The source of infection in 50 COVID-19 cases in Kerala between May 4 and 29 is yet to be traced. For a state that has in the past been quick to trace and isolate contacts of patients and thereby contain the spread of COVID-19, these 50 cases have proved a challenge for health officials.
Some of the most puzzling cases are from Kannur, where the authorities have not not been able to trace how 14 members of a family from Dharmadom were infected with the virus. The cluster was detected after their 61-year-old mother tested positive in Kozhikode and later died.
“She had epileptic seizures and was admitted for treatment in Kozhikode’s Meitra hospital. Since she was a comorbid patient, the hospital took a COVID-19 swab test as per protocol. To everyone’s surprise she was found to be positive and shifted to the Kozhikode General Hospital where she later died,” Kannur District Medical Officer Dr K Narayana Naik told TNM.
After her death, 13 of her kin tested positive for the coronavirus between May 22 and 28. However, authorities are unsure who the index patient in the cluster is.
“The patient’s husband and son sell fish at the crowded Thalassery market and could have brought the virus home. But we have found that none of the people the two men came in contact with tested positive. Only the family members did,” Naik added.
Two days after the 61-year-old woman tested positive, a 24-year-old pregnant woman from a tribal colony in Ayyankunnu was found to be infected. The colony in Kannur has had no cases of the virus before her.
“She had visited the Kannur district hospital for a check up and was referred to the Pariyaram Medical College Hospital. It was here that she tested positive for the virus,” the Kannur DMO explained. An expert team has been set up to trace the source of this patient’s infection. Her family members in the tribal colony have tested negative for the virus. The team also collected 30 samples of the colony’s residents, all of which returned negative.
From May 4 - when Kerala opened its borders for inter-state travelers - until May 29, the state has reported a total of 651 COVID-19 patients. Out of these, 74 patients have contracted the infection from contacts, says the official COVID-19 live database of the government. However, the state has not been able to identify the source of infection for all of these patients who have supposedly contracted the virus through contacts. In fact, the source of infection has been identified in only 25 of these patients, while 50 others remain ‘orphan’ cases - a term used by health workers for people whose source of infection remains unknown.
This group of 50 patients include 13 health workers and two police officers who may have been exposed to the virus while on duty. Some of the COVID-19 positive health workers were posted at the Walayar check post in Palakkad which sees large numbers of inter-state travellers entering Kerala. Two of the positive health workers, however, are nurses from Thalassery who worked in non-COVID-19 wards in the district.
Further, the data also includes one patient with ‘unknown’ source of infection, who was detected by sheer accident.
This is Patient 785, a 43-year-old auto driver from Kasaragod’s Kodom Belur. He suffered serious injuries to his spine after a jackfruit fell on his head when he climbed a tree to cut the fruit. On being admitted to the hospital, he was tested positive.
The patient is currently on ventilator support and is being treated at the Kannur Medical College hospital.
“Since we cannot get any details from him, it is difficult to trace his source of infection. He does not come from a containment zone either. We are yet to find out if he had contracted the virus during his travel as an auto driver,” Kasaragod DMO Dr AV Ramdas had told TNM.
In a similar incident, a young waiter working in a hotel in Kanjikode in Palakkad tested positive for the virus. His source of infection is attributed to visitors in the hotel, and remains untraced as yet.
COVID-19 has not spared Kerala’s prisons. In what came as shock to the state law enforcement, five remand prisoners in the Thiruvananthapuram and Kannur sub jails were found to be positive for the virus earlier this week. This state immediately quarantined scores of prison duty officials and jail inmates who shared the barracks with these patients.
Three police stations namely Venjaramoodu (in Thiruvananthapuram), Cherupuzha and Kannapuram (in Kannur) were also shut down completely and the Nedumangad and Pariyaram magistrates were asked to quarantine themselves.
On Friday, CM Pinarayi said that new additions to the state’s prisons will now be housed and observed in COVID-19 first line centres, set up in every district. This so that they do not mix and spread the virus in the prisons.
Despite these measures, health officials in Kannur and Thiruvananthapuram are still unclear about the origin of the infection of these jail inmates.
The count of untraced cases in Kerala has seen a spike. However, authorities maintain that the state has not yet reached the third stage of the pandemic - community transmission.
“These patients in Kannur are one-off cases where contact tracing has become difficult. We cannot say that the origin of their infections can never be traced. However if several similar cases start cropping up, then that is a hint that there is community spread,” Dr Narayana Naik told TNM.
CM Pinarayi Vijayan also stated that the sentinel surveillance tests - done by the state to check for community spread, had given ‘good results’. A total of 11,648 samples were tested as part of the sentinel surveillance among priority groups who have greater risk of exposure. Out of this, samples of 10,635 returned negative.
“Most of the cases have come from abroad or other states. Kerala remains among the states with the lowest number of patients infected through contacts. In every 100 tests done in Kerala, 1.7 people turn positive, which means the Test Positive Rate or TPR is 1.7%. The national TPR is 5%. All the countries are trying to bring it below 2% while Kerala has already achieved that,” he added.