contact between those infected and the general public. Covid First-Line Treatment Centres were set up to manage the outbreak regionally. All mild and moderate cases are treated in these centres and severe cases are referred to Covid hospitals (Health & Family Welfare Dept., 2020). Covid-care centres were also established to provide a home for people who do not have facilities for quarantine at home. These centres were provided with ample security and all basic amenities.

Disha and Norka District Intervention System for Health Awareness or DISHA is a 24x7 helpline number launched in 2013 under the National Health Mission and Government of Kerala. The 16-member team is called in during crises. They had been actively involved in the outreach work of the recent floods in Kerala, the Nipah outbreak, the Ockhi cyclone and so on ("DISHA," 2013). Disha team played a crucial role in managing distress calls from the people. They managed to provide 24x7 psychosocial support to the people in need. The team also had doctors who were available to answer the queries of the people. Department of Non-Resident Keralites Affairs (NORKA), the division managing the affairs of Keralites staying outside the state, has been in the process of bringing expatriates back with priority given to pregnant women, people who need medical assistance, the elderly and people with an expired visa. Over 3 lakh non-resident Keralites have registered on Norka so far (Mathrubhumi, 2020).

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MANPOWER SUPPORT SYSTEM INVOLVED Kerala Police The lockdown, containment, and surveillance actions imposed by Kerala Police were noteworthy. To monitor lockdown enforcement, drones and exclusive women police bullet patrol teams have been deployed. Active monitoring was enforced at railway stations and airports. To confine the movement of the general public, a geo-fencing app was set up and checkpoints were set up along with mobile and foot patrolling. Interstate and inter-district borders were sealed off. Police were accountable for supplying essential travel passes through an online pass system. Kerala Police developed a "Road Vigil app for monitoring the movement of vehicles during lockdown period (Official Website of Kerala Police, 2020).

Asha Workers and Kudumbashree Accredited Social Health Activists (ASHAs), who are community health volunteers, approximate one for every 1000 to1500 population (Menon et al., 2020). ASHA workers were entrusted with the duty of informing if anyone violated the quarantine regulations. They, along with the health workers, conducted regular household surveys. Also, they were entrusted with communicating information to the public. ‘Kudumbashree’ units are part of women empowerment programmes of the Government of Kerala. The programme was launched in the year 1997. ‘Kudumbashree units’ in Kerala, a women self-help group under the leadership of Local Self Government, is one of the largest women empowering projects in the country. They were involved in the production of safety equipment, cook and provide food for the needy, serve the elderly and other needy persons. Community Kitchen initiative is regarded as one of the notable services rendered by Kudumbashree units.

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Volunteering Services People with experience in relief operations during the flood and other crises joined hands even during the covid-19 emergency. Volunteers were catered with proper directions through registered apps and videos (GoK Dashboard, 2020). They were involved in supplying food, medicines, groceries and also assisting people in need.

PRESENT SCENARIO OF THE STATE During the early stages, the state had received international acclaim in controlling the virus. The number of infections began to rise in July and reached a peak almost by October. Despite the hard work, the state reported the highest number of cases in India with a high-test positivity rate during February 2021. As the test positivity rate keeps vacillating, the Government have decided to ramp up the testing through Government laboratories to achieve 1 lakh Covid-19 tests per day, in which 75,000 tests should be RT PCR (GoK, Heath & Family Welfare (F) Department, 2021). Infection transmissions occurred mainly through the intermingling of people. To slow down the rate of transmission, the Government had initiated a “Back to the Basics” campaign in response to the current context of the upward trend of positive cases. The campaign entails strategies for the prevention and control of Covid-19 in a renewed manner. The campaign aims to revive and adhere to all the Covid-19 prevention measures laid down by the Government. The ‘OttakallaOppamundu’ is a program launched by the government for providing Psychosocial support to the people in quarantine, isolation, school children and other categories of the population as well as to the community in general. The test positivity rate in the state is 10.6 per cent as of 1st February 2021 (Weekly Bulletin, 2021). The rate has dropped to 3.05 per cent by the second week of March 2021. This reduction is achieved by the diligent efforts of the Government, including the increase in testing those suspected with symptoms.

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The Government of India almost completed the mission of Vaccination drive across India for its 3 crore Health workers and Frontline workers starting from 16th January 2021. The next set of people in queue is the 27-crore people who are of age above 50 and those below 50 years of age and co-morbidities. Covishield from Serum Institute of India which is based on the Oxford AstraZeneca vaccine and Covaxin by Bharat Biotech is being administered to the people (The Hindu, 2021). The Government of Kerala constituted the State Steering Committee, State task Force, District Task Force and Block Task Force for policy initiatives and coordination and implementation of COVID-19 vaccine introduction (GoK, HFW, 2021). The State began its second phase of COVID-19 vaccination on 1st March 2021. The Health Department has communicated that those aged 60 years and above and others aged between 45 and 59 years with co-morbidities can register during this phase. Private hospitals are also included in administering the Covid vaccine to the General Public. Those who are eligible for the vaccination in this phase can register themselves on the government's portal, Co-WIN (a digital platform that was formed for real-time monitoring of COVID19 vaccine delivery) for the same (Times Now news, 2021). In Kerala, around 300 private hospitals have been identified for the second phase. These hospitals can charge up to Rs 250 for a single dose. Government authorisedcentres will provide the vaccine to the public free of cost.

CONCLUSION Kerala is like any other state and has nothing extraordinary. The state has managed and coordinated all the available facilities to tackle the situation. Kerala's efficient health care system, the Police, the Local selfGovernment bodies, NGOs, self-help groups and voluntary workers, all joined hands for the state to fight the Covid-19 virus. Also, the learning experience from the past floods and Nipah outbreak aided the state in managing the scenario. Till the beginning of the second wave, Kerala was successful in containing the disease. But at a later stage, the authorities

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and the public were less vigilant of the preventive measures, and it resulted in the heightening of Covid cases. The present situation in Kerala has implications for the nation at large. Hence it is the nation’s responsibility, not just of the state, to launch all possible measures in controlling the COVID- 19 situations in Kerala. The Union health ministry and other relevant ministries must back up the Kerala government in a big way to bring down the number of cases. The state requires re-defining its past strategies and scheming and fashioning new plans and strategies to go back to normal. Kerala has always maintained a position of leadership in the vaccine compliance list of the universal immunisationprogramme. Vaccination must be done in a priority-based manner such as; the maximum number of at-risk individuals, which includes health care workers, other front line workers, and individuals older than 50 and those below 50 years who have comorbidities. A collaborative effort of all the current strategies will show a decline in the number of COVID cases in a controllable manner.

