High elderly population to high NCDs, Centre gives nine reasons for Kerala’s high count

The Centre on Tuesday said it has identified nine unique challenges Kerala is facing in controlling Covid-19 cases in the state.

Dr Sujeet Kumar Singh, director, National Centre for Disease Control, who recently visited Kerala and had last week submitted a detailed report to the Centre, said one key challenge is that there is very little demarcation between rural and urban areas in the state, leading to high intra-house transmission.

“The rural-urban divide is very faint. Like we see in North Indian states, especially in high-population density states, farmlands create a natural barrier for spread of infection,” Singh said. “In Kerala, houses are spread in a linear manner. Home isolation is not taking place properly there.”

He said the state is reporting a high number of cases of re-infection, including many among those who have received both vaccine doses. “As data shared by the district collector, for instance in Patnamthitta (shows), 5,042 got infected after two doses of vaccines. We are still investigating how long after second dose those people turned positive. We also asked for data on whether the person got severe disease and was hospitalised.”

Singh said prevalence of non-communicable diseases (NCD) is close to 30% in the state — in May and June, 25-30% deaths took place within 72 hours of hospitalisation. “High prevalence of NCDs is another factor helping in higher disease prevalence. The infection rate increases with diabetes,” he said.

According to Singh, two others factors — 55% susceptible population and prevalence of 90% of highly infectious Delta variant in the state — are also big reasons behind the surge.

Singh said Kerala’s high proportion of elderly population — due to high life expectancy — is “a big susceptible population” “The other issue is substantial national and international migration,” Singh said, adding that “strict public health measures”, such as local lockdowns, are needed to interrupt transmission.

Singh said unlocking of several activities, the Onam festival on August 20, and opening of tourism in the state have all “created challenging scenario”. He presented that the current value of Rt of Kerala is 1.12. “Going by the current trend, it is expected that for the period of August 1 to 20, the state may witness a cumulative incidence of cases of 4.62 lakh approximately with 95% CI (Confidence Interval),” according to Singh’s presentation.