On January 24, Kerala recorded a test positivity rate (the number of infected when 100 people are tested) of 12.8 per cent, the highest in 43 days. It was on December 12, last year, that the TPR was higher, 14.91 per cent.
But the December 12 test positivity rate seemed like an aberration, a stray event of no consequence. The day's number was the only 10-plus TPR figure in December; the days that followed and the days that came before mostly stuck to a TPR of 8-9 per cent.
On the contrary, the TPR of January 24 seems ominous. It looks like the first sign of a COVID-19 surge after the first major case explosion in October, 2020.
It has also been confirmed that the new highly infectious variant from the UK has nothing to do with the rise in cases. The variant was detected in only 10 of the 70 people who had returned from the UK and they were isolated the moment they arrived, preventing any further spread.
Second surge in the wings
The new year began with a TPR that was marginally less than 9 per cent, and for most part of the month, till January 19, the TPR never went above 10 per cent.
From January 20, the TPR jumped to 11 percent, held on with a marginal increase for three more days, and then on January 24, shot up to 12.48 percent. On Monday, because the number of tests were way low at just 30,903, the TPR seemed a moderate 10.88 per cent.
The general consensus, even among top government health officials, is that the effect of the New Year opening up is about to show up in higher daily cases. Already Kerala tops the country in daily COVID-19 cases. In the last seven days alone, there has been a 35 per cent or more increase in the number of cases in at least seven districts.
The October explosion
It was in the middle of October last year, when public restrictions began to ease in a big way, that the infection rate threatened to gallop out of control. The TPR had then touched a peak of 18.16 per cent on October 13, 2020. More than half the days in October had a TPR of more than 13 per cent.
By the second week of November, the infection rate slowed down and later, even amid campaigning for local body polls, the TPR fell below 8 per cent. In November, the TPR hovered around 9-11 per cent, and there was no major increase in daily deaths either.
Merciful local body polls
The local body polls did not push up COVID-19 numbers to the alarmingly high levels estimated but the government expected the Christmas vacation and New Year celebrations to throw up larger numbers. By the second week of January, theatres were thrown open for mass shows. By then, school and colleges, too, were partially opened.
It was estimated that the number of daily cases could touch 9000 by the middle of January. The number but remained below 6500.
Mountain and a plateau
Yet, it is by far the highest in the country. Kerala is the only major state in India that was not showing a 'plane landing' COVID-19 curve. Neighbouring states like Andhra Pradesh, Telangana, Tamil Nadu and Karnataka brought their daily caseload to three figures, two of them below 500.
Daily cases in Delhi, which was once the worst affected in the country, are below 200. Maharashtra alone had higher cases, but it was still below 3,000, far lower than the 6,000-plus Kerala is clocking daily.
At the moment, Kerala is not showing an upward trend. Here, the cases have plateaued, but at a very high level. In other words, Kerala consistently throws up a high number of COVID-19 cases daily, and even this number is now threatening to go up.
If Kerala's Covid situation looks like a horizontal straight line with a slight upward curve towards the end, the national COVID situation, shown as a graph, resembles a mountain, its peak attained towards the end of September, 2020.
Keeping death at bay
Kerala seems to be the only state where the situation is grim. However, health officials say this was the result of a deliberate preventive strategy. "Right from the start, our plan was to delay the peak so that we have the necessary infrastructure like hospitals beds and ICUs in place when the peak actually hits us. This is why our death rate is the lowest in the country," a senior doctor who advised the Health Department on COVID-19 strategy said.
Admittedly, Kerala has a fatality rate of 0.41 per cent, one of the lowest in the country. Postponing the peak allowed the creation of a responsive health care system. The upshot was that none without comorbidities (like diabetes, asthma or cardiac issues), except two or three, had died of COVID-19 in Kerala. Official figures show that 99.9 per cent of COVID-19 deaths in Kerala were the result of the virus worsening existing health conditions of the victims.
But even this hope-giving statistic is taking on a distressing shape. On October 10, it was 0.28 per cent. Now, three-and-a-half months later, it has inched up to 0.41 per cent.
Fatal failure
Kerala might have been able to keep its deaths low but, on the other hand, it has failed to bring down its daily deaths. While Kerala's daily mortality figures, for over four months, has hovered consistently between 20 and 24, official death figures have fallen in other parts of the country.
It is true that other states have shockingly high numbers of total deaths when compared to Kerala's 3,624; Maharashtra (50,578), Karnataka (12,197), Tamil Nadu (12,316), Delhi (10,808), West Bengal (10,115).
But at this point, except for Maharashtra, all other states have a far less daily mortality figure than Kerala. In Delhi, Karnataka, Tamil Nadu, Uttar Pradesh, West Bengal and Odisha it is in single digits. Andhra Pradesh and Rajasthan have brought it down to zero.
Inadequate testing
Top health officials in Kerala attribute this to poor testing, a general lowering of official guard, in other parts. "In Kerala, we persist with our meticulous ways. We still keep screening and testing, and we keep proper records," a doctor involved in COVID-19 duties said.
However, there are complaints that Kerala is not testing enough. The plan was to do 70,000 to 75,000 tests daily. But daily tests had crossed 70,000 only once in the last four months, on November 4 when 71,270 tests were done. And it was only eight times in the last four months that more than 65,000 tests were done.
"Fact is, even if we are willing, we don't get as many people to test a day," the health official said.