REFERENCES Aiyappa, V (2020). ‘Kerala Police: A Model Policing Paradigm in Handling COVID-19’. One India. https://www.oneindia.com/india/ kerala-police-a-model-policing-paradigm-in-handling-covid-13075490.html (accessed January 2021). Ajayakumar, Aarathi., Mehar Shagufta, Ayesha., Joseph, Roselent (2020). COVID-19 management andcontrol: The Kerala story. Internship. Society For Community Health Awareness, Research And Action (Sochara), Bengaluru. Anilkumar (2020). Kerala Lockdown: Kerala to go under lockdown till March 31 | Thiruvananthapuram News-Times of India [WWW Document]. Times India. URL https://timesofindia.indiatimes.com/ city/thiruvananthapuram/kerala-to-go-under-lockdown-till-march31/articleshow/ 74778886.cms (accessed January 2021).

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Bisht, R. & Menon, S. (2020) 'ASHA Workers Are Indispensable. So Why Are They the Least of Our Concerns?'. The Wire. https:// thewire.in/rights/asha-workers-coronavirus(accessed January 2021). Cascella, M., Rajnik, M., Cuomo, A., Dulebohn, S.C., Di Napoli, R. (2020). Features, Evaluation and Treatment Coronavirus (COVID19), in StatPearls. StatPearls Publishing, Treasure Island (FL). CDC, 2020a. Coronavirus Disease 2019 (COVID-19) [WWW Document]. Cent. Dis. Control Prev. URL https:// www.cdc.gov/ coronavirus/2019-ncov/php/principles-contact-tracing.html (accessed 5.25.20). CDC, 2020b. Coronavirus Disease 2019 (COVID-19) [WWW Document]. Cent. Dis. Control Prev. URL https://www.cdc.gov/ coronavirus/2019-ncov/prevent-getting-sick/social-distancing.html (accessed 5.28.20). Choolayil, A. C.,and Putran, L. (2021).COVID-19, The Local and the Global: Lessons from Kerala. 41 (January 2020), 7–21. https://doi. org/10.1177/0262728020966102. Economic Times (2020). Amid lockdown, migrant workers a content lot in Kerala [WWW Document]. Econ. Times. URL https:// economic times.indiatimes.com/news/politics-and-nation/amid-lockdownmigrant-workers-a-content-lot-in-kerala/articleshow/75243908.cms (accessed 25 February 2021). ENVIS Centre Kerala. State of Environment and Related Issues: Health. http://www.kerenvis.nic.in/Database/HEALTH_813.aspx (accessed July 2020). GoK Dashboard [WWW Document]. URL https://dashboard.kerala.gov. in/index.php (accessed 25 February 2021). GoK Dashboard [WWW Document]. URL https://health.kerala.gov.in/ weeklyBulltin.html.(accessed25 February 2021). GoK Dashboard [WWW Document]. URL https://dhs. kerala.gov.in/2021/02/25/25-02-2021/(accessed 25 February 2021). Huang C., Wang Y., Li X., et al. (2020).Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet,

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395:497-506. [PMID: 31986264] doi:10.1016/S0140-6736(20)30 183-5. Menon, J. C., Rakesh, P. S., John, D., Thachathodiyl, R., Banerjee, A., Ps, R., andJohn, D. (2020). What was right about Kerala's response to the COVID-19 pandemic ? 1–5. https://doi.org/10.1136/bmjgh2020-003212. Parry, Nicholas (2020).Shigella outbreak at medical camp in Kerala, Health Issues India, 24 December 2020, https://www.healthissues india.com/2020/12/24/shigella-outbreak-at-medical-camp-in-kerala/ [accessed 26 February 2021]. Physiopedia contributors (2020). 'Endemics, Epidemics and Pandemics', Physiopedia, https://www.physio-pedia.com/index.php?title=Endem ics,_Epidemics_and_Pandemics&oldid=261904> [accessed 25 February 2021]. Reid, D. (2020). ‘India Confirms its First Coronavirus Case’. CNBC. https://www.cnbc.com/2020/01/30/India-confirms-first-case-of-thecoronavirus.html. Sadanandan, R. (2020). Kerala's Response to COVID ‑ 19. 189–191. https://doi.org/10.4103/ijph.IJPH. Sulaiman, K. M., Muhammad, T., Muhammad Rishad, A. P. and Afsal, K. (2020). Trace, quarantine, test, isolate and treat: A Kerala model of Covid-19 response. MedRxiv, 49, 120–131. https://doi.org/10. 1101/2020.06.15.20132308. The Hindu (2020). Coronavirus | India approves COVID-19 vaccines Covishield and Covaxin for emergency use. [WWW Document]. URL https://www.thehindu.com/news/national/drug-controllergeneral-approves-covishield-and-covaxin-in-india-for-emergencyuse/article33485539.ece(accessed 27February 2021). The Hindu (2020). Coronavirus | First phase of vaccination to start on January 16. [WWW Document]. URL https://www.thehindu.com/ news/national/india-to-start-covid-19-vaccination-drive-on-jan16/article33536670.ece (accessed 27February 2021). Times Now News (2021).COVID-19 vaccination for 60+, comorbid people from March 1: How to use Co-WIN App to register yourself.

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[WWW Document]. URL https://www.timesnownews.com/ india/ article/covid-19-vaccination-for-60-comorbid-people-from. Unnithan, P.S.G. (2020). 'Kerala Reports First Confirmed Coronavirus Case in India. India Today. https://www.indiatoday.in/india/story/ kerala-reports-first-confirmednovel-coronavirus-case-in-india1641593-2020-01-30. Upadhyay, A. (2020) Coronavirus Outbreak Explained: What Are the Different Stages of corvid-19 Transmission. https://swachhindia.ndtv. com/what-are-the-different-stages-ofcovid-19-transmission-expertsexplain-43036. WHO (2020, July 2) Responding to COVID-19—Learnings from Kerala. https://www.who.int/india/news/feature-stories/detail/responding-tocovid-19---learnings-from-kerala.

In: Pandemics and Global Health ISBN: 978-1-68507-228-5 Editors: N. Balan and M. Thomas © 2022 Nova Science Publishers, Inc.

