Unlike the remainder of India, Kerala has maintained the identical degree of every day testing regardless of a discount in variety of circumstances
From mid-February, a spike in every day new circumstances was reported from just a few States together with Maharashtra. For days on finish, the Health Ministry stored repeating the message that Kerala too was “witnessing an upsurge of daily new cases”. Even as not too long ago as March 6, the Health Ministry wrongly implicated Kerala for the surge in circumstances when it stated “Maharashtra, Kerala, Punjab, Tamil Nadu, Gujarat and Karnataka continue to report a surge in the COVID-19 daily new cases.”
Kerala continues to contribute a excessive variety of circumstances every day. However, there has not been any surge or spike in every day circumstances, as seen in different States. In actuality, Kerala has been witnessing a gradual decline in every day circumstances since end-January.
“From a second peak of 6,078 seven-day moving average of daily cases as on January 23, we have been seeing a steady decline in cases in Kerala. There has been a 50% decline in the seven-day moving average of daily cases from the fourth week of January to March 4,” says Dr. Rijo John, Health Economist and Consultant primarily based in Kochi, Kerala. “The seven-day moving average of daily cases in Kerala as on March 4 was 2,996. The absolute number of daily cases on March 4 was 2,616.”
While different States have lowered the variety of every day exams in current months, Kerala has been persevering with with the identical variety of every day exams. “The seven-day average daily tests conducted was over 60,000 when the test positivity rate was 15% during the peak in the first half of October last year. Now, even when the test positivity rate is under 5% seven-day average, the average testing has increased to 70,000 since the first week of February,” says Dr. John.
“Keeping daily testing at high levels even when daily cases are declining inspires more confidence that the decline in daily cases is real and is not due to reduced testing,” Dr. John provides. Maharashtra and Gujarat haven’t elevated testing regardless of reporting extra circumstances every day.
While the remainder of the nation witnessed a peak in mid-September when the every day recent circumstances touched almost 98,000 on September 16, Kerala witnessed a peak a month later in mid-October. Unlike different States that witnessed a gradual decline in every day circumstances, there have been a lowered variety of every day circumstances in Kerala since mid-October, however the numbers continued to remain excessive and didn’t steadily decline to low ranges.
First wave
“The first wave is yet to decline in Kerala. The daily cases have plateaued in the State for a long time and are now seeing a decline,” says Dr. Raman Gangakhedkar, former chief epidemiologist of ICMR who was part of the nationwide COVID-19 process drive until he retired in June final 12 months. “There has not been any resurgence of cases lately [in Kerala].”
According to Dr. Giridhara Babu, epidemiologist on the Public Health Foundation of India, Bengaluru, the decline in circumstances since late January might be as a result of excessive an infection price that’s near herd immunity wanted for the decline to start.
As on March 5, over 0.8 million individuals have been vaccinated within the State. “It is too early to say that vaccination could have contributed much to the decline. The number of people vaccinated is not large enough to have significantly contributed to the decline,” says Dr. Babu.
“If the seven-day average test positivity rate stays below 5% for a few weeks it indicates that the pandemic is under control,” says Dr. Gautam Menon, Professor of Physics and Biology at Ashoka University and co-author of COVID-19 modelling research. Dr. Menon attributes the decline in every day circumstances to the lengthy period of background seroprevalence throughout the State, and so new infections are solely anticipated to say no.
“The long plateauing of cases has ensured a good fraction of people have experienced an infection. In the circumstances, one can expect a decline in daily numbers across the State. But the only way to check this is through serosurvey,” Dr. Menon provides. “My guess is that about 40% of the population would have been infected. This is just my guess.” Based on anecdotal proof, Dr. Menon says aggressive tracing and quarantining would have contributed to the decline in circumstances. “Unlike Kerala, other States have not been able to pick up a steady increase in cases in the rural areas,” he says.
Herd immunity?
Refuting the opportunity of widespread an infection within the inhabitants taking it near herd immunity contributing to the decline in circumstances, Kerala Health Secretary Dr. Rajan N. Khobragade says that as per the third countrywide serosurvey carried out by the ICMR between December 17, 2020 and January 8, 2021, the seropositivity within the State was solely about 11.5%. “So nearly 82% of the population in the State have not got infected,” Dr. Khobragade says.
Dr. Khobragade’s assertion of low seroprevalence within the State is supported by Dr. Anurag Agrawal, Director of the Institute of Genomics and Integrative Biology (IGIB), a CSIR lab in Delhi. “The second serosurvey carried out across CSIR labs found Kerala had the lowest seropositivity,” says Dr. Agrawal.
“The State has managed to stretch the curve such that the new infections are spread out over a longer period of time. The State also continues to undertake more testing and reporting,” Dr. Agrawal says.
“For the first six months, the outbreak was minimal in the State. We have been undertaking active case finding in the State. Anyone with influenza-like illness is tested for coronavirus infection,” Dr. Khobragade says.
Dr. Khobragade additionally cites 30-40% mattress occupancy for sufferers with COVID-19 as proof that the State didn’t expertise large-scale unfold of the virus within the inhabitants. “Our healthcare system was never overwhelmed by COVID-19 patients. There has been not one instance when COVID-19 patients have been denied admission in a hospital due to bed shortage,” he says.
Talking concerning the pioneering efforts undertaken by the State, Dr. Khobragade cites the post-COVID-19 care and administration supplied to individuals experiencing issues after recovering from COVID-19 illness. “Kerala is the only State to provide post-COVID care and management to people. As a result, we have collected sufficient post-COVID-19 data,” Dr. Khobragade asserts. There are 1,284 post-COVID-19 clinics at main well being centres, taluk and basic hospitals and medical faculties.
Genome sequencing
Kerala in collaboration with IGIB was the primary to start sequencing the genome of samples collected from all of the 14 districts to determine any variants/escape mutants. “We began discussion with the State government in September, and the programme became operational in December,” says Dr. Agrawal. “They collect 25 samples from each district per week from people with high viral load, extract the RNA and ship the samples at low temperature. This really helps the operations as we can begin sequencing immediately on getting the samples. Their support is outstanding.”
Over 1,000 samples despatched from Kerala have been sequenced to this point. “This is the largest number sequenced from any State,” provides Dr. Agrawal. “We did not find anything of concern, in terms of variants/mutations in the genomes we sequenced from Kerala.”
