The Kerala Conundrum

 Many parts of the world  including  India are still fighting the second wave of infection .This wave included variants of the Corona   notably the Delta variant which has more potential for infectivity. 

In India ,the second wave started somewhere in North India and was probably fuelled by a lot of factors including potential superspreaders like election rallies,  Kumbh Mela gatherings etc .

In Kerala however the wave seems to have started a bit later maybe some time in the month of May. Daily cases were  to the tune of 3000 odd while  neighbours like Karnataka and Tamil Nadu   were  having daily cases much higher than that .Suddenly in the first week of May after election results were announced a spike occurred  in the number of cases . There was also a rapid  and remarkable increase in.the number of tests which were in excess of 1 lakh daily  now Correspndingly the number of cases went up dramatically     tipping the scales at 42,000 on 1 particular day  The test positivity rate also went up  reaching over 20 percent . 

This naturally  resulted in the State calling for a lockdown  since   May although keeping several categories exempt from.the lockdown .there was also classification of entire  panchayat,municipalities abd corporrations  based on their  test positivity rate.By the end of July though ,TPR did reduce but not to the extent that people thought it would with about 2 months of lockdown . TPR  continues to be over 10 percent  steadily while the state continously  reports large number of cases  Meanwhile bowing to some  pressure from.the trader lobby the Govt decided to  withdraw  restrictions that were placed and relaxed it for Bakreid .Understandably the trader who had been having no business for over a year  were in the doldrums and  this was a golden opportunity  to regain some lost ground .

However as a result  of this relaxation cases went up yet again .While the rest of India is reporting lesser cases averaging about 40,000 per day,Kerala continues to contribute  nearly  half the number of cases as of now leaving its next competitor  Maharashtra far behind 

What  exactly was or rather the  problem in Kerala  .Kerala was the entry point for the Corona  virus in India with 3 medical students pursuing their medical studies in Wuhan being the first patients if Corona and they were detected as early as the last week of January2020 

Kerala also has a very robust health system   both in the public sector and the private sector and boasts of some  of  the best Human Development  Indices in the world corresponding to any developed country .More recently it won fame for succesfully tackling the state's worst floods   and the Nipah outbreak

In 2020 when the entire country was facing  the effect of the pandemic ,Kerala managed to do reasonably well thereby getting a lot of praise from all around for its handling. In particular  the then Kerala Health minister  KK Shailaja Teacher   got special  mention and got accolades all over.However there were some persons who thought this was due to lesser testing .Shailaja Teacher herself in a few interviews said that the state was doung strategic testing abd efforts were on to keep test postivity rate low. Now   this  'strategic ' testing was a new word which WHO never mentiomed anywhere. Instead  WHO said that Test Treat,Isolate later modified to Tests,Trace ,Treat abd Isolate  .What is meant by  strategic testing is still unknown but to my mind it would be testing of a group of people rather than the entire population  for whom testing is needed .This can occur  theoretically  in a situation in which  there is a shortage of testing kits and not otherwise.It may have  been possible  at that time since  number of private  laboratories doing tests were low.However there was a sinficant rise in numbers tested from April.to June 2020 . 

Coming back to the present spike in the number of cases  ,there was no Kumbhaela Mela nor any farmers protests .However there were huge election  rallies  taken out abd even prior to the April  elections there was the elections to local self governing bodies in Novemeber 2020 .These elections to local self governing bodies which by themselves gad no major rallies but people did go housr to house canvassing in a very big way.

Those claiming that the Kerala  model is a successs rest their  thoughts on a few points some of which may not stand up logically .

For example one of the main things that is mentioned is an ICMR seroprevalence study which shows Kerala,Maharshtra,West Bengal and Assam as having low seroprevalenve m of about 40.percent much less than the national average of around 70 percent .This means that  less than 50 percent have got exposed to the virus either  through natural infection or through vaccination  in these 4 states as compared to the rest of India .Here  there are a few points that deem consideration Firstly the survey  was done in 4 stages with the last one being done in May 2021  by which time vaccination had started This involved 2 groups 1 of health xare workers and the other of  normal.persons  .Also  and  understandably so the sample sizr was small probably averaging less than 3000 per survey meaning a total of  10 -12000 persons per state. 

Assuming for a moment that we go by ICMR prevalence studies this shows that poll.bound state ( except Maharashtra)  have a lower seroprevalenve .Kerala,Assam and West Bengal went to the polls together . So does it mean that rallies have no role in the spread of the virus and on the contrary  they give some  protective effect .Or as a corollary of that,is indoor spread more than outside spread .In that case why have lockdowns at all.

