Editorial: The Kerala chromosome

The state, once the poster child for COVID management, recorded 31,445 cases, and 215 deaths over one day last Wednesday, a statistic that sent newsrooms and administrators in the state into a tizzy. This was the biggest surge in coronavirus cases reported in Kerala in over three months. The state had the distinction of bearing 68 per cent of the new cases reported nationally (46,164), while maintaining a test positivity rate of 19.03 per cent. The numbers have raised fears that Kerala could become the springboard for the third wave of the pandemic. 

So what is driving the rise in cases in Kerala? According to V Muraleedharan, the Minister of State for External Affairs and a BJP leader, the Central team that visited Kerala had two observations to make. One was the lower numbers when it came to contact tracing. The second was pertaining to institutional quarantine. From the start of the pandemic, the local administration in Kerala was confident that cases could be brought under control via home quarantine, instead of institutional quarantine. That strategy had miserably backfired, according to Muraleedharan. Daily testing also seems to have dipped in Kerala over the past two weeks by 35 per cent. 

Epidemiologists are looking beyond the obvious reasons, and digging deeper into the causes for Kerala’s spike. One of the reasons is that the spread of the virus in Kerala has been comparatively slower than in the rest of India. Also, a large section of the state’s population is unexposed to the virus. The percentage of vulnerable individuals is also comparatively greater in the state. Another argument involves the timing of the arrival of the second wave in Kerala - two months after the rest of India. Sceptics opine that the testing backlog accumulated during Onam holidays might have also contributed to the sudden spike. Also, under-reporting of COVID deaths is said to be the lowest in the state, which might explain the significant casualties. 

As per infectious disease experts, it is inevitable that a surge in cases is witnessed once relaxations are made post the lockdown. Even in developed nations where as much as 70 per cent of the population was vaccinated, surges were reported as soon as lockdowns ended. Interestingly, reports suggest that there was no major spike in ICU occupancy and volume of hospitalisation in Kerala, despite the increase in new cases. A silver lining is the fact that the case fatality rate in Kerala is the lowest across India at 0.5 per cent and the rate of vaccination is also encouraging. Of the 3.5 cr people, 50 per cent have received at least one dose, while 20 per cent of its eligible population have had both shots. According to Rajib Dasgupta, head of the Centre of Social Medicine & Community Health at JNU, Kerala’s strategies have managed to keep mortality low and detected one in six cases compared to one in 33 nationally. The efficient detection rate seen in Kerala, combined with a population density over twice that of the national average, brings more perspective to its high number of cases. 

So can Tamil Nadu garner any lessons from its neighbour in managing the pandemic? For starters, an increased testing rate goes a long way in catching infections early and ensuring immediate treatment. Kerala, which tests 86 per 100 people, is miles ahead of UP where 33 of every 100 are tested. Here in Chennai, beaches, theatres and cultural centres have opened up creating avenues for mass gatherings. A festive season also looms ahead. These are sitting ducks for super-spreaders. We have seen how even heroes falter having come so close to victory. It’s essential that the government and citizens take these lessons to heart and work in tandem to tide over the pandemic.