New Delhi: Kerala, which was once lauded for its containment strategy for Covid-19, is now continuing to record the highest number of coronavirus cases in the country even as the rest of India has been witnessing a decline.
“Only two states — Kerala and Maharashtra — have more than 35,000 active Covid cases and together contribute to 71 per cent of cases. Kerala has 65,670 active Covid cases and Maharashtra has 35,991 active cases,” said Rajesh Bhushan, Health Secretary, at the weekly press briefing Tuesday.
Kerala is the only state where active cases are steadily rising.
According to the health ministry’s weekly press briefing Tuesday, the total active cases in Kerala rose from 64,434 on 9 January to 65,670 on 9 February. But Maharashtra saw cases declining from 53,006 on 9 January to 35,991 on 9 February.
On 11 February, India recorded a total of 9,353 new cases with 85 deaths and 15,722 recoveries.
Kerala Thursday recorded the highest daily cases and second highest deaths (after Maharashtra) — 5,281 cases, 16 deaths and 400 recoveries.
Officials in the Kerala government, however, told ThePrint the pandemic is under control in the state and that the healthcare system is not overwhelmed even though the daily cases are not declining.
But experts said there is a need to increase testing and ensure Covid protocols are strictly observed.
Highest daily caseload in the country
Data available on covidtoday.in, a crowd-funded website, showed India has been witnessing a declining trend in Covid cases since 16 September when 97,860 cases were recorded.
Since then, daily cases dropped to 62,304 on 16 October; 28,609 on 16 November; 18,172 on 16 December, 15,050 on 16 January and 12,923 on 10 February.
But Kerala didn’t register a decline. The state recorded 3,830 cases on 16 September; 7,283 on 16 October; 2,710 on 16 November; 6,185 on 16 December; 5,960 on 16 January and 5,980 on 10 February.
In terms of deaths, Kerala’s case fatality rate as of 10 February stands at 0.4 per cent, as against the national average of 1.4 per cent. It has seen a total of 3,936 deaths due to Covid since the beginning of the pandemic.
The state’s testing has also been a cause of concern.
Kerala’s test positivity rate is 9.6 per cent, almost double the national average of 5.3 per cent, according to covid19india.org.
‘Healthcare system not overwhelmed’
Despite the worrying numbers, officials in the Kerala government said there’s little to be concerned about.
“We had the most number of cases in October. But even then not even 25 per cent ventilators were occupied and nor did the ICU-bed occupancy go above 50 per cent. So that indicates that our surge capacity is enough,” said Dr Mohammad Asheel, executive director, Kerala Social Security Mission and a core member of Health Minister K.K. Shailaja’s Covid-19 team.
“After that, cases have plateaued. When you don’t control the pace of the pandemic, the healthcare system gets overwhelmed. But in Kerala, the pandemic is moving slowly and our healthcare system is not overwhelmed and we have detected cases 7 times more efficiently than the Indian average if you go by the last national sero survey,” he added.
According to the sero prevalence study, Asheel claimed, Covid was detected in one of every three persons tested in Kerala, against the corresponding national figure of one positive case every 22 tests.
Speaking to the media earlier this week, Chief Minister Pinarayi Vijayan also said more cases were being reported in Kerala because the state has “systems in place to track and trace” Covid patients.
“The spread has been much less in Kerala than rest of India. More cases being reported in Kerala shows that we have systems in place to track and trace,” he said, adding that Kerala has been able to control the spread of Covid-19 “much better compared to other states”.
Asheel, meanwhile, said the mortality rate has also been under control.
“We have recently conducted a study comparing 2019 data against 2020 deaths data and found that even with the pandemic Kerala has registered lower deaths than in 2019. Whereas in countries like Italy and the US, the deaths increased in 2020.”
He added: “Kerala is also the diabetes capital of India and hypertension cases are also high. Despite this, deaths remained under control as our healthcare system was not overwhelmed.”
Former government officials also said the number of infections will go down in the coming months once vaccination picks up.
“Kerala’s Covid fatigue along with its dense population is reflecting in high infections. The state has ensured that the infections remain below the surge capacity and the cases too have remained steady due to the strategy of testing and contact-tracing. In the next 3-6 months, as vaccination picks up, infections too will go down,” said Rajiv Sadananda, former Kerala health secretary.
‘Ramp up testing’
Experts ThePrint spoke to said there is a need to ramp up testing though cases have plateaued in a sense.
“The state has increased testing in the last week from 55,000 to about 70,000. When testing increases, daily cases also increase. But despite that cases have remained around 6,000, which has brought down the test positivity rate from above 10 last week to below10 now,” said Dr Rijo M. John, health economist and consultant at WHO.
However, there is still a need to increase the tests and ensure compliance of Covid protocols, he said.
“Kerala has seen many events one after another. Local body elections just concluded and now assembly elections are around the corner. Mask compliance has gone down. Chief Minister Vijayan promised to increase daily testing to 1 lakh a day, but that still hasn’t happened. Even though pandemic is moving slowly in Kerala, there is still a need to increase testing,” he said.
The experts also said the state failed to effectively check the incoming population.
“Kerala has a high expat population, which came in from other parts of the country as well as abroad. About 18 lakh people came into Kerala and they weren’t screened properly and now Covid appears to have reached every household,” said Dr P.T. Zacharias, president, Indian Medical Association, Kerala.
“We have urged the government to not allow schools below 10th standard to open. We have also urged the government to ensure Covid compliance in political rallies and increase testing,” he added.
The experts said Kerala’s numbers should also be seen in the context of decreasing tests in other states.
“India is averaging 70 lakh tests a day now. Earlier in September, India conducted 1 million tests overall. Several other states have also scaled down testing, while Kerala has increased testing, which is reflecting in the numbers,” said John.