Chapter 3

HUMAN DIASPORA AND PANDEMICS: A REVIEW IN THE CONTEXT OF COVID-19 Shaibu Jacob1,*, P. S. Ajith2, M. B. Arya2, David Abin3, Rogimon P. Thomas4, PhD and Joby Paul1, PhD Department of Botany, St. Thomas’ College (Autonomous), Thrissur, Kerala, India 2 Bodhi Cultural Centre, Indian Science Research Academy (ISRA), Adimali, Idukki, Kerala, India 3 Trinity Adventist Academy, Mavelikkara, Alappuzha, Kerala, India 4 Department of Botany, CMS College (Autonomous), Kottayam, Kerala, India 1

ABSTRACT The human diaspora started from the beginning of civilization but its intensity and speed were enhanced or induced by the advancement in the travel sector. Pandemics during human history indicated that diaspora is the main vector/ tool of spreading among the millions. In this context, this chapter is focused to understand the perspective and *

Corresponding Author’s Email: [email protected].

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Shaibu Jacob, P. S. Ajith, M. B. Arya et al. conscious level of nations in the following four questions. 1. Is there any satisfactory technological advancement to identify the pandemic diseases of international travelers in the context of the developed stage of diaspora? 2. How the advanced technological development catalyzed the intensity and speed of dispersal mechanism of pandemic disease outbreaks like COVID-19? 3. Is there any apt security against pandemics among nations and how will it be formed? It was observed that, during the COVID-19 period, the immediate response of science and technology was not sufficient to ensure the security of the people in the context of diaspora. Even though nations had successfully developed bio-weapons through technological advancement, they had failed to guarantee security consciousness to their people. The diaspora of the present century is facing the extreme challenge of pandemic diseases because of the poor predictive mechanism on the evolution of microbes in the climatic changing scenario.

Keywords: pandemic, technological advancement, diaspora, virtual vector

INTRODUCTION The World Health Organization (WHO) has alarmed the current outbreak of the novel coronavirus (COVID-19) as a global pandemic (Lau et al. 2020). All nations were frightened due to its accelerated dispersion among the continents. It could make a drastic decline in the social and economic development of the world. Medical technology advancement has been stressful to stop the transboundary dispersal but in contrast, aviation technology acted as a ‘virtual vector’ of coronavirus. As a result of the lack of intelligent measure and policies, migrants of different countries turn to panic and that lead to the rush return to the homeland which ultimately leads to the diffusion of the virus in every continent literally. The attack of the virus named COVID-19 started in Wuhan in December 2019 and it spread to the rest of China and then to the whole world (Kraemer et al. 2020). The causative organism of this pandemic is Coronavirus, distributed in humans, mammals, and birds can cause

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respiratory, intestinal, hepatic, and nervous system diseases (Perlman et al. 2020). Due to its variable incubation period, it was difficult to identify its rapid spreading (Poletto et al. 2014) and it overrides the age barriers of people. Due to its virulence and air transmission mechanism, approximately 119,609,831 people were infected and a death toll of 2,651,700 lives around the world as of 13th March 2021. The period of COVID-19 is historically relevant in the context of Human diaspora because this pandemic affected adversely in all levels of migration and its allied sector especially, low-income job migrants. Around the spreading range, the highest number of migrants including countries affected this pandemic in the high level of range and due to this fall down the international migrants and remittances such as 31% and 37% respectively by this pandemic (GMDAC analysis based on UN DESA, 2020; World Bank, 2020a; WHO, 2021). COVID 19 pandemic affected the transboundary migrants and the international migrants account for 3.4% of the world population, especially the international migrants of these 20 nations, between 11 March 2020 to 22 February 2021 (IOM, 2021). The economic emergency induced by COVID‐19 could be long, bottomless, and inescapable when observed through an emigration lens. An exponential development happened in the case of law and policies making against COVID-19 such as lockdown breakage of transboundary journey distancing etc were led to an economic depression in worldwide. Host nations faced supplementary challenges in many sectors, such as health and agriculture that depended on the obtainability of migrant workers. Migrants faced the threat of infection and also the possible loss of employment, wages, and health insurance coverage (World Bank, 2020). India is an important nation of origin for international immigrants with about 17 million emigrants according to the latest assessments released by the United Nations (2019). Every year a large number of people from India go abroad for overseas employment and study purposes. This chapter analyses the migration status of international and national scenario, state-level accounts in the context of COVID-19 and

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also try to point out the connection of aviation and COVID-19 spread. This analysis elucidates a clear virtual connection among migrants, aviation, and covid-19.

CORONAVIRUS PANDEMIC IN THE WORLD The ability to spread the pattern of the coronavirus can hold 210 nations of the world and hit around two million people worldwide [Appendix -1]. Without following covid prevention measures like social distancing and lack of abdicating instruments leads to more adverse conditions among migrants in the United States of America (Tharoor, 2020). The coronavirus disease 2019 (COVID-19) pandemic is the key challenge that healthcare systems around the world are presently facing (WHO 2021). The coronavirus disease 19 (COVID-19) is a highly infectious and pathogenic viral infection caused by unembellished acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which emerged in Wuhan, China, and blow-out around the world (Shereen et al. 2020). The novel coronavirus (termed 2019-nCoV) was testified in December 2019 from the genomic screening of clinical samples from patients with viral Pneumonia in Wuhan, China. The primary viral pneumonia patients were found to be epidemiologically linked to the Huanan seafood marketplace in Wuhan City, Hubei Province, China, where other non-aquatic animals, such as bats, pangolins, and rabbits, were on sale before the outbreak (Dietz et al. 2019, Tan et al. 2020, Zhu et al. 2020, Sofi et al. 2020). Through the use of next-generation sequencing, a new human infecting coronavirus, provisionally called the 2019 novel coronavirus (2019nCoV), was identified. Subsequently, on February 11, 2020, an outbreak or disease previously known as “novel coronavirus” or 2019-nCoV was officially renamed as C-O-V-I-D-19 or COVID-19, and the causal virus was named as “severe acute respiratory syndrome-related coronavirus 2” or SARS-CoV-2 (Sofi et al. 2020, WHO 2020) and this virus spread around the world (210 nations) by the movement of human and a drastic decline happened in the all-developmental sectors in the world.

