Background: Secondary attack rate is the proportion of primary contacts that develop infection or symptom within one incubation period after contact with an index case. The secondary attack rate will help in studying and understanding the transmission dynamics of infectious diseases. As coronavirus disease (COVID-19) is a novel disease which has resulted in a pandemic, understanding the transmission dynamics is very important for strengthening preventive measures.Methods: The present cross-sectional study was conducted to estimate the secondary attack rate among primary contacts of COVID-19 cases admitted in a tertiary care centre in Northern Kerala. Secondary attack rate was calculated as the percentage of primary contacts that tested positive for COVID-19 with RT-PCR test within 14 days of exposure.Results: Secondary attack rate was found to be 5.88%, secondary clinical attack rate 2.35% and secondary infection rate 3.53%. Among those contacts that developed disease, 80% were household contacts.Conclusions: Secondary attack rate was 5.88% and household contacts were the majority to get the disease.

Background: Kerala is one among the Indian states that has incorporated local self-government (LSG) bodies into its public health system. The focus of this research is to study the role of these bodies in the COVID-19 response strategy taken by the state.Methods: Interviews were conducted with the heads of various local self-government bodies in the district of Kannur to collect information on the COVID-19 management role they undertook. The interviews were then transcribed and analysed by adopting the inductive approach to derive themes and conclusions.Results: The interviews reflect that LSGs have undertaken a wide range of initiatives in their COVID-19 response strategy. Organisational capacity, networking with various agencies, community participation, resource mobilization, inter-sectoral coordination, etc. were significant factors in successfully conducting these activities.Conclusions: Managing the pandemic by planning activities at local level has gone a long way in controlling spread of the viral infection in Kerala, during initial phase. The involvement of the local self-government, primarily constituted for legislative and executive purposes, has had a major role in public health activities and positive impact in the health status of the state. This can serve as a model for effective implementation of public health programs as illustrated in the case of COVID-19 pandemic.

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