Kerala’s TPR still over 10%, a concern

KOCHI: Among larger states, only Kerala’s TPR is over 10%. For others the same is below 5%, except a few north-eastern states. TPR in Kerala remains high despite the efforts of a few local bodies, with high TPR, to test the general population at places and families where there are no positive cases even as there is no insistence on testing contacts of infected persons or the vulnerable population.
Kerala’s 7-day average TPR (as on July 6) was 10.2% while the national average stood at 2.4%. In Karnataka and Tamil Nadu, the 7-day averages were 1.8% and 2.5%. This is a real concern, as neighbouring states were able to drastically reduce their TPR. A month ago, on June 6, India’s 7-day average TPR was 6.2%, while Kerala’s was 14.8%. Karnataka then had a 7-day average TPR of 11.1% and TN14%.

World Health Organisation (WHO) has said that to ensure adequacy of testing, test positivity should not exceed 10% and should remain less than 5%. In August 2020, when Kerala’s TPR was 3.3%, a technical report on testing from the health department endorsed this and said, “The positivity rate goes up when the epidemic grows and testing lags. So as such, it captures the size of the epidemic and the scale of testing in a single number.”

“High TPR shows that infection rate is high in state and even now there are several people who have Covid. There are reports that at a few places there are deliberate attempts to reduce TPR, but despite this, TPR remains high and this is a major concern,” said public health expert Dr SS Lal, who had worked with the WHO.
“TPR can be manipulated easily depending on whom you test. As pressure from society to lift lockdown restrictions increases, the chances of possible manipulation of TPR is high. But, this can be dangerous as it will create a sense of false security among people,” said rheumatologist and immunologist Dr Shenoy Padmanabha, who has been analyzing Covid patterns across India.
Public health experts warned that unless Kerala brings stringent measures at the grassroots-level and not just lockdowns, Covid cases will not reduce and spread of the infection will be quick. Last week, Kerala saw a slight increase in cases by 4%. Between June 27 and July 3, Kerala on an average reported 11,942 cases/ day.
Since then there has been an upward surge, with Kerala reporting 15,600 cases on Wednesday and 14,373 cases on Tuesday. TPR remains above 10% though testing has increased. While on Wednesday, TPR was 10.36% after 1,50,630 tests were conducted, on Tuesday it was 10.9% after 1,31,820 tests were conducted.
“What is happening now is people with minor symptoms or family members of a positive person are not getting tested and it is self-implied that they may be positive. Even authorities don’t insist on testing them to reduce TPR. But these people often violate quarantine norms and may probably spread infection. Random community testing is a good surveillance measure, but to control spread of the infection, what is needed now is contact tracing and testing,” said Dr Jayakrishnan AV, chairman of IMA’s committee on Covid vaccines and vaccination strategy.