Kerala urged to alter testing strategy

KOCHI: Kerala has entered a crucial phase in its Covid control programme. Not only is the contact positivity increasing at an alarming rate, the number of positive cases with unknown sources is also growing, along with a large number of clusters developing across the state.
The health department has been urged to change its testing strategy and test more locals and focus more on outside penetration into the state through coastal areas, porous border towns, and traders from neighbouring states, besides quarantining the returnees. The expert health committee headed by Dr B Ekbal has already expressed concern about the present outbreaks in the clusters.
“Even as we continue quarantining returnees, now our focus needs to shift to testing more people in the local communities. Health department immediately needs to look at the data of those infected, the circumstances and places they are affected and then rework on its present surveillance and testing strategy," said Dr Rakhal Gaitonde, professor, Sree Chitra Tirunal Institute for Medical Sciences and Technology. The situation in Thiruvananthapuram indicates a potential community spread across the state in the coming months. Malappuram is the best example of successful tackling of entry points. While there are 42,522 in observation in the district, just 42 tested positive on July 16. But in Thiruvananthapuram, 399 were tested positive out of the 14,302 in observation. In the last few days, the contact day-to-day positivity in Thiruvananthapuram and Ernakulam districts has touched 80%.
“Through gatekeeping and screening at various known ports of entry, we could control the infection till now. But now we are entering a critical phase, testing anywhere shows positive cases. It is time for us to conduct maximum tests in the community, identify clusters and segregate people based on the results,” said Dr A Althaf, associate professor, community medicine, Manjeri medical college.
The most vulnerable areas now are not districts with a large number of returnees but the entire coastal belt, along with Thiruvananthapuram, Idukki, Kollam and Palakkad districts that have porous borders. Doctors are concerned that once the cases increase locally, it would be difficult to contain Covid and mortality may also increase to 15-20% from the present 0.37%, if persons in reverse quarantine are infected.
“We are now focusing on early detection through sentinel surveillance and are doing 16,000 tests daily. Only about 4000 are returnees, the majority are those in the community. Focus is on extensive sampling to check positivity and take precaution where necessary,” added principal Health secretary Dr Rajan Khobragade.