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CORONAVIRUS HIT INTENSITY INDUCED BY POPULATION DISPERSAL INTENSITY Migration, urban population growth, and high population density are considered major factors (Connolly et al. 2020) for the spreading of pandemics. China has experienced large-scale migration in recent decades (Shen 2018; Chan 2014). Return migration range of early 2020 can assume to assess the migration to the Hubai province between 20102015 (Jianfa, 2020). Many travelers came back to their native place by the declaration of lockdown by the Chinese government before the spring holiday. Within 30 days coronavirus spread over from Wuhan to every province in China in 2019 (Gao et al. 2020). After that, it was confirmed outside on 13th January 2020 in Bangkok (Thailand) (WHO, 2020, Gennaro et al, 2020) On the 2nd March 2020, 67 territories outside mainland China had reported 8565 confirmed cases of COVID-19 with 132 deaths, as well as substantial community transmission were seen in several countries worldwide, including Iran and Italy and it was declared a global pandemic by the WHO on the 11th March 2020 (Hsu, et al. 2020, Gennaro et al. 2020). The number of confirmed cases has been constantly increased worldwide and after Asian and European regions, a steep increase was being observed in low-income countries (WHO, 2020). Based on the migration status, Wuhan had verboten all transport in and out of the city as of 10:00 on January 23, 2020, this is maybe the largest quarantine/movement constraint in human history to avert infectious disease spread (Tian et al. 2020). It could maintain control over hundreds of millions of Chinese residents, including 9 million Wuhan residents’ reduction of inter and intra-city movements. Due to the Wuhan lock-down (Yuan et al. 2020), Read et al. (2020) proposed that travel restrictions from and to Wuhan city are unlikely to be effective in halting transmission across China; with a 99% effective reduction in travel led to reducing 24.9% on February. There they had a 10-day delay in between infection and detection, which means that about a 5-day incubation period and an average 5- day delay from symptom commencement to

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detection of a case (Imai et al. 2020; Yang et al. 2020; Li et al. 2020). Around five million migrants turn back to their native destination before lockdown and they consider as potential disease spreaders. Case distribution and its correlation with population emigration from Wuhan in the early epidemic are of great importance for early warning and prevention of future outbreaks (Chen et al. 2020). The outbreak in China was largely under control by the end of March 2020. Kraemer et al. (2020) found a positive correlation between the COVID-19 cases and the population flow from Wuhan.

PRESENT SCENARIO OF COVID-19 IN THE WORLD The sum of confirmed cases is increasing every day with the obtainability of swift testing kits. This pandemic is going to impact harshly in the socio-economic and psychological aspects. COVID-19 is being considered as overwhelming as the World influenza epidemic of 1918 (Jahangir et al. 2020). The light of the above table can illustrate the following contents about the spread of this disease from one nation to another. According to the following table, 118852593 cases were reported in the world while this time and 94379293 recovery cases were also reported by WHO but 2635511 deaths were reported all over the world on 8thMarch 2021 (Table 1). Table 1. Present scenario of COVID-19 in the world Sl. No. 1 2 3 4 5 6 7

Country, Other Afghanistan Albania Algeria Andorra Angola Anguilla Antigua and Barbuda

Total Cases 55901 114840 114681 11130 21161 18 882

Total Deaths 2451 1986 3026 112 516 23

Total Recovered 49499 77498 79428 10708 19761 18 489

Active Cases 3951 35356 32227 310 884 0 370

Total Population 39528110 2875623 44394002 77350 33562497 15095 98488

Human Diaspora and Pandemics Sl. No. 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47

Country, Other Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Brazil British Virgin Islands Brunei Bulgaria Burkina Faso Burundi Cabo Verde Cambodia Cameroon Canada CAR Caribbean Netherlands Cayman Islands Chad Channel Islands Chile China Colombia Comoros Congo Costa Rica

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Total Cases 2169694 176286 8227 29090 484916 238383 8642 128428 554156 3353 298960 794605 12355 6501 731 868 256462 140990

Total Deaths 53359 3239 77 909 8798 3262 185 476 8502 37 2070 22347 316 81 12 1 11884 5410

Total Recovered 1961640 165441 7929 26218 450862 230244 7483 121776 507920 3002 289622 53888 11962 5552 690 866 200900 119904

Active Cases 154695 7606 221 1963 25256 4877 974 6176 37734 314 7268 718370 77 868 29 1 43678 15676

Total Population 45481402 2967070 107079 25703415 9041847 10202123 395831 1741774 165818974 287618 9447173 11624438 402577 12340011 62119 777454 11782447 3266670

32912 11205972 153

413 270917 1

27765 9913739 131

4734 1021316 21

2384149 213601044 30370

192 269579 12230 2369 15892 1163 36794 896739 5023 622

3 10999 143 3 155 1 566 22335 63 6

183 220049 11886 773 15236 597 32936 843962 4920 470

6 38531 201 1593 501 565 3292 30442 40 146

440363 6912161 21294381 12132125 560143 16877961 26997350 37970105 4887367 26391

460 4231 4043 867949 90018 2285960 3611 9329 207832

2 149 86 21206 4636 60773 146 131 2848

430 3729 3955 818337 85201 2187473 3427 7514 188151

28 353 2 28406 181 37714 38 1684 16833

66253 16747259 174967 19229245 1439323776 51256145 882282 5610902 5126156

38

Shaibu Jacob, P. S. Ajith, M. B. Arya et al. Table 1. (Continued)

Sl. No. 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83

Country, Other Croatia Cuba Curaçao Cyprus Czechia Denmark Diamond Princess Djibouti Dominica Dominican Republic DRC Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Eswatini Ethiopia Faeroe Islands Falkland Islands Fiji Finland France French Guiana French Polynesia Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe

Total Cases 248838 59157 4862 38065 1365724 218660 712

Total Deaths 5635 361 22 235 22624 2384 13

Total Recovered 238914 54084 4686 2057 1178832 208020 699

Active Cases 4289 4712 154 35773 164268 8256 0

Total Population 4087715 11321834 164556 1213418 10722709 5806286

6227 151 244923

63 3204

5950 138 200284

214 13 41435

997869 72109 10922800

26738 296841 188361 61814 6371

712 16105 11128 1935 96

22432 256009 145418 58440 5739

3594 24727 31815 1439 536

91416350 17827025 103657333 6508788 1434345

2988 80929 17203 169878 660 54 66 64609 3963165 16693 18509 16313 4792 274045 2537043 86737 4259 214661 31 148 10614

7 686 658 2466 1

2538 57716 15513 140035 657 54 57 46000 269019 9995 4842 14374 4203 267421 2337000 81299 4139 179672 31 147 2242

443 22527 1032 27377 2 0 7 17833 3604581 6611 13526 1846 436 3002 126679 4782 27 28052 0 0 8210

3580149 1327152 1168432 116909397 48991 3549 900923 5546668 65373300 303969 282028 2261642 2462978 3983867 83968953 31517045 33684 10387775 56838 112883 400171

2 776 89565 87 141 93 153 3622 73364 656 93 6937 1 162

Human Diaspora and Pandemics Sl. No. 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 119 120 121 122 123 124

Country, Other Guatemala Guinea Guinea-Bissau Guyana Haiti Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Isle of Man Israel Italy Ivory Coast Jamaica Japan Jordan Kazakhstan Kenya Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macao Madagascar Malawi Malaysia Maldives Mali Malta

