New Delhi: Kerala, once lauded for its Covid containment strategy, has witnessed an explosion of cases in September. The Kerala government data reveals that the state has more than doubled its case tally in one month, adding over a lakh cases in September alone.
Total cases have increased to 1,87,276 on 30 September from 76,525 on 1 September. As of 30 September, Kerala recorded 719 deaths and 1,24,688 recoveries. It has 62,588 active cases. According to the Ministry of Health and Family Welfare (MoHFW), the state has the highest percentage of active cases — at 33 per cent as of 30 September.
In the last week alone, Kerala recorded over 40,000 new cases, hitting new highs almost every day. According to a report by Jeevan Raksha, a public-private partnership initiative that has been analysing Covid trends, active cases in all 14 districts in Kerala have registered a total surge of 130 per cent through September.
The report, analysed by ThePrint, also reveals that both the seven-day moving growth rate and 30-day moving growth rate are more than double the national average.
Government officials that ThePrint spoke to said the spike is due to easing of lockdown measures and the state’s high population density. The officials also said despite the rising cases, deaths have not increased in this period.
Chief Minister Pinarayi Vijayan Monday said the state will impose strict restrictions to tackle the cases.
Experts that ThePrint spoke to, however, said the spike in cases is due to people’s complacency and testing not keeping pace with the rising infections in the state.
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Spike in September
According to the Kerala government health bulletins, daily cases increased by nearly seven times in September — from 1,140 on 1 September to 7,354 on 29 September.
The last week of September alone added 48,645 cases to the state’s tally — 4,125 (22 September); 5,376 (23 September); 6,324 (24 September); 6,477 (25 September); 7,006 (26 September); 7,445 (27 September) and 4,538 (28 September), and 7,354 cases (29 September).
According to the Jeevan Raksha report, prepared with the guidance of the Indian Medical Association and the Public Health Foundation of India (PHFI), Kerala’s seven-day as well as 30-day moving growth rate (which shows the week-on-week growth rate) are more than double the national average.
Kerala’s seven-day moving growth rate as of 26 September was recorded at 28 against the national average of 11 on the same day. The state’s 30-day moving growth rate as of 26 September was 98 against the national average of 46.
The report also said active cases in three districts — Kollam, Palakkad and Kannur — have increased by over 200 per cent from 29 August to 26 September. During the same period, active cases in five other districts — Ernakulam, Thrissur, Kozhikode, Idukki and Kottayam — have seen a 150 per cent increase.
Testing in the last month has more than doubled, rising from 14,137 tests on 1 September to 36,027 on 28 September. However, Kerala’s test positivity rate, which implies the percentage of people who test positive for the virus, is at 13.6 per cent, above the national average of 6.1 per cent.
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Govt blames opposition, high population density
A Kerala government official told ThePrint that the surge in cases is due to the high population density in the state.
“Kerala’s high population density at 859/sq km along with its elderly population of around 14 per cent makes the state vulnerable. We were able to delay the peak earlier but even with this spike, we expect the real peak to come sometime in October or November,” said Dr Mohammad Asheel, Executive Director of Kerala Social Security Mission.
With the easing of lockdown measures, more people are out and that has contributed to the spike, especially after the Onam festivities, he added.
On 25 September, Health Minister K.K. Shailaja came down heavily on the opposition for organising protests amid the pandemic. “What the opposition is doing here is a big crime, something that weakens the government’s Covid-containing activity to save people,” she said.
On Monday, CM Vijayan also slammed the violation of Covid-19 norms. “Covid guidelines such as wearing masks and maintaining social distancing have to be followed. There is a sense among a section of the people that these guidelines are not required anymore. That is dangerous.” he said.
‘Ramp up testing, impose medical emergency’
Experts that ThePrint spoke to, however, said both the government and the people are partly to blame for the spike in cases. “Kerala does have high population density but that’s not the only reason behind the spike. Once lockdown measures were eased, Covid protocols have been completely violated during Onam as well as during these ongoing political rallies across the state,” said Dr Abraham Varghese, the Indian Medical Association’s Kerala in-charge.
“We have urged the government now to impose a medical emergency in the state to ensure Covid protocols are not violated and hefty fines are imposed for violations.”
Experts also said while Kerala has increased testing, it has not kept pace with the spike in infections.
“Daily growth of testing is only above 1 per cent while daily growth rate of cases is above 3 per cent. This implies that testing needs to be ramped up. Unlike the last time when cases had surged, the magnitude of increase is much higher now,” said Dr Rijo M. John, health economist and consultant at the World Health Organization.
While the state has increased testing, it’s Rapid Antigen tests that have seen a rise, raising concerns about false negatives.
Data reveals that of the 28,04,319 samples tested as of 29 September, 14,37,083 have been rapid antigen tests against the 1,41,855 Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) tests, considered the gold standard for testing.
Government officials, however, said the testing strategy has been changed to keep up with the level of the pandemic.
“RT-PCR tests take far too much time and the level of the pandemic has changed. Our goal is to catch the symptomatic patients and to catch the infection early. Our focus on symptomatic patients has kept the test positivity rate up,” said Dr Asheel.
Doctors, however, said mortality rate that is 0.4 per cent now is likely to increase in the coming weeks due to the surge in cases. “This surge will reflect in a higher death rate in the next few weeks,” he said.
The Kerala government maintained that the healthcare system is more than prepared to tackle the crisis despite the surge. “We have enough facilities but don’t want to be overconfident,” said Dr Asheel.
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And where is that propagandist called Shivam Vij now who was in awe of the Kerala model now?