The second point that is  said by public health experts is the low death rate .Well if one compares with Maharashtra death rates are low but not if one compares withthe  rest of India. Another question is why are there over 100 deaths per day  if there is no shortage of  oxygen or ICU beds or ventilators. Is there some delay in diagnosis  due to long waiting for RTPCR  tests .Is  there hesitancy in going to hospitals for financial or other reasons .Or are there  any issues in the treatment. Clearly this needs to be investigated 

Yet another point raised is the undercounting of deaths as based on Sample Registration Dystem.figures  

Across the country  there has been a rise in number of deaths for whatever reason.Again it is not necessary that all deaths  are due to Corona . Also  many deaths are not reported at all particularly in North India  Based on this some experts said that Kerala has done a good job with least underreporting of deaths as compared to the rest of the states thereby imply that the deaths in other states are higher but are not revealed.   This may have been possible overlaps earlier but after April,May and all media  visibility in this may not be the case now .

Again experts talk of flattening the curve, long pleatuing etc. These are just terms that look good but in real meaning it's different .For example 100.deaths per day is plateaued but is that satisfactory How long are we going to.keep this plateau.Clearly this too needs explanation 

Yet again a new term for testing called targeted testing has come  What exactly what it is nobody knows for sure but persons say that suspects are being tested .Coming to testing in the month of April,the centre sauf tgat 50 percent of all tests should necessarily be RTPCR  .After this the cased increased dramatically  .So it does appear that Kerala's relative sucesss may have been due to more factors than we think 

Evidently, the Kerala Corona story had still a lot of unsolved riddles 

25 ekbalpore lane

I was

 a long time resident of 25 Ekbalpore Lane , Calcutta23 . For all those of you who have lived here let me take you on a trip down memory lane . I was not born in this building but I moved in when I was old enough to understand the sights and sounds of Calcutta . As i remember it it was a big buildiong oposite the lal masjid on Ekbalpore lane . It was also called Queens Manzil and had an imposing gate which by todays standards would have costed a small fortune . It also had small alleys (gullis ) where as kids we would play . and also a big courtyard inside the gate where as kids we would play cricket , badminton , football etc

 . More interesting than the building per se would be perhaps the nature of its inhabitants . It did in the sixties ,seventies and well into the eightities It had a number of people from various parts of india and with different languages and practising different faiths . It was indeed a melting pot of various cultures . Thus we had Hindus , Muslims , Christians , and Sikhs in the same building . we also had people from different states like Bihar , UP , Kerala , Tamil Nadu , Punjab staying in the same building . but never did we ever feel the differences among us . We would celebrate Diwali as much as we would celebrate Christmas or Id .One still remembers the mithais distributed during Diwali, the Christmas cakes and the sevai distributed during id . However in spite of all our cultural differences one factor that probably was common to all of us was the English language . I am not sure how many kids staying in other buildings during the same time were as fluent as us in the English language There are many anecdotes and stories related to our building which may have to wait for another post . We did have some very interesting persons in our building As mentioned earlier apart from the South Indians , Punjabis , Biharis and UPites we also had a fair sprinkling of Angloindians in our building . In spite of having such a diverse community we were careful enough not to land ourselves in any sort of controversy as our strict parents were always at hand .Maybe it was a sign of the times . Although there were eligible bachelors and girls from the same community in the same building it is a fact that no one married anyone else from the building . We are told that MS Subbalakshmi used to stay here or sing her songs here ( please correct me if I am wrong ) 

The floods in 1978 was a major event in the building . For probably the first time there was waterlogging for 3 consecutive days and all of us had to move to the first floor . It also saw a rare camaraderie among all of us . Irrespective of caste or creed we shared our meals and lived as one family .It also cemented a bond among us  which extends to this day  Alas the building is but a shadow of its former self . The imposing gate is still there and there are a few tenants but the old grandeur is gone .So too is the camaraderie . Whether it is a sign of the times we live in one doesnt know

25 Ekbalpore Lane: Introduction...

25 Ekbalpore Lane: Introduction...: "Lalitha. Yes I was resident of 25 Ekbalpore Lane. I started my journey from here. I want to recollect all my childhood memory and see if I c..."

Introduction...

Lalitha. Yes I was resident of 25 Ekbalpore Lane. I started my journey from here. I want to recollect all my childhood memory and see if I can meet all my friends!