Central special team lists 9 reasons for high COVID numbers in Kerala

Lack of clear divide between rural and urban areas causing "high intra-house transmissions", a large vulnerable elderly population, the Delta variant, migration etc., are Kerala's current challenges in curbing the pandemic, said a National Centre for Disease Control report

Gagandeep Kang, eminent virologist argues that Kerala does more COVID-testing than other states and targets areas where positivity is believed to be high thus recording higher number of ‘positive’ results. Pic: PTI

Kerala, which continues to record a high number of COVID-19 cases in the country, faces nine unique challenges to control the infection spread in the state, said the Centre on Tuesday (August 11).

The challenges have been listed out by Dr. Sujeet Kumar Singh, director, National Centre for Disease Control (NCDC), who had submitted a detailed report to the Centre last week after his recent visit to the southern state, whose situation has reportedly become a “matter of concern” for the Centre, said media reports. NCDC is the nodal agency in the country for disease surveillance.

In his report, Dr. Singh blamed the lack of demarcation between rural and urban areas leading to “high intra-house transmissions.”

Dr. Singh said that the rural-urban divide is blurred and unlike north-Indian states, especially in high-population density states, farmlands act as a natural barrier to the spread of infection. “In Kerala, houses are spread in a linear manner. Home isolation is not taking place properly there,” he was quoted as saying by the media.


Dr. Singh also attributed the high rate of non-communicable diseases (NCD) among residents, which is close to 30 per cent in the state, as another reason for the increase in COVID-19 cases. In May and June, 25-30 per cent deaths took place within 72 hours of hospitalisation, he pointed out. If NCDs are prevalent in the population in a big way, then the COVID-19 infection rate too goes up.

“The infection rate increases with diabetes,” he was quoted as saying in an Indian Express report.

Two others factors — the 55 per cent susceptible to the virus population and the fact that the highly infectious Delta variant was active in the state, nearly 90 per cent of the cases were stemming from this variant — are also playing their role in augmenting the numbers.

Dr. Singh also offered another reason for the COVID-19 spike in the state. Kerala’s high proportion of elderly population, caused by high life expectancy in the state, makes them highly vulnerable to the virus. Constant national and international migration are also adding to the surge.

Also read: Why people who’ve taken both vaccine jabs aren’t fully COVID-safe

Dr. Singh also castigated the state for relaxing COVID-19 restrictions allowing people to mingle for the Onam festival on August 20 and for opening up tourism in the state. All this has created challenging scenarios, he said. Further, the report said that the state is also reporting a worrying surge in re-infection cases, including among those who have received both vaccine doses.

Quoting data shared by the district collector of Pathanamthitta district in Kerala for example, Dr. Singh said, nearly 5,042 got infected after two doses of vaccines. Investigations were on to find out how long after taking the doses the people turned positive. They have also asked for data on whether the COVID victims were severely affected and had to be hospitalised, the IE report added.

Moreover, Dr. Singh predicted that since the current value of Rt of Kerala is 1.12, it is expected that between August 1 to 20, the state may witness a cumulative incidence of cases of 4.62 lakh approximately with 95 per cent CI (Confidence Interval). He recommended that the state impose “strict public health measures” such as local lockdowns to curb the transmission.

Meanwhile, renowned epidemiologist Gagangdeep Kang had told The Wire that the rising numbers in Kerala was “a very small part of the overall picture.” Stating that Kerala could be a model to other places on COVID control, she said there was not much to worry about Kerala. However, she had added a cautionary note and said Kerala should take steps to bring down the R0 number – which had reached 1.2. This number conveys the number of people a person with COVID-19 can infect. She also urged the state to impose restrictions on travel and movement, local lockdowns in areas with high infection rates and other “non-pharmaceutical interventions.”