Kerala’s test positivity rate on decline, but doctors say need to keep vigil

The upcoming local body elections and festivals pose serious challenges, say doctors.
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On November 1, the test positivity rate (TPR) of COVID-19 cases in Kerala was 14, meaning that 14 out of 100 people tested would turn positive. In 15 days, the number has slowly come down, indicating lesser active cases, lesser spread. On Sunday, November 15, the TPR was 9.93 – 4,581 people testing positive for the coronavirus, out of 46,126 samples. It is a good sign, doctors say, but one that can only be maintained if the present vigil continues.

“It was after Onam celebrations that the number of cases peaked. In the first two weeks of October, there was an average of 8,000 to 8,500 new cases recorded every day. After that there has been a decline but then there are the upcoming local body elections and Christmas celebrations when cases are likely to increase again,” says Dr Padmanabha Shenoy, a Kochi-based rheumatologist who has been analysing COVID-19 data.

On November 8, he wrote on Facebook, "Keralites has some good news. Kerala daily cases reported has reached a plateau but dipping TPR suggests that in the coming week we can expect a dip in number of cases."

What has worked for Kerala, he tells TNM, is that the state does not have winter and Deepavali is not celebrated in a big way as it is in other states. “But then the local body polls will pose an even bigger challenge. Campaigning will take place with house visits, crowds will gather, and there will be hundreds of candidates in the fray.”

If people in Kerala are not careful – maintaining the COVID-19 protocol as physical distancing and wearing of masks – there can be a second surge, like it happened in Delhi, Dr Shenoy warns.

However, it is not herd immunity (when most people become immune either by mass infection or by vaccination) that’s reduced the number of cases in recent days. Kerala has not reached that stage yet, Dr Shenoy adds.

In earlier weeks, the data had been inconsistent, the TPR fluctuating between 12 and 17, especially in September, when in addition to Onam celebration, there were also large scale protests on the streets.

However, the November data shows a progressive decline – TPR dipping to 11 in the first week, and less than 10 in the second.

“That is a natural phenomenon. There will be a wave and then the cases decline. It is reliable data, not a temporary trend. However, the local body polls in December and the Sabarimala pilgrimage season (beginning November 16) pose challenges,” says Dr Joseph Chacko, state president of Kerala Government Medical Officers Association.

The COVID-19 measures followed so far – distancing, masks and washing of hands – are the only way to prevent the spread, Dr Joseph says, but that will not be easy during festivals and elections. “It creates crowds and we should remember that even when the test positivity rate is reduced, the number of deaths has not. We are still recording 25 to 30 deaths every day. Kerala is a state where there is a higher number of elderly people compared to the rest of India. So the risks of the disease will be more,” Dr Joseph says.

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