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
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