The recent days in relation to fresh COVID-19 infections have been surreal for Chennai residents. From being the epicentre for one of the largest COVID-19 clusters in the country -- Koyambedu market cluster -- and reporting around 2000 fresh cases on a daily basis in June 2020, Chennai has come a long way in reducing the number of fresh cases of COVID-19. In the last couple of weeks, the district has been reporting around 650 new COVID-19 cases per day, a significant reduction from what it was in June 2020.
A look at the data on the number of fresh cases in Chennai since August 2 shows us that the number was oscillating between 900 and 1350 till October third week. It was only after October 18 that the new COVID-19 cases started to decrease in Chennai. Meanwhile, the number of patients dying due to COVID-19 has also marginally decreased in the last three weeks. From reporting 22 deaths on August 16, the number has come down to 11 deaths as of November 1.
Trend of the fresh cases of COVID-19 in Chennai
Number of deaths in Chennai has declined marginally in the recent past
TNM spoke to a few epidemiologists to understand the reason for this decline and whether the worst is over for Tamil Nadu’s capital city.
Chennai city, under the limits of the Greater Chennai Corporation (GCC) at one point was testing around 14,000 samples per day. Extensive fever camps and street-level surveillance were put in place to combat the deadly virus which was finding its way through the nooks and corners of the city. A senior government officer told TNM that the decline could be attributed to the fact that around 30% of the city’s residents have developed antibodies against the virus and around 60% of the residents are strict in wearing masks in public places. “This would have slowed down the movement of the virus among the people,” he said, on the condition of anonymity.
Dr P Kuganantham, epidemiologist (retired) from the GCC and a member of the state-level task force headed by Chief Secretary K Shanmugam, agreed with this view. “The only difference between the epidemic in our country and other countries is the population. We have a high population and high density in cities like Chennai. A lot of people are infected including those who are asymptomatic and have not been tested. So, I expect a large number of people have already been infected, thus causing a slump in the spread of the virus,” he told TNM.
J Radhakrishnan, Principal Secretary for Health, Government of Tamil Nadu told TNM that it could be a combination of multiple factors that has led to a decline in the number of fresh cases in Chennai. “The main factors that contributed to this decrease are that we followed the guidelines given by international organisations like the World Health Organisation (WHO) and also the state government. Secondly, the inter-departmental cooperation was excellent on the ground which helped us trace cases,” he said, adding that the cooperation of the general public in following non-medical methods like using face masks and washing hands also contributed to the decrease in the number of fresh cases. “This (discipline) will continue to be critical to prevent a second wave,” he pointed out.
While the cases have seen a marked fall, the number of tests conducted in Chennai has also seen a significant decline. From conducting around 14,000 tests at one point, the GCC has conducted 10,795 tests on November 1. The immediate question that pops up is if the decline in the number of new COVID-19 cases is because of a decrease in the number of tests.
“The reason why testing has come down to around 10,000 tests a day now is because the number of cases have also come down. I believe it is not right to view these parameters as standalone items. We must look at it together. Whenever there is a case, we generally test the high-risk contacts as well, which causes the test numbers to go up. Now with the number of cases coming down, the test numbers will also decrease to an extent,” Radhakrishnan explained. He added that other factors like the private labs not working on Sundays and the general reluctance among people to not visit fever camps during festival days (unless they are absolutely unwell), might have also contributed to the decrease in test numbers.
COVID-19 is a risky disease, especially to those who are in the high-risk category -- persons with comorbid conditions like diabetes, hypertension, kidney issues, those above 60 years of age etc. As of November 5, Tamil Nadu has reported 11,272 deaths due to COVID-19, of which 3,693 are from Chennai. However, in the last two weeks, the number of deaths has come down slightly.
Radhakrishnan acknowledged the marginal dip in the number of deaths in the city but was not entirely happy with it. “The weekly mortality has come down. We are aiming at bringing the mortality to below 1%. We have to improve it. Direct deaths are quite less actually, most of them are due to comorbidities or arriving at the hospital very late,” he said. Experts also said that the mortality rate will come down only when the decline in the caseload is steady and sustained over a period of time.
“The number of deaths has reduced in the recent past. But it all depends on masking and physical distancing. Deaths can come down only when transmission comes down. Transmission can come down only when safety protocols are followed with discipline,” said Dr G Srinivas, Professor of Epidemiology, Dr MGR Medical University, Tamil Nadu.
Chennai has been under lockdown -- severe and not-so-severe ones -- since March third week and lakhs of people have lost their livelihoods due to the pandemic. With the caseload seeing an encouraging decline, TNM asked the experts if the worst is over for Chennai as far as the pandemic is concerned.
“Herd immunity is on the rise in India, especially in cities like Chennai. The epidemic will not be any worse, henceforth,” Dr Kuganantham said, adding that it is, however, imperative to take extremely good care of the vulnerable population (high-risk persons). He attributed this to the higher rate of herd immunity in Chennai. “Even during Deepavali, if the cases spike, care must be taken to ensure that our elderly don't get affected. Instead of fearing a spike in cases, people must be encouraged to stick to the personal protection and community protection protocols like masking and washing hands,” he added.
Dr Srinivas, while acknowledging that the worst is over for the city, said that it is important for the public to cooperate better in the coming days. “Right now, we have had exceptional accomplishments due to the participation of the public. Especially, in the last two months. So if the people continue to cooperate, especially during Deepavali, this can be controlled much better,” he pointed out.
With the festival season in full swing, Radhakrishnan sounded more cautious and said that it is not the time to relax and celebrate the decrease in caseload. He explained that going forward, the people must understand that this is a public health emergency and hence must follow non-medical methods of protection until a vaccine or a curative medicine is found.
“We still feel that this is the period where any of us is capable of being a super-spreader of the virus. Though there is heavy focus on the usual crowded places like markets and shopping places, any place with over 20 people is risky,” he said.