Total Cases 180393 17208 3327 8928 12594 175442 11151 489172 6070 11305877 1403722 1723470 745642 224588 1091 812823 3149017 36028 28968 443001 457151 220770 111185 204388 86692 48 92274 405407 10525 2026 142671 2596 203992 57056 48 20155 32614 319364 21144 8710 25640

Total Deaths 6522 101 51 205 250 4301 203 16497 29 158325 38049 61016 13671 4499 25 5955 101184 206 475 8402 5169 2821 1899 1144 1476 1737 5180 309 85 2340 55 3363 673 300 1077 1200 64 358 341

Total Recovered 166410 15403 2696 8211 9967 68350 10694 344267 6023 10947162 1224603 1471179 674345 23364 422 770156 2550483 32966 14781 422542 382949 204129 87994 189155 83718 42 82665 318800 3922 1898 129706 2519 190131 53453 47 19543 24381 300620 18534 6452 22176

39 Active Cases 7461 1704 580 512 2377 102791 254 128408 18 200390 141070 191275 57626 196725 644 36712 497350 2856 13712 12057 69033 13820 21292 14089 1498 6 7872 81427 6294 43 10625 22 10498 2930 1 312 7156 17544 2546 1900 3123

Total Population 18142761 13375898 1999803 789171 11498123 10012743 7538891 9643370 342770 1389345702 275514280 84732072 40839991 4975737 85343 9197590 60400305 26824609 2970088 126208366 10272869 18931182 54581787 4313950 6598061 7348083 1871712 6804268 2153952 5138962 6935506 38204 2695875 632967 655418 28177203 19467533 32651098 547074 20648538 442355

40

Shaibu Jacob, P. S. Ajith, M. B. Arya et al. Table 1. (Continued)

Sl. No. 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141 142 143 144 145 146 147 148 149 150 151 152 153 154 155 156 157 158 159 160

Country, Other Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia Moldova Monaco Mongolia Montenegro Montserrat Morocco Mozambique MS Zaandam Myanmar Namibia Nepal Netherlands New Caledonia New Zealand Nicaragua Niger Nigeria North Macedonia Norway Oman Pakistan Palestine Panama Papua New Guinea Paraguay Peru Philippines Poland Portugal

Total Cases 4

Total Deaths

Total Recovered 4

Active Cases 0

Total Population 59465

6928 17385 664 18604 2144558 1 200124 2062 3561 82029 20 487286 63645 9 142114 40631 275070 1138796 74 2416 6537 4848 159646 109262

47 442 10 129 192488

6783 207 62 15511 266074 0 20793 161 710 9052 1 4843 14318 0 7191 2077 942 N/A 16 85 2137 192 17670 9845

375064 4733102 1273226 277314 129865108 115853 4027473 39434 3314526 628121 4994 37211482 31852751

26 175 179 1993 3244

98 16736 592 2964 1685996 1 175111 1875 2847 71864 18 473738 48616 7 131722 38104 271116 N/A 58 2305 4225 4477 139983 96173

77601 145257 597497 203669 346301 1819

632 1600 13377 2211 5957 21

66014 135227 566493 181452 333675 846

10955 8430 17627 20006 6669 952

5450455 5195338 223831323 5182511 4361396 9063183

174013 1387457 607048 1849424 812575

3387 48323 12608 46373 16635

144144 1294623 546671 1516540 744196

26482 44511 47769 286511 51744

7192788 33287453 110583559 37817932 10176124

4220 26 4 1113 1 8705 711 2 3201 450 3012 15998

54661300 2572457 29496163 17161066 287388 5002100 6678765 24801718 209630676 2083315

Human Diaspora and Pandemics Sl. No. 161 162 163 164 165 166 167 168 169 170 171 172 173 174 175 176 177 178 179 180 181 182 183 184 185 186 187 188 189 190 191 192 193 194 195 196

Country, Other Qatar Romania Russia Rwanda Réunion South Korea Saint Kitts and Nevis Saint Lucia Saint Martin Saint Pierre Miquelon Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Sint Maarten Slovakia Slovenia Solomon Islands Somalia South Africa South Sudan Spain Sri Lanka St. Barth St. Vincent Grenadines Sudan Suriname Sweden Switzerland Syria Taiwan

41

Total Cases 168829 845352 4360823 19846 13801 94198 41

Total Deaths 264 21252 90734 271 71 1652

Total Recovered 157242 774277 3959533 18118 12389 84675 41

Active Cases 11323 49823 310556 1457 1341 7871 0

Total Population 2807805 19148700 145977728 13171603 899717 51299687 53458

3941 1571 24

47 12

3722 1399 24

172 160 0

184206 39118 5774

2 3511 1696

1 474 282

199323 33980 221949

3 4062 2010

77 32

381348 36195 503291 3032 3928 60070 2077 331571 198234 18

6551 935 4644 15 79 29 27 8244 3918

371850 31467 400347 2809 2769 59939 2034 255300 183848 16

2947 3793 98300 208 1080 102 16 68027 10468 2

35186108 17045174 8712992 98767 8088085 5882050 43211 5461470 2079136 698395

8820 1524174 9205 3178442 86685 638 1674

338 51015 103 71961 515 1 8

4079 1445979 7906 2823433 83561 462 1114

4403 27180 1196 283048 2609 175 552

16195700 59822837 11283999 46767300 21475225 9898 111183

28766 8990 707192 569312 16187 978

1915 175 13111 10088 1079 10

23268 8498 N/A 526511 10625 936

3583 317 N/A 32713 4483 32

44549353 590252 10142695 8698250 17791224 23846563

42

Shaibu Jacob, P. S. Ajith, M. B. Arya et al. Table 1. (Continued)

Sl. No. 197 198 199 200 201 202 203 204 205 206 207 208 209 210 211 212 213 214 215 216 217 218 219 220 221

Country, Other Tajikistan Tanzania Thailand Timor-Leste Togo Trinidad and Tobago Tunisia Turkey Turks and Caicos UAE Uganda UK Ukraine Uruguay USA Uzbekistan Vanuatu Vatican City Venezuela Vietnam Wallis and Futuna Western Sahara Yemen Zambia Zimbabwe

Total Cases 13308 509 26598 159 7737 7743

Total Deaths 90 21 85 92 140

Total Recovered 13218 183 26000 94 6534 7509

Active Cases 0 305 513 65 1111 94

Total Population 9684201 60894519 69920970 1335655 8411398 1402618

239368 2821943 2190

8292 29227 15

205719 2649862 2071

25357 142854 104

11903738 84963623 39077

419996 40520 4241677 1425522 66484 29866708 80347 3 27 143796 2533 129

1369 334 125168 27685 678 542274 622

399803 15095 3348489 1210246 57134 20640756 79051 1 15 135869 2048 7

18824 25091 768020 187591 8672 8683678 674 2 12 6520 450 122

9972587 46724486 68132056 43551614 3482043 332341490 33802407 312053 802 28380156 97941814 11102

