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Why southern states that better handled Covid before now account for 33% of India’s caseload

Authorities in the five southern states say increased testing has led to a spurt in Covid numbers but point out that mortality rate is low despite the high number of cases.

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Bengaluru: The southern states, barring Telangana, were among the ones better off in the country in terms of handling the Covid-19 pandemic during the early days, tracking those affected early, ensuring strict quarantine and just about staying ahead of the curve.

Of late, however, there has been a spurt in cases across all five states.

Kerala, which had been once lauded for the strides it was making towards ‘flattening the curve’, even admitted that community transmission has started in the state. Karnataka Medical Education Minister Dr K. Sudhakar also acknowledged last month that “cluster and community” transmission of Covid-19 had begun in the state.

The five states together now contribute a little more than 33 per cent of the national Covid caseload. Of the total 15,83,792 cases in the country, as of Thursday morning, more than 5.27 lakh cases are from the five southern states — Andhra Pradesh, Telangana, Karnataka, Tamil Nadu and Kerala.

Kerala 

Kerala nearly flattened the Covid-19 curve in May, but Chief Minister Pinarayi Vijayan admitted on 17 July that the state is now grappling with “community transmission”.

The state government has identified two fishing hamlets — Poonthura and Pulluvila — near Thiruvananthapuram as the hotspots and strict stay-at-home orders have been issued.

Kerala has also deployed commandos to ensure people stay home at both hamlets, which together saw an 87 per cent increase in cases in just the first week of July.

Members of the fishing community have been travelling along the coast all the way towards Mumbai and Tamil Nadu, mixing with other clusters and causing the virus to spread, Kerala Health Secretary Rajan Khobragade told ThePrint.

Kerala, however, still has the lowest number of active cases among the southern states.

As of Wednesday, Kerala recorded a total of 21,798 cases with 65 deaths. As many as 11,365 patients have been discharged, leaving the total number of active cases at 10,350.

Dr Sulfi Nuhu, secretary of the Kerala chapter of Indian Medical Association (IMA), said there are broadly three reasons for the spike — opening up of the state following lockdown, possible violation of quarantine as the state had close to 2 lakh people under home quarantine, and high population density.

“We expected such a spike. Our efforts are to ensure that people recover faster and the mortality rate is kept low,” said Nuhu. “We are now looking at a triple lockdown to curb the spread. If we can keep the cases to 1,000 a day, we will be able to control it in the next couple of months.”

At some point, a sense of complacency set in, said Irudaya Rajan, professor at the Centre for Development Studies. He said since the state was doing well, people thought it would continue to do so.

The government should have allowed people to travel before the lockdown and then used the lockdown to contain the virus, he said.

When asked if narrow testing criteria contributed to the spike, Khobragade disagreed. He said Kerala’s tests per million numbers have been adequate.

“The ratio is one of the best and we have the lowest fatality rate with 63 deaths so far. 16,000 tests per day is not a small amount,” he said. “We are the only state that is doing sentinel surveillance for active case finding. We have more than 15,000 samples coming in per day.”

The logic that tests are low is a flawed one, Rajan said, adding that everyone cannot be tested. “We are preparing long-term plans for disease containment and capacity building,” he said.

Andhra Pradesh 

After having earned praise for its contact tracing and effective handling of the pandemic, Andhra Pradesh crossed the 1 lakh mark Monday, registering one of its highest spikes of 6,051 cases on a single day.

As of Wednesday, Andhra Pradesh had a total of 1,20,390 confirmed cases, of which 63,771 were active while 55,406 patients had recovered. As many as 1,213 people died.

Authorities in the state, however, insist they are making great strides in containing the pandemic.

“When the panic started, we did not have a single laboratory to help us test. From there to becoming a state today that is doing highest tests per million shows the efforts and leadership that has gone to build such capacities,” Katamaneni Bhaskar, Commissioner for Health and Family Welfare, told ThePrint.

AP has had high testing rates and has introduced various innovative measures to trace primary and secondary contacts. AP health officials say they conduct close to 50,000 tests per million and peg the positivity rate at 5.86 per cent and the recovery rate at 48.08 per cent.

“The more you find positive cases, the better it is. There are people who are affected by the virus. You track, isolate and treat them, it will help in reducing the spread,” Bhaskar explained. “Making it an issue that positive cases are rising is not correct. States that are testing more are doing better. We have targetted testing, and (we) test the right pockets of people.”


Also read: In special Covid drive, Andhra police rescue over 4,000 children through Operation Muskaan


Tamil Nadu

Tamil Nadu crossed the 2 lakh cases mark last week but has managed to bring its positivity rate down. Last week, the positivity rate dropped from 37 per cent to 12 per cent.

In all, Tamil Nadu had a total of 2,34,114 confirmed cases as of Wednesday, with 3,741 deaths. So far, 1,72,883 people have been discharged, leaving 57,490 active cases. The silver lining has been the number of discharges that outnumber the active positive cases.

Tamil Nadu Health Secretary Dr J. Radhakrishnan, said they are not worried about the high number of positive cases.

“TN focuses more on aggressive testing, tracing and identification,” he said. “On an average, we test around 30,000-40,000 RT-PCR samples in a day. The focus is to catch people early, not the number of positives.”


Also read: ‘Judge me for my work, not name’ — daughter Vidhya on Veerappan, politics and BJP


Telangana

Telangana consistently stands out as one of India’s problematic states. Numbers here started to spike steeply in June and the cumulative figure now stands at 60,717 with 505 deaths as of Wednesday.

The state has 15,640 active cases, while 44,572 patients have recovered.

State officials, however, said the mortality rate of around 0.86 per cent is much lower than the national average of 2.3 per cent.

The surge here, however, was predictable as the state had low testing numbers, something the government came under immense criticism for.

In early July, the government also stopped tallying private lab numbers citing too high a test positivity rate, which it attributed to rampant data discrepancies.

Authorities now claim they conduct over 15,000 tests a day.

To tackle the surge, Telangana Director (Health) Dr G. Srinivas Rao said, they have adopted a strategy of being judicious in using their resources while ensuring maximum impact in controlling the pandemic.

“The fight will be drawn out and the state’s focus will be on testing and early detection without exhausting resources,” he said.

Karnataka 

Karnataka also has crossed the 1 lakh mark.

As of Wednesday, the state had 1,12,504 cases, with 67,447 of them active and 42,901 recovered. The state saw 2, 147 deaths due to Covid-19 until Wednesday.

Lack of coordination between officials, ministers and mismanagement of a robust contact tracing system led to the undoing of all the good work and planning during the lockdown.

The Bruhat Bengaluru Mahanagara Palike (BBMP) has been blamed for the worsening situation.

“A dramatic increase in the number of cases since the ‘unlockdown’ has exposed the lack of coordination and preparedness by the BBMP,” Dr Giridhar Babu, epidemiologist and member of Karnataka’s Covid-19 expert committee, told ThePrint.

Bengaluru has 36,224 active cases and 16,000 containment zones to curb the spread. The city has seen 987 Covid deaths. The authorities have acknowledged that community transmission is happening and severe shortage of healthcare workers and hospital staff and Covid beds have contributed to the state’s problems.

According to C.N. Manjunath, a State Task Force member, the spread in Karnataka can be attributed to migration and possible spread through clusters of people such as domestic helps, drivers and security personnel who live in congested quarters.


Also read: Yediyurappa says it’s been a trial by fire as he completes one year as Karnataka CM


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