The Sabarimala temple. Photo: Saurabh Chatterjee/Flickr, CC BY 2.0.
New Delhi: With the Kerala government confirming that the Sabarimala temple will allow pilgrimage from November 16 for the Mandalam-Makaravilakku season, a set of recommendations by a group of doctors published in a medical journal says that only 5,000 devotees, all of them from within the state, should be allowed to visit the shrine.
During the 42-day pilgrimage season, around 30 lakh pilgrims make the trip to the Ayyappa temple. However, with Kerala experiencing a surge in COVID-19 cases after initially appearing to control the outbreak, the doctors suggest that a strict protocol must be followed to control the spread of the coronavirus.
Kerala’s Devaswom minister Kadakampally Surendran confirmed to The Print that the temple will throw its doors open on November 16. “The state shall ensure all COVID-19 protocols will be followed and the number of devotees will also be restricted. It will be mandatory for all devotees to submit [COVID-19]-negative certificates before they undertake the pilgrimage,” he told the website.
The paper, published in the International Society of Travel Medicine on September 5, says that if the Sabarimala pilgrimage is held without any restrictions, it can compromise the “near-mitigated but fragile COVID-19 status” of Kerala and is also likely to accelerate the outbreaks in other states and potentially in multiple countries with emigrants from Kerala. They suggest a “highly restricted, organised, and managed event”, similar to the Hajj pilgrimage this year to control the spread.
The authors note that while Kerala was able to control the spread of the virus within the state due to its strong health infrastructure, the arrival of emigrants and internal migrants has seen the outbreak spin out of control. If an unrestricted pilgrimage is allowed, there are likely to be even more cases, they say.
“We welcome the Kerala state government decisions to make the virtual queue system into a mandatory requirement for this year’s pilgrimage and to restrict the number of pilgrims in Sannidhanam (the main temple premise) to 50 at a time. However, without a blanket restriction on [the] number of pilgrims who can register through the queue system, even this may result in the stranding of thousands of registered pilgrims elsewhere on the way to temple. Also, the pilgrimage site being located in a forest, illegal routes may be formed by eager pilgrims,” the doctors say.
The doctors said though they do not have data on international participation in Sabarimala pilgrimage, the “high volume” of international emigrants from Kerala – on an average, one person per 8 households – coupled with Kerala’s population density and air linkages “would be sufficient” to accelerate international transmissions.
‘Highly controlled event’
The doctors say that though cancelling the pilgrimage is the “best option” to avoid all event-related transmission of COVID-19, such a move could “cause resentment among a section of the community”. On the flip side, “an escalation of COVID-19 cases from a poorly managed pilgrimage can erode people’s trust in government and compliance fatigue of mitigation advisories”, they note.
Therefore, the state government must oversee a highly controlled pilgrimage, with only 5,000 in-state pilgrims allowed to visit the temple in a staggered manner during the six weeks. The pilgrims would be chosen through a lottery system, after registering through a mobile app/website – which the doctors suggest should be designed in Malayalam, Tamil, Kannada, Telugu and Hindi languages. District level in-person registration venues should also be opened, the recommendations say.
Of the 5,000 pilgrims, 60% should be people who are from other states but are residing in Kerala at the time of registrations, they suggest. The authors estimate that since 65% of the pilgrims are usually from Tamil Nadu, Karnataka, Andhra Pradesh and Telangana, such a quota would ensure that people of these ethnicities who reside in Kerala can visit the temple.
The doctors also suggest the people who are above 20 years of age and below 50 years should only be allowed. Persons with a verified medical history of comorbidities that increase the chance of fatality if they contract COVID-19 (uncontrolled diabetes mellitus, congestive heart disease, etc) should be excluded from the pilgrimage, the doctors say. “The mobile application/website should have a feature for
uploading self-declared information. Priority given to COVID-19 recoverees,” they suggest.
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Once a person is selected via the lottery system, their health status should be verified and a COVID-19 test must be done 15 days prior to the scheduled date of departure. “Placement of individually identifiable electronic non-removable monitoring tools on all registered and accepted pilgrims, to enable
compliance monitoring of home isolation for 14 days prior to Sabarimala and 10 days postpilgrimage and to aid contact tracing when needed,” the recommendations add.
Apart from the usual precautionary measures such as wearing face masks and sanitizing regularly, the doctors advise that restaurants should not be open. Instead, they say the Kerala government should provide packed food and drinking water at a nominal cost.
In the temple, areas with “high crowd potential” such as the Sannidhanam (the main temple), the 18 steps leading to the deity, the halls and the altar should ensure strict crowd management. “Religious offerings (Prasadam including appam) to be packed and given to pilgrims only when they board the return buses. Only the temple priests and staff to attend the Harivarasanam (the evening prayer while
closing the temple),” they say.
If any of the pilgrims begin to show symptoms, they should immediately be isolatied and quarantined at the on-site hospital and should be excluded from taking part in the rituals.
Once the pilgrimage is done, all the devotees should again be tested for COVID-19 before they depart. When they reach their destination, the authorities must ensure that the pilgrims quarantine themselves in their homes, the doctors say.
The authors of the paper include K. Rajasekharan Nayar, a professor at the Global Institute of Public Health in Thiruvananthapuram; Shaffi Fazaluddin Koya, a research analyst at the Boston University School of Public Health in the US; Althaf Ali, an associate professor of Community Medicine at the Government Medical College in Manjeri; and Shahul H. Ebrahim, an adjunct professor at the University of Sciences, Technique and Technology in Bamaco, Mali.