10 2627 83913 36341

1 661 1148 1489

8 1452 80027 33953

1 514 2738 899

607375 30275469 18735154 15011546

1407 35

A Virtual Relationship of Airport and COVID-19 in the World The different response is principally due to the detail that the COVID-19 crisis has quickly spread globally. The majority of countries in the world implemented travel restrictions, lockdowns and other measures to prevent the spreading of corona virus (Monmousseau et al. 2020, Suzumura et al., 2020, White House, 2020, European Council,

Human Diaspora and Pandemics

43

2020, Iacus et al. (2020). Italy was the first country to enforce a national lockdown (World Atlas, 2020) from March 9th, 2020 to February 21st, 2020 an initial measure confining only the northern region of Lodi (Monmousseau et al. 2020). Followed by the EU officially closed the external borders of 26 of its member states to nearly all non-EU residents on March 17th, 2020 (New York Times 2020, Monmousseau et al. 2020). The top five nations with the largest number of infected people were the USA, Brazil, Russian Federation, India and UK (WHO, 2020. Bindu and Indu, 2020). Airports Council International (ACI) prophesied that COVID-19 can wipe out two-fifths of passenger traffic and half of the airport incomes in 2020 (ACI, 2020). The International Civil Aviation Organization (ICAO) assessment that during the first half of 2020, compared to their original forecast, showed an overall reduction of 47% to 58% of seats offered by airlines and face loss of around 112 to 135 billion USD (ICAO, 2020. Sanchez et al. 2020). Comprehensive information on air traffic between international airports has been demonstrated to be useful in retrospectively authenticating and prospectively envisaging case emergence in other countries. For the ongoing COVID-19 epidemic, 24 countries had authoritatively described cases by the first week of February 2019. All of the first reports in these countries had travel antiquity to China (mostly to Wuhan city of Hubei province) and also, they assess the global importation risk of novel coronavirus disease (COVID-19) for other countries based on travel to China (Adiga et al. 2020). Brockmann (2020), clearly demonstrated the risk factor of COVID-19 in the context of pandemic disaster by the aviation industry of the world and they consider the time and distance from the epicenter of COVID-19. According to Adiga et al. (2020) COVID-19 pandemic spread induced by the aviation sector could be simply imagined by the transportation network of around 4000 airports in the world (Adiga et al. 2020). Brockmann (2020) observed the potential of this pandemic by using 2019 data from the International Air Transport Association (IATA) and identified all cities in China that received at least 100000 airline passengers from Wuhan during February through April 2019. In a

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Shaibu Jacob, P. S. Ajith, M. B. Arya et al.

scenario where these cities might experience local epidemics, analyzed the volumes of airline passengers to international destinations from February to April 2019 and reported that around 50 international cities contribute the number of migrants to the mainland of China. And another necessary observation is that the analyzed international airline passenger trips from the following 10 cities: Wuhan, Beijing, Shanghai, Kunming, Chengdu, Xiamen, Haikou, Guangzhou, Shenzhen and Hong Kong. The migrants return from the city by using connecting flights e.g., Taipei (1359253), Bangkok (1232307), Tokyo (1086105), Seoul (1008960) and Singapore (751 064). 90% of the passengers were received by Asia, with London, the UK ranked 10th in volume (252 127). Other nations include Paris (142724 passengers) and Moscow (114925 passengers). Sydney (242577) passengers, while Los Angeles (184808), New York (148133) and San Francisco (140556) received the highest volumes to North American destinations. Cairo (62470) is the one and only migrants received nation in Africa (50 destinations). Table 2. Key facts and figures from the World Migration Report, 2000 and 2020 Key facts-World migration reports Estimated number of international migrants Estimated proportion of world population who are migrants Estimated proportion of female international migrants Estimated proportion of international migrants who are children Region with the highest proportion of international migrants Country with the highest proportion of international migrants Number of migrant workers Global international remittances (USD) Number of refugees Number of internally displaced persons Number of stateless persons Source: PhD. Research Bureau, PHDCCI compiled from IOM.

2000 Report 150 million 2.80% 47.50% 16.00% Oceania UAE 126 billion 14 million 21 million -

2020 Report 272 million 3.50% 47.90% 13.90% Oceania UAE 164 million 689 billion 25.9 million 41.3 million 3.9 million

In the case of a pandemic, flights are the major speedy spreading carrier in technologically advanced travel. Because the topmost affected countries have more potential to spread disease to the other region

Human Diaspora and Pandemics

45

because of the high number of airport and air services. Good health incorporates mental, social and physical comfort. The field of migration and health encompasses health apprehensions arising from human agility, such as the transmission of transferrable diseases, and should engross with all aspects of well-being in the framework of migration and with totally who are affected, including families of migrants and the public fitness of communities with whom migrants interrelate during all phases of the migration journey (World migration report 2020) (Table 2).

A VIRTUAL RELATIONSHIP OF COVID-19, AVIATION AND MIGRATION IN THE INDIAN CONTEXT Epidemic in India Epidemic waves affected people and also their humanity. The return of migrants may bring disease into the native region and the same occasion happened in the 1980s in the case of HIV/AIDs and the population became risk (Maharatna, 2014, BBC, 2020, Bhagat et al. 2020). In a different period, pandemic disease adversely affected people’s life as well as the global economy. Migrants may be the carriers of diseases or a part of a disease outbreak because of their borderless long journey. Different period’s pandemic diseases adversely affected migration and also the global economy. Such examples of the pandemic are Smallpox epidemic (1974), Cholera (1910-1911, Death- 8,00,000), Spanish Flu (1918 – 1920, Death-17-18 million Indians), Plague in Surat (1994), SARS (2002- 2004), Dengue and Chikungunya Outbreak (2006), Swine flu outbreak (2014-2015, Death-2000 Indians), Nipah Virus outbreak (2018) and the very end of 2019 COVID, 19 emerged. COVID19 has rapidly spread worldwide by travelers or migrants coming from the epicentre of the outbreak or countries with reported cases. COVID-19 has been confirmed on all continents, including in the European Union

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Shaibu Jacob, P. S. Ajith, M. B. Arya et al.

