Geospatial Mapping of COVID-19 Cases in Kerala Using Clinical Data: A Case Study from South India for Policy Advocacy

The first case of the COVID-19 pandemic in India was confirmed on 30th January 2020 in the Thrissur district of Kerala, a State along the south-west coast of India. In this study, we aim to use remote sensing and geospatially map the district-wise spread of COVID-19 in Kerala. As part of the study, spatial-statistical analysis of geographical proportions of COVID-19 was conducted in each district of Kerala using Geographic Information System (GIS) technology. As of 31st March 2022, Kerala has the second highest number of confirmed cases in India, after Maharashtra. This study includes the pandemic mapping integrated with spatiotemporal analysis, ecological parameters and web-based mapping, which showed that more than 90% of known cases were due to community spread. As of May 2021 Ernakulam, Malappuram, Thrissur, Thiruvananthapuram and Kozhikode were the COVID-19 hotspot districts in Kerala. Our spatial GIS maps showed that the infections were spreading fast in coastal hamlets during the first wave, and Kerala’s pandemic curve was on a declining trend until February–March 2021. However, a sudden rise was observed after March 27th, 2021; the time when the second wave started. The State government had announced a complete lockdown in Kerala till 23rd May 2021 over the rising COVID-19 cases. Wastewater-based epidemiological (WBE) studies have been found to be effective tool in early signalling of the spread of COVID-19. Along with this, advanced GIS and remote-sensing technologies for early signalling and spatiotemporal dynamics of COVID-19 spread can give a holistic picture of the COVID-19 scenario for better decision-making, social mobilization, community responses and planning. We recommend that public health agencies, policy makers and administrators can devise a policy to make extensive use of WBE and GIS mapping to understand COVID-19 outbreak patterns in real time in order to identify at-risk populations and plan targeted interventions, such as evaluating available facilities or increasing healthcare capacities.