Kerala's northern districts, from Palakkad upwards, are witnessing a gradual spike in fresh COVID-19 cases. Kerala recorded 24 new cases on Wednesday, the third highest daily toll after the numbers started moving northward since May 13.
All except one had come from outside; 12 from the Gulf, eight from Maharashtra and three from Tamil Nadu. One person in Kannur was infected by a returnee; this is the first infection acquired through contact in the last three days.
The active cases in Kerala is now 161. Eight days ago, on May 8, it was only 16, an over 900 per cent jump in active cases. “We are entering a very serious situation,” Chief Minister Pinarayi Vijayan warned.
Unlike in the earlier wave, when the viral eruption was concentrated in one or two districts at a time, now it looks like there is an even spread. On Wednesday, cases were reported from 10 districts. On May 18, it was reported from 12 districts.
On Wednesday, he highest number was reported in Palakkad: seven. Malappuram had four; Kannur, three; Thiruvananthapuram and Pathanamthita, two each; and Alappuzha, Ernakulam, Kozhikode and Kasaragod, one each.
All districts from Thrissur above have active cases in double digits. Malappuram has the highest, with 33. With seven new cases on Wednesday, Palakkad now has the second highest active cases in Kerala: 20. Kasaragod has 18, Kannur and Wayanad has 15. All three had one recovery each on the day.
With two recoveries on the day, the number of active cases in Thrissur has come down to 12. Kozhikode also has the same number.
In the southern region, Kollam has the highest number: eight. Idukki has the least with just one active case.
Vijayan said things could spiral out of control if the cases continue to rise. “There will be no exemptions in containment zones, and controls will be intensified in these areas,” he said.
Home remedy
Pinarayi Vijayan said the only way out was a strict home quarantine strategy. “Those in quarantine should not step outside, and should not interact with others inside the house, too. they should stay inside the room,” he said. At the moment, there are 74,398 people under surveillance in Kerala, and 73,865 of them are in home quarantine.
The objective is to prevent the virus from spreading from the 'imported' cases to others. During the last wave, which began with the return of the Ranni-based family from Italy on February 29, Kerala had succeeded to limiting the contacts.
It is officially said that less than 30 per cent of COVID-19 patents in the last phase were contacts of imported cases. On average, a person who had returned from outside was not transmitting the virus to even one person. This means that the R number, or the reproductive capacity of the virus, in Kerala was less than 0.5, can be considered to be highly safe.
The chief minister said the strategy for the new wave was also the same. “Some people come in with the virus. Our responsibility is not to let them infect others. Cut the contact,” he said.
He said to make this happen, ward-level committees - made up of ward members, Kudumbashree workers, ASHA workers, and volunteers – and the police should keep a tight watch on those n quarantine.
Quarantine to break the chain
Strict observance of quarantine is also important to prevent asymptomatic cases from infecting others. Those with symptoms are shifted to hospitals but others, especially those coming from other states, are allowed to go home. A fraction of them could be asymptomatic but infective.
Take for instance a 22-year-old who had tested positive in Kozhikode on Wednesday. He had arrived in Kerala on May 11, and he showed symptoms six days later, on May 17, the usual time when symptoms like fever are manifested in over 85 per cent of COVID-19 patients.
It is highly likely that he could have been infected by an unknown co-passenger, probably an asymptomatic case, in the private bus he had travelled to Kerala. If there is such a case, the person would now be in quarantine, blissfully unaware that he is infected.
Aircraft's mystery carriers
The flight arrivals can also be puzzling. Given that there is a shortage of testing kits, it can leave the authorities clueless on who should be tested.
An Alappuzha native who had reached Kerala on May 9 tested positive on Wednesday. His wife, a pregnant woman, had tested positive on May 18.
It looks unlikely they had boarded the flight with the virus. They arrived from Kuwait on May 9. The wife started showing symptoms on May 16, seven days after arrival, and she was declared positive on May 18. The husband's symptoms manifested on May 18, nine days after the arrival, and was declared positive on Wednesday.
They had developed symptoms seven and nine days after arrival, longer than even the 5-6 days more than 85 per cent of patients take to show symptoms after infection. Therefore, there is a high possibility they were infected by a mystery source, probably an asymptomatic patient, inside the aircraft.
“There were more than 170 passengers in the plane. Any of them could have been the infectant but it is not practical to test all of them, especially because there is a huge shortage of testing kits. The next best thing is to ensure that those in quarantine are prevented from having contacts with anyone else till their 14-day quarantine period is over,” a top health official said.
Arrivals without secrets
It is only rarely people come in with full knowledge of their health status, like the two Palakkad natives who tested positive on Wednesday. They had returned from Chennai after testing positive in Chennai. They were taken over by the Health Department the moment they crossed the border, effectively cutting off even the remotest chance of transmission.
As for the rest, they are unaware they have already been infected or get seeded during the return journey.
Important points from the CM's press meet:
• The remaining SSLC, Higher Secondary, Vocational Higher Secondary exams will be held from May 26-30 as per the earlier timetable.
• Provisions will be made to ensure that all students are able to write their exams. Precautions and travel arrangements for students will be made by the state government.
• Those in red zones must take strict precautions as the chances of virus spread is high.
• Stricter measures will be brought in containment zones.
• CM had interacted with district collectors, police officials, DMOs, and panchayat officers to introduce new measures and strengthen existing ones to curb the spread of virus as lockdown restrictions ease in the state.
• Those in quarantine must not step outside or interact with family members. They must remain inside the allotted room and stay there for 28 days.
• Police officials have been directed to check on those undergoing home quarantine, ensure the strict adherence of social distancing norms. Local authorities too have been roped in for this effort.
• The state must unite to combat the virus. It is not the responsibility of just the health authorities, CM said.
• DMOs will be directed to prepare a list of all doctors. This will be shared with the district authorities to ensure that those in need can seek medical help easily.
• Rain is likely to bring more contagious diseases. Waste should be disposed properly. Water bodies should be cleaned. Efforts must be taken to prevent the breeding of mosquitoes.
• Those coming from abroad have been advised to undergo home quarantine. Govt will only make provisions for those who are unable to get home/don't have facilities.
• Around 6,000 temporary posts created to ramp up fight against coronavirus. Of this, 2,000 new posts were created to include those who had come from abroad.
• Those who handle currency, coins must wear gloves at their workplaces.
