Covid-19: As active cases spiral, what happened to Kerala’s model pandemic management?

A high-level team from the Union Ministry of Health & Family Welfare will arrive in Kerala today amid an exponential rise in Covid-19 cases over the past few weeks that threatens to derail India’s overall management of the pandemic. The multi-disciplinary team will collaborate with the state’s health authorities and institute effective public health measures, the ministry said. The six-member team, which will visit a few districts, is being led by National Centre for Disease Control (NCDC) Director Dr. S.K. Singh.

During its time in Kerala, the team members will assess the situation on the ground and make suggestions to the state health department regarding interventions that it can make to contain the spike in cases. Kerala reported more than 22,000 fresh cases on Thursday — the third consecutive day —logging 22,064 new cases and 128 deaths. Its overall caseload now stands at 33,49,365, while 16,585 people have succumbed to the virus.

According to the Union Ministry of Health & Family Welfare, with an active case load of 1.54 lakh, Kerala contributes 37.1 per cent of the country’s total active cases. The number of active cases has grown 1.41 time in the past week. The state’s positivity rate — 11.97 per cent weekly and 12.93 per cent cumulatively — is also among the highest with six districts reporting weekly positivity over 10 per cent.

While some experts have attributed the spike in numbers to higher testing and easing of restrictions, the argument falls flat as most other states have also lifted local curbs. The answer to the state’s Covid-19 spike might be found in the Indian Council of Medical Research’s latest sero survey, which shows that Kerala has the worst seroprevalence in the country with 44.4 per cent. In other words, nearly half the state’s population is still vulnerable to the virus.

While it is too early to link the low seroprevalence to the spike in cases, states that have recorded higher seropositivity are witnessing a decline in caseload additions. A lower seroprevalence, however, also means Kerala managed to protect residents during the first and second Covid-19 waves. Experts suggest that a lower seroprevalence means more people were protected during the first two waves, leading to them becoming vulnerable to the virus now that restrictions have been lifted.

According to data available from Covid19.org, Kerala also conducts more tests per million than the rest of the country, except Delhi. While the higher number of tests has resulted in a higher caseload, Kerala’s test positivity rate is also quite high, as mentioned in the Union Ministry of Health & Family Welfare report.

However, despite the higher caseload, Kerala also has one of the lowest fatality rates with 0.5 per cent. Kerala is also ahead on vaccination, with nearly 37 per cent of the state’s population receiving at least one dose while 16 per cent have been fully vaccinated. The national average for both the doses stands at 7.1 per cent, while that for a single dose is 25.63 per cent, according to the ministry. Kerala has a population of around 3.4 crore and its move to develop immunity by vaccination and not exposure could be seen as a risky move, but one where the rewards are also high.