The state can’t afford to let its guard down, like it did during Eid
Kerala has gone from being celebrated internationally last year for its Covid management to becoming the object of national concern, with the Union government sending a team to the state against the backdrop of the alarming number of cases it is reporting. It now accounts for 50% of India’s daily new Covid cases. The state’s test positivity rate, after holding steady nearly all of July, is now inching upwards.
At more than 12% over the past week, it is worryingly high. Part of this can perhaps be attributed to the fact that it had the lowest seroprevalence—presence of antibodies against SARS CoV-2 in the body due to previous infection/vaccination—amongst 21 states, as reported by the latest ICMR sero-survey.
At just 44%, the state’s seroprevalence means 56% of its population, at the time of the survey, could still get infected. While other states, too, have reported low seroprevalence numbers—Assam has reported 51% and Maharashtra 58%—epidemiological logic holds that the higher the seroprevalence of a geography is, the slower and narrower transmission it will see. Consequently, while there are likely to be marked differences in the transmission picture with a Madhya Pradesh (seroprevalence 79%), Kerala will still report a more aggressive transmission picture than even a West Bengal (seroprevalence 61%).
Also, Kerala likely under-reports cases the least, as an analysis based on ICMR seroprevalence data done by epidemiologist Chandrakanth Lahariya shows, reporting one in every six cases, against the national average of one in every 30 and Uttar Pradesh’s showing of one in every 98.
Also, the fact that the state has managed one of the lowest case fatality ratios in the country—something that National Institute of Epidemiology’s Jayaprakash Muliyil believes is an indicator of good Covid management—is testament to its superior Covid-management and the strength of its public health.
That said, the state government can hardly afford to drop its guard. It went ahead with relaxation of restrictions in the run up to Eid—albeit, allegedly, under threats of wilful breaching by traders’ associations—even while the Supreme Court had taken the Uttar Pradesh government to task over permitting the Kanwar Yatra. This is likely to have worsened spread.
At the same time, the state needs to formulate its restrictions in a manner that doesn’t cause crowding when establishments are allowed to function—there is a lot of scientific literature showing Covid-19 spread worsens with crowding, especially in poorly ventilated spaces. The fact that the state’s R0 is doggedly above 1 shows that the state is struggling to contain the spread.
With a large hitherto-uninfected-population, this can spell disaster if the numbers surge as more infective and virulent variants of the virus emerge. The state has done admirably on vaccination, with 40.7% of its population having received at least one dose of the vaccine, and17% having received both doses—against the national average of 27% and 7.8%, respectively. It will have to keep up the momentum on this. Meanwhile, the testing and tracing excellence it has become synonymous with needs to be maintained.