Kerala CM says no, but his expert committee feels community spread would have already begun

CM says no but his expert committee feels community spread would have already begun

Even on a day when another high of 84 fresh COVID-19 cases were reported, Chief Minister Pinarayi Vijayan stuck to his stand that there was as yet no community transmission in Kerala.

However, the expert committee advising the government on how to scientifically deal with the outbreak had told the chief minister on May 26 itself that it was time to move ahead with the understanding that community transmission had already taken place in Kerala.

“It is turning out to be difficult to find the source of infection in a number of cases,” Dr B Ekbal, the chairperson of the expert committee, told a review meeting chaired by the chief minister on May 26.

“So rather than worry about whether community transmission had happened, we should take steps in the belief that such a process had already begun,” Dr Ekbal told the review meeting. The chairperson's advice is recorded in the minutes of the May 26 review meeting.

Pinarayi's unwavering belief

But the chief minister continued to be in denial even two days after the advice. “The sentinel surveillance that we are conducting has confirmed there is no community transmission in Kerala,” the chief minister said during his customary sunset briefing in Thiruvananthapuram on Thursday.

“Nonetheless, if we consider the increase in cases now, we cannot with any certainty rule out community transmission tomorrow,” he added.

The chief minister seems to derive his confidence from the fact that the bulk of the new cases, more than 95 per cent of them, are imported ones, those who had come infected from outside.

CM says no but his expert committee feels community spread would have already begun
Chief Minister Pinarayi Vijayan

“Though the numbers have increased, those getting infected through contacts have not gone up. This is a big relief, it gives the confidence that we could prevent the spread of the virus,” he said.

Nonetheless, it was on the basis of this feedback that the government has decided to do 3000 sentinel surveillance tests a day. Now, it is 9000 tests a week.

Burgeoning 'orphan' patients

The number of contact patients might be small but their gradual increase is a matter of worry. In the last six days, 36 people have acquired the infection through contact. The source of infection of at least 20 of them, including health workers like nurses and ASHA workers, have not yet been traced.

Health workers informally call these patients 'orphans' as their source of infection is unknown.

CM says no but his expert committee feels community spread would have already begun

Joint family paradox

The source of infection in Asiya's large joint family, in which now 14 have been declared positive, is a big mystery. Asiya is the 61-year-old Kannur native who had died in Kozhikode Medical College on May 25.

The guess is Asiya was infected by her husband and son, fish wholesalers who bought their catch from neighbouring states.

What is puzzling is that in spite of their high social exposure (they sell fish in the crowded Thalassery market), the men in the family had not infected, at least till now, anyone outside the family; not their neighbours nor friends nor even fish retailers they regularly supply to.

This has prompted authorities to suspect that the family got infected by Asiya herself. Asiya, in turn, would have got the infection from any of the government and private hospitals in Kannur she had gone for treatment, and was even admitted to for days, since April 14.

CM says no but his expert committee feels community spread would have already begun
A passenger undergoes thermal screening after arriving at Lokpriya Gopinath Bordoloi International Airport following the resumption of domestic flight services after a gap of two months, during the ongoing COVID-19 lockdown, in Guwahati, Tuesday, May 26, 2020. (PTI Photo)(PTI26-05-2020_000105A)

Tribal worry

How a tribal woman in Ayyankunnu panchayat in Kannur, where not a single positive has been recorded, got infected continues to baffle authorities. The tentative explanation is that she could have been infected by the two nurses in Kannur General Hospital who had tested positive.

Fact is, the pregnant woman had not come into contact with both these nurses. "Now, if samples were taken from areas around the general hospital, more positive cases will be revealed," a top health official said.

Two nurses who had tested positive in Thalassery, too, could have been infected by silent carriers in the community. No one has still been able to trace the source of the virus in a Kasaragod-based autorickshaw driver who was rushed to the Pariyaram Medical College in Kannur after he broke his spine falling from a jackfruit tree and tested positive for COVID-19

CM says no but his expert committee feels community spread would have already begun
The increasing recovery rate of the COVID-19 patients, which is at 41 per cent, is a bright spot in India's fight against deadly viral infection. Photo: Reuters

Asymptomatics out in the street

It is also felt that the presence of asymptomatic cases could disguise the real extent of the spread of the diseases. In Asiya's family, except for her, none of the others have exhibited even the mildest symptoms.

“There are many carriers who are freely mingling with family members and the society in the belief they would be the last to be infected. Being highly immune they would recover without even being aware of it, but they could transmit the virus to others who would find it hard to deal with the virus, especially the old and those with other ailments. This is why we need to ramp up tests in a big way,” the official said.

Changing perspectives

Even those patients whose source of infection was thought to be identified are now given a second look.

Take for instance an ambulance driver who tested positive in Thiruvananthapuram on May 25. Initially, it was believed he got infected by a patient he had taken to Parippally Medical College.

But now health authorities say that if the patient was the source, then it was not yet time for the virus to reveal itself as outward symptoms in the driver. The patient was taken in the ambulance on May 23 and the driver tested positive on May 25. It would take a least four days for the symptoms to show.

The remand prisoner who tested positive in Thiruvananthapuram on May 25 is another patient whose source of infection is turning out to be as elusive as a vaccine for COVID-19.

A contact list of 200-plus has been drawn up but it was later realised his most infective period could have been between May 15 and 20. Since he was hopelessly sozzled during the time, the man has still not been able to remember the places he had gone to and the people he had met during this period.

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