Abstract
Background: Kurnool, one of the four districts in the Rayalaseema region of the Indian state of Andhra Pradesh, emerged as a COVID-19 hotspot by mid-April 2020. Method: The authors compiled the publicly available information on different public health measures in Kurnool district and related them to the progression of COVID-19 from March to May 2020. Results: Two surges in pandemic progression of COVID-19 were recorded in Kurnool. The ini-tial upsurge in cases was attributed to return of people from other Indian states, along with return of participants of a religious congregation in Delhi, followed by in-migration of workers and truckers from other states and other districts of Andhra Pradesh, particularly from the state of Maharashtra (one of the worst affected states in India) and Chennai (the Koyambedu wholesale market - epicenter of the largest cluster of COVID-19 in Tamil Nadu). In a quick response to surging infections the state government launched operation ‘Kurnool Fights Corona’ to contain the outbreak. Kurnool had taken a targeted approach to testing, scaled up testing in areas with high case load, and conducted contact tracing for each positive case, along with requisitioning oxygenated beds in the district hospitals to meet the anticipated spurt in the number of positive cases. This combined approach paid rich dividends and from 26th April to May 9th, the growth curve flattened. Conclusion: Although the in migration of laborers and return of residents from other Indian states and abroad during the COVID-19 pandemic was a complex challenge, the timely actions of testing, tracing and isolation conducted by the district authorities in Kurnool greatly reduced transmission. Although this response assessment is based on a single district, the perspectives have revealed some important lessons regarding risk communication, preparedness and response for pandemics which will facilitate consolidation of the policy and program response to pandem-ics in future.
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