(EU) countries and has already caused victims in the EU. European Centre for Prevention and Control assessed the risk for people travelling within the EU as high, especially from the United Kingdom, France, Germany, Italy, Spain and the Netherlands. The world spread of COVID19 pandemic disease also largely affected the workers due to the shutdown of factories and workplaces in India. Millions of migrant workers also faced issues like loss in their income, food scarcity and uncertainty about the future. However, necessary steps have been taken by the government with the support of citizens and are trying to reduce socioeconomic impact.

Lockdown and Interstate Migration Lockdown is essential to prevent pandemics and pollution but before the implementation necessary apt arrangements should cover otherwise it will badly affect poor people. According to the Shahas (2020) study revealed that migrants from north-central India show that the majority of the workers were the daily wage earners and they faced many adverse conditions such as lack of food, shelter, no identity card and angry from police and local people because of a notion of feeling against the covid spread. (India Today, 2020). In India, mass return migration to the homeland could be seen by challenging all difficulties. The very effort to stave off the pandemic turned into one of the greatest human tragedies in India’s recent history (Bhagat et al. 2020). Migrant workers stood as the backbone of the Indian economy. There were permanent and semi-permanent workers (15 million and 194 million) among the migrants (482 million) in India (Keshri and Bhagat, 2012). For life sustenance, many of them came to the urban sector for employment and contribute a significant account in urban population (50%) and interstate migrants also have an essential role in it (1/5 of the urban population). Around 53 million came from the rural sector and tried to take part in urban development. Out of 53 million-plus cities, eight of them are mega-cities with a population of 5 million and more

Human Diaspora and Pandemics

47

(Bhagat et al. 2020). In general, in-migration rates were higher in highincome states such as Delhi, Goa, Haryana, Punjab, Maharashtra, Gujarat and Karnataka, whereas low-income states such as Bihar, Uttar Pradesh, Jharkhand, Rajasthan and Odisha reported relatively higher rates of outmigration (Bhagat et al. 2020). Due to the absence of transportation facilities, millions of migrant labours started their exodus to their native places. States like Delhi, Uttar Pradesh, Rajasthan, Karnataka and Bihar have looked into the situation and had arranged transport buses to help the workers reach their homes. But this massive transportation had resulted in a problematic situation and increased misunderstanding between the states. As this was a violation of and a threat to the benefits of lockdown and was risky for them and people in the villages, the Government of India gave a licensed order to seal all borders and make necessary arrangements like temporary shelters, food, clothes etc. (Press Trust of India, 2020; Government of India, 2020).

The Indian Diaspora According to the United Nations (2019), there have 17 million international migrants from India and also the top remittance (USD 78.6 billion) received nation (World Migration Report 2020). Indian migrants mainly focused on the United States of America, Malaysia, Saudi Arabia, the U.A.E, United Kingdom, South Africa, Canada, Singapore, Kuwait, Oman, Qatar, Thailand, and New Zealand. But some skilled, semiskilled and students focused on USA, UK, Canada, Australia etc., where labour and employment laws are well defined and emigrants’ interests are well protected under the local law, a considerable proportion of the emigrants from India are less educated and less or semi-skilled workers migrating to Gulf countries. According to the United Nation, around 3% of the world population migrated from poor to rich countries, poor to poor countries, rich to rich countries and rich to poor countries by political and economic existence.

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Shaibu Jacob, P. S. Ajith, M. B. Arya et al.

Indian diaspora that constitutes an important and exclusive force in some reverences blow-out across all six continents and 125 nations. Table 3. The present situation of COVID-19 in India Sl.No.

Name of the states/UT

Active cases 1 Andaman and Nicobar Islands 7 2 Andhra Pradesh 998 3 Arunachal Pradesh 3 4 Assam 1627 5 Bihar 313 6 Chandigarh 710 7 Chhattisgarh 2820 8 Dadra and Nagar Haveli and Daman and Diu 12 9 Delhi 1803 10 Goa 688 11 Gujarat 3140 12 Haryana 2031 13 Himachal Pradesh 614 14 Jammu and Kashmir 892 15 Jharkhand 463 16 Karnataka 6881 17 Kerala 41162 18 Ladakh 44 19 Lakshadweep 158 20 Madhya Pradesh 3606 21 Maharashtra 99205 22 Manipur 28 23 Meghalaya 13 24 Mizoram 8 25 Nagaland 20 26 Odisha 747 27 Puducherry 176 28 Punjab 7497 29 Rajasthan 1755 30 Sikkim 50 31 Tamil Nadu 3997 32 Telangana 1807 33 Tripura 30 34 Uttarakhand 632 35 Uttar Pradesh 1647 36 West Bengal 3163 Total 188747 Source: Ministry of health and family welfare (08 March 2021).

No. of people affected 4955 882520 16780 214947 260899 21253 307642 3402 628377 53922 265831 267433 57507 124190 118703 935772 1031865 9657 327 257166 2068044 28890 13811 4410 12106 335080 39022 174967 316988 5989 838606 296562 33003 95095 593895 563182 10882798

Confirmed death 62 7174 56 1094 1546 355 3858 2 10921 799 4415 3056 997 1962 1093 12362 4300 130 1 3871 52478 373 148 10 91 1917 670 5927 2789 135 12518 1642 391 1695 8737 10278 157853

Human Diaspora and Pandemics

49

Over the past two centuries, India has reached the world’s most diverse migration history. The Indian diaspora has a promoter for economic development in both within India as well as the migrated nations. Indian diaspora has its own scope; an expatriate is migrated to the foreign land from their own territories. Around 20 million Indian people are spread over the globe, and it constitutes an important strengthening of the world culture.

How Is COVID-19 Hitting India? The first case of COVID-19 surfaced in India on January 30, 2020, and following out-break the lockdown in the entire country was announced on 24th March for a period of 21 days (Bhagat et al. 2020). Kerala has the top migration rate among other Indian states (Bhagat et al. 2013). The lockdown directly affects the migrants and states economies of all nations (The Indian Express, 2020). To mitigate the effect of the lockdown on the vulnerable groups, the Government of India on 26 March 2020, announced a 70-lakh crore package under the Pradhan Mantri Gareeb KalyanYojana. Both governments decided to spend 52000 crores of the Building and Construction Workers Welfare Fund for relief work. (DBT) (DHNS, 2020; Government of India, 2020). The Ministry of health and family welfare (08 March 2021) had revealed a clear picture of the COVID-19 affected states/UT and its range. According to this 188747, active cases and 10882798 people of India were affected by COVID-19. By coronavirus attack 157853 life was lost in India. All details are illustrated in the following Table 3.

