Understanding Why Kerala’s Covid Caseload Remains High

What is the issue?

The has been growing concerns with Centre briefing that Kerala contributed to over 50% of the country's COVID cases

What are the centre’s reasons for high caseload?

Intra-house transmission - The rural-urban divide is very faint in Kerala leading to high intra-house transmission
Reinfections - Kerala is witnessing high reinfections among the people who have received both doses of vaccine
Non-Communicable Diseases (NCD) - High prevalence of NCD is yet another factor responsible for higher disease spread
High life expectancy - As Kerala has high life expectancy, it has a higher proportion of those who are easily susceptible to the virus.
Migration - Massive migration of people from within India and abroad is another cause for the virus spike
Containment zones - Kerala has also not defined containment zones according to Centre's guidelines
Containment classification - Kerala reviewed its containment classification as per 7 day moving average but it actually takes 14 days
Unlocking process - Relaxations for tourism and the impending Onam festival has aggrevated the situation.

What is the other side of the view?

Measure of case fatality is not an appropriate comparison across the population
The fatality associated with Covid-19 intensified with pre-disposed risks of the patient as well as the age profile.
Comparability of Test Positivity Rates (TPR) levels - Comparability not only depends on the magnitude of testing but also the testing protocols adopted by the health system.
In Kerala, testing is done in clusters where the likelihood of positivity is obviously greater than the general population.
Extent of testing - Greater access to testing and greater sensitivity to the spread of Covid-19 makes Kerala’s numbers higher.
However, Kerala’s case fatality rate as of August 20 remains among the lowest (0.51 ) of all Indian states and against a national average CFR of 1.36.

How can a genuine comparative assessment be done?

The entire road from the detection of infection to recovery has to be evaluated
The evaluation should include the number of patients needing hospitalised care, the rate of their progression to oxygen dependence, ICU care and ventilators and finally, fatalities, etc.
Comparative evaluation of this kind in many of the northern and eastern states needs adequate infrastructure

Source: The Indian Express