A six-member central team that visited eight districts of Kerala has said that from August 1 to August 20, the state may witness around 4.6 lakh COVID-19 cases. The team cited unlocking of activities, approaching of the Onam festival (August 20) and reopening of tourism as challenging scenarios. This is a matter of concern, National Centre for Disease Control (NCDC) Director Dr Sujeet Singh, who headed the team, said at a press conference in New Delhi on Tuesday. The team has also alleged lapses in contact tracing and the containment strategy of the state.
Kerala accounted for more than half of the COVID-19 cases recorded in the country in the last seven days, the Union government said on Tuesday. According to the report submitted by the Union government deployed team, the COVID-19 positivity rate in Kerala was found to be more than 10% in all the eight districts and at some places, it was found to be increasing. Over 80% of the cases were of the Delta variant of the virus.
"Contact-tracing was found to be abysmally low and the Rt value (reproduction rate of virus), which was the lowest (0.8) on June 1, is continuously rising with a current Rt value of 1.2," Singh said. "The current Rt value of Kerala is 1.12. Going by the current trend, it is expected that for the period of August 1 to August 20, the state may witness around 4.62 lakh COVID-19 cases," Singh said.
The team visited Kasaragod, Kannur, Kozhikode, Malappuram, Alappuzha, Kollam, Pathanamthitta and Thiruvananthapuram districts in Kerala. During the visit, the team found that containment zones (CZs) were not made according to the Union government’s guidelines, and the perimeter control and cordoning off of the CZs were not strict. Also, there were no buffer zones surrounding the CZs, Singh said. The test positivity rate (TPR) was found to be ranging from 10 to 14% and in some areas, it was 15 to 20%. The TPR in Malappuram and Pathanamthitta was showing a rising trend.
As far as the health infrastructure for COVID-19 care is concerned, Singh said the bed occupancy rate in the southern districts was found to be in the range of 40 to 60% and in the northern districts, it was 70 to 90%. The bed occupancy rate for ICU and ventilator was quite high at 74 to 85% in the most-affected Malappuram district, he added.
The bed occupancy rate was higher in the private sector and according to the available data for May, June and July, 25-30% deaths occurred within 72 hours of hospitalisation, Singh said.
Up to 80% cases were permitted to be in home isolation, but the guidelines for home isolation were not followed, the central team said.
"The absence of compliance to home isolation of suspects or cases and quarantine of contacts resulted in the inability to contain the infection. Intra-house transmission was high, often leading to clusters," Singh said.
The containment strategy relied on passive surveillance and pre-structured containment zone boundaries i.e. panchayats and the enforcement of guidelines regarding the number of people attending social and religious gatherings was lacking. Meanwhile, the Kerala government on August 10 announced a ban on gatherings during upcoming festivals in the state like Onam and Muharram.
Singh said that 55% of the state's population is still susceptible to the infection as per the sero prevalence data. There is a high proportion of elderly people in Kerala's population due to high life expectancy, which is contributing to the susceptible pool. Besides, there is substantial national and international migration.
Meanwhile, the NCDC director also said the state has recorded a high number of infections even after two doses of the vaccine being administered and the issue is being probed. For example 14,974 people got infected with the virus after receiving the first dose and 5,042 after being administered both doses of the vaccine in Pathanamthitta (according to information shared by the district), he said. Data accessed by TNM, however, shows that only 258 ‘breakthrough infections’ were reported in Pathanamthitta. A breakthrough infection has been defined by the United States’ Centres for Disease Control and Prevention (CDC) as the detection of the SARS-CoV-2 virus that causes COVID-19 in an individual 14 days or more after they are fully vaccinated.
Besides the NCDC director, the central multi-disciplinary team comprised former deputy director general Dr P Ravindran, NCDC Advisor (PH) Dr SK Jain, Additional Director Kozhikode Branch of NCDC Dr K Regu, Dr Pranay Verma who is the Joint Director of NCDC, and Dr Ruchi Jain who is the Public Health Specialist from regional office of the Ministry of Health and Family Welfare in Thiruvananthapuram.