COVID-19 and Return Migration in the Indian Context Considering the COVID-19 affected countries, India stands on the top 5 infected nations in the world. However, India has taken effective measures to regulate the pandemic and boost the economy. However, the

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Shaibu Jacob, P. S. Ajith, M. B. Arya et al.

sudden stoppage of movements of people and the suspension of travel has drastically influenced the tourism and aviation industry in India (Bindu and Indu, 2020). The government of India has taken necessary precautions for preventing the COVID-19 outbreak so the nationwide lockdown was implemented on 25th March that was extended to 7th June 2020 and on 13 March 2020, all visas were suspended except diplomatic and other official visas (Chanana, 2020). In India, the borders were sealed to break down borderless travel by lockdown (Bindu and Indu, 2020). As the initiative of central and states governments, many of the migrants came back to their home land. In this mission, two- way approach was done by concerned governments with the help of the Indian navy and airlines. The first mission was taken by the Indian navy named ‘SamudraSetu’ and the second mission is Vande Bharath Mission (VBM).

‘Samudra Setu’ and Return Migration In India ‘Samudra Setu’ is the first program to initiate for evacuating Indian migrants from other nations and it was completed on May 5, 2020. By this attempt around 3992 Indian migrants were reached their homeland. In this operation participated four ships of the Indian Navy named Shardul, Magar, Jalashwa and Airavat and travelled around 23,000 km. The details are given in the table (Table 4). Table 4. COVID-19 and ‘Samudra Setu’ undertaken by Indian Navy Name of Date Port of the Ship Embarked Embarkation Jalashwa 08-May Malѐ Magar 10-May Malѐ Jalashwa 15-May Malѐ Jalashwa 01-Jun Colombo Jalashwa 05-Jun Malѐ Shardul 08-Jun Bandar Abbas Airavat 20-Jun Malѐ Jalashwa 25-Jun Bandar Abbas Source: Official web site of Indian Navy.

Number of Citizens 698 202 588 686 700 233 198 687

Date Disembarked 10-May 12-May 17-May 02-Jun 07-Jun 11-Jun 23-Jun 01-Jul

Port of Disembarkation Kochi Kochi Kochi Tuticorin Tuticorin Porbandar Tuticorin Tuticorin

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Vande Bharat Mission The second phase of the return migration named Vande Bharat Mission was initiated on 7th May 2020 and is enduring in June 2020 (Ministry of Civil Aviation, 2020). Air India, Air India Express, and Indigo became part of it. As per MoCA, by June 23rd, 2020, a total of 681 inbound flights brought back 1, 29,339 passengers to India while a total of 686 outbound flights carried 45,095 passengers to their respective countries. On March 22, the international flights were suspended by India, followed by domestic air transport services on 24th March (Table 5). Table 5. Return to the homeland through VBM VBM No. No. % Of passengers in Phase of flights of Passengers the total VBM 1 84 15296 0.6 2 260 50744 1.99 2+ 186 3412 0.13 2++ 132 5005 0.19 3 553 103906 4.08 4 1082 198193 7.79 5 1104 194792 7.66 6 1289 227938 8.96 7 1441 261108 10.27 8 1651 299360 11.77 8+ 1508 278948 10.97 9 1697 323129 12.71 9+ 1481 282849 11.12 10 1557 297371 11.69 Source: Ministry of External Affairs, Government of India.

From No. of nations 12 47 15 8 41 29 28 29 26 28 29 27 26 28

Total No of states 11 17 16 11 20 19 16 18 15 12 14 14 15 15

% Of States 37.93 58.62 55.17 27.58 68.96 65.51 55.17 62.06 51.72 41.37 48.27 48.27 51.72 51.72

MIGRATION FROM INDIA Today there have assessed around 3.4% of the world population is migrants. Globalization, demographic alterations, conflicts, earnings inequalities and climate change encourage many workers, and their

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Shaibu Jacob, P. S. Ajith, M. B. Arya et al.

families to cross boundaries in search of employment and safety. India is a foremost country of origin and transit, as well as a popular terminus, for workers crossways international borders. There are 30 million Indians migrants but 9% of the Indian migrants were focused on the gulf region. In the context of eligibility90% of the migrants are included in low and semi-skilled workers but limited data is available in this sector. That is, labour migration data is available mostly for workers who have to register for emigration clearance (Wadhawan 2018). As far as the majority of Indian migrants are concerned, they depend on the pull factor in that point of view, the Indian migrants have specific corridors.

Diaspora of Kerala towards COVID-19 and Vande Baharat Mission COVID-19 in Kerala Context The first case of coronavirus was reported in Kerala on January 30, 2020. Only three were reported in the first phase. The patients were properly quarantined in the hospital and treated. No other persons were affected by them. The second phase of COVİD-19 was started by Italian migrants who allegedly escaped from the airport testing facility. By the end of March, the number of active cases crossed a hundred. Kerala then resorted to complete lockdown. The next day, the Government of India also pronounced country-wide lockdown until April 15 which later extended multiple times until May 31 (Jayesh and Sreedharan 2020). On March 23, Kerala announced a state-wide lockdown until March 31 (India Today, 2020). A day later, the central government announced a nationwide 21-day lockdown until April 15 (CGO 2020). And also extended the lockdown until May 3, which further extended until May 31 (Jayesh and Sreedharan 2020). Kerala government makes prevention against COVID-19 through social mobilization under the leadership of Kerala health ministry. This process can be done in light of the experience of Nipa outbreaks in 2018 (Sadanandan 2020). Kerala became the model for a comprehensive

Human Diaspora and Pandemics

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strategy made and implemented against COVID-19 pandemic, in this context world attention initially turned to Kerala. (Issac & Sadanandan, 2020; Rajan, 2020c; Vijayan, 2020). Around 5 million migrants work outside the state among these 2.5 million works in COVID-19 affected nations like gulf countries (Jalan and Sen 2020). The way of approach of the Kerala government against COVID-19 can be considered as a benchmark for how the public health department can be utilized properly (Jayesh and Sreedharan 2020). Kerala captured the attention of Worldwide Media and was appreciated for the efficient management of COVID-19 (Jayesh and Sreedharan 2020, CGO 2020, KGO 2020). The present situation of Kerala in the context of COVID-19 is illustrated in the following table. According to it, there are 37150 active cases, and the total case reported in Kerala is 1081055. The efficient health work could cure 1116281 no: of persons and the total number of persons in quarantine are 166107. Unfortunately, 4328 deaths were reported by COVID-19. The following statics are based on the Kerala government updates until 09-03-2021. The district-wise details are illustrated in Table 6. Table 6. COVID-19 statistics of Karla by govt. updates (until 09-03-2021) Sl. No. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 Total

Name of the District EKM PTA KLM TSR KKD KNR KTM PKD KKD ALP MPM IDK TVM WYD

Active cases 6185 3198 3099 3071 