However, in mid-May, there was an increase or "second wave" of new cases, following the return of Keralites from other countries and other Indian states.

Active cases peaked at 97,525, and started to decline from November, before bouncing back to over 4,00,000 in May 2021 following the state elections.

They belonged to Thrissur, Alappuzha and Kasargod districts of Kerala and two of them were medical students at a university in Wuhan.

[30] As of 4 March, 215 health care workers were deployed across Kerala and 3,646 Telephone counseling services were conducted to provide psycho-social support to families of those suspected to be infected.

[31] Despite the threat of coronavirus infection, the Kerala government decided to go ahead with Attukal pongala, a large, annual, all-women religious congregation in Thiruvananthapuram.

The app will focus on general announcements, information and updated guidelines for travellers, details about the quarantine protocol and also health and safety tips for visitors to the state.

[43] A citizen science initiative, Collective for Open Data Distribution - Keralam (CODD-K), by a group of technologists, academicians, and students advocating open data released first bilingual (Malayalam and English) online dashboard (March 22, 2020) for non-specialists to provide real-time analysis, and daily updates of COVID-19 cases in Kerala by leveraging publicly available data from the daily bulletins published by the department of health services (DHS), Government of Kerala, and various news outlets[44][45] On 23 March, Chief minister Pinarayi Vijayan announced a statewide lock-down until 31 March to prevent further spread of the coronavirus.

[47] The Kerala government introduced a mass hand washing campaign named break the chain on March 15 to educate people about the importance of public and personal hygiene due to the spread of the novel coronavirus across the state.

[58] Data of 351,636 NORKA registered expatriates based on their included type:[59] Following the lockdown, steps were taken to help Keralites stranded in other countries - particularly the Persian Gulf nations - return to India.

At least 4.27 lakh NRKs (non-resident Keralites) had registered on the NORKA (Department of Non Resident Keralites Affairs) portal, of which about 1.69 lakh people constituted the most vulnerable sections, those who had lost their jobs or whose employment contract had not been renewed; those released from prisons and awaiting deportation, pregnant women, elderly people, students who had completed courses and whose visa had expired etc.

[62][63] For weeks, the state health department had been engaged in setting up facilities and protocols to be pushed into action when the expatriates come home.

[65] The Indian Consulate had appealed to passengers not to overcrowd the airport, maintain social distancing and follow all necessary precautions stipulated by the authorities.

[66] Separate mobile health applications had been created to register and track the expatriates who arrive at three of the airports in the first phase – Kochi, Thiruvananthapuram and Kozhikode.

[69] The repatriation exercise was conducted in keeping with a standard operating procedure (SOP) prepared by the central government.

Meanwhile, the sources said, two other Naval ships are waiting off West Asia, which hosts the largest share of Indian citizens abroad.

Since the area is also being served by the Air India repatriation flights, the sources added, the Ministry of External Affairs (MEA) has not decided which country they will need to enter to undertake the exercise.

[77] Kerala suffered severe shortages in vaccines, but oxygen supply was sufficient and cylinders were even sent to neighbouring states.

[85] However, customers at shops were required to have either a recent covid negative RT-PCR test result, at least one dose of vaccination, or successful recovery from COVID-19.

Following the Kerala High Court's criticism of the decision to exclude Bevco outlets from these requirements, similar rules were applied there.

[89] Following decline in the test positivity rate and 75% of adults getting at least one dose of the vaccination, the Sunday lock-down and night-time restrictions were withdrawn on 7 September.

[91] Considering the safety of students and the general public, unvaccinated school staff were asked to produce either a medical exemption certificate or weekly negative RT-PCR test results taken at their own expense.

Following a fall in the number of active cases, the government stopped publishing daily reports on 11 April.

KGMOA Proposed that testing should be shortened to those people with symptoms and to those coming in the contact list also the Lab facilities should be increased.

The mass vaccination campaign should also be limited because this may cause increase in spread, the IMA noted[97] 4,59,893 people registered for the first phase, targeting healthcare workers and police staff.

[177][178] One fake message claiming to be an advisory from UNICEF asks people to avoid ice creams to ensure that coronavirus cannot spread in temperatures over 27 degrees.

[179] Another fake news recommends intake of Vitamin C and drinking frequent sips of water as a preventive measure for coronavirus infection.

[178] Indian National Congress leader and Member of Parliament from Vatakara constituency, K. Muraleedharan claimed that the SARS Cov-2 virus cannot survive temperatures exceeding 30 °C.

[185] Liquor sales in Kerala is a public sector undertaking, through which the government earns a significant revenue.

The state's economy is largely dependent on NRI remittances and the economic slowdown of affected Gulf countries is expected to have a direct impact.

[186] KSRTC, Kerala's state-owned public transport system has reported losses worth crores due to reduced number of travelers.