Kerala baffled as ICMR study indicates the presence of a mystery COVID-19 patient

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Imagine a doctor gravely telling a seemingly normal man that he is in danger and then, as if struck by sudden memory loss, walking away without saying anything more.

Indian Council of Medical Research seems to have put Kerala in a similar kind of predicament. It has recently published the conclusions of a study its senior researchers had done on the stored samples of 5911 Severe Acute Respiratory Illness (SARI) patients across the country to check the presence of Sars-CoV-2.

It was found that 104 of them had COVID-19. One of them was in Kerala.

The study was initiated because of the widespread concern that many who had gone to government hospitals with some kind of respiratory illness during February and March could actually be carrying the Sars-CoV-2 virus. The data needed for analysis were extracted from Virus Research and Diagnostic Laboratory Network where information from all government-approved laboratories are stored.

For Kerala, which had more or less accounted the source of infection of all positive cases, this came as a shock.

The ICMR study indicated the presence of a new case outside the radar of Kerala's COVID-19 surveillance system. A mystery patient in some unknown district in Kerala who had gone to a government hospital for some respiratory distress was actually a COVID-19 patient.

The study also raises the possibility of more such “mystery cases”. It is said the study perhaps offered just a faint glimpse of the hidden danger as it was highly limited; samples from only five labs in Kerala were used for the study.

Health officials say the ICMR has not bothered to share any details about the hidden COVID-19 patient, not even the district. No one knows whether this patient had come into Kerala's COVID-19 surveillance network later or is still left out on the assumption that he or she is suffering form some other kind of respiratory disease.

“The ICMR is obliged to share the information of patients with all states concerned. But they have not done it,” a top Health official said.

The Health Department now seems to take solace in sanity-sustaining guesswork. A top official said the lone patient the ICMR study had identified could be Abdul Azeez, the retired policeman who had died of COVID-19 in Thiruvananthapuram's Pothencode on March 31. The source of Azeez's infection has still not been traced. But fears of community transmission had vanished after viral antigen tests done on the samples of 100-odd people in Pothencode considered close to Azeez had turned negative.

However, there are health officials who feel it was highly unlikely the ICMR would have chosen Thiruvananthapuram for testing. “Thiruvananthapuram became a focus area only after Azeez's death. The ICMR, if they were keen on picking up the right trends, would have in all likelihood chosen any of the northern districts where the incidence was higher. Ernakulam, where there was an initial spurt, or even Pathanamthitta, where the post Wuhan wave started, were more justifiable choices than Thiruvananthparam,” a community medicine expert said.

Now, the urgent thing to be done is to conduct quick antibody tests in select clusters, especially health workers and specific areas in Kasaragod, Malappuram and Thiruvananthapuram districts where community transmission is suspected.

But for this to happen, antibody kits have to reach Kerala. “This is not happening any time soon as we are now told that supplies were being snatched away at the airport before they could be despatched to developing and poor countries by developed countries like the US and the UK where they are desperate to slow down the transmission,” a senior pathology expert said. “The Central Government also seems indifferent to the possibilities of rapid tests or else it could have easily ramped up domestic production of the kits. India has the capability,” the doctor said.

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