THIRUVANANTHAPURAM: 100 days after it recorded the first COVID-19 case, Kerala has finally declared that the state has flattened the curve. Kerala has recorded 0.59 per cent case fatality rate and 92 per cent recovery rate, while the doubling rate is above 80 days. The state was gradually entering into the safe zone.
However fresh cases for the past two days indicate that the inflow of expats and people from other states pose new challenges in Kerala's fight against coronavirus. The state does not plan to opt for controlled spread as of now. Kerala will eventually get herd immunity through reverse quarantine, says Health Minister KK Shailaja. In a chat with The New Indian Express, KK Shailaja says if the virus attack slows down in the entire country, the state can hope to recover in 4-5 months time.
100 days have passed since the state recorded its first COVID-19 case. The government has now declared that Kerala has flattened the curve. So have we finally entered a safe zone?
In a way, we have achieved a lot when viewed holistically. In 100 days, only 503 cases and just 3 deaths - all from pre-existing co-morbid conditions. So a case fatality rate of 0.5 per cent.
Among the number of dead, why is the death of the patient from Mahe not included?
He was based in Mahe and had come to Kerala only for treatment. The Centre wants it to be added to the Kerala tally, but there's no reason why we should add a person who came only for treatment, due to lack of facilities at Mahe.
What are the factors that contributed to the flattening of the curve? And what's the next step?
Usually, case fatality rate is calculated based on closed cases; then Kerala would have a recovery rate of 99 per cent. But when live cases - those currently hospitalised are included - the state has a recovery rate of 92 per cent.
If we look at the doubling rate - the time taken for the number of cases to double - it's below seven days in several states, and in a few it's as less as two days. But in Kerala, it was 72 days earlier and now it's 80 days. Going by these trends, Kerala is for now in a safe zone.
On Friday, the sole positive case was of a person who had returned from Tamil Nadu. With more people returning from affected regions and abroad, there could be more positive cases in the near future. About ten of those who came from abroad were found symptomatic and isolated. So we need to keep a track of such people. It won't be easy, as the numbers of returnees are increasing day by day. We have included local self-government officials, volunteers and police to ensure that all such persons follow laid-down quarantine procedures.
But even in quarantine, they tend to move around inside the house. That's how in Koothuparambu, ten in a family tested positive. Luckily, they all had remained at home, unlike the family that returned from Italy. People have themselves become more vigilant now. Now in the case of institutional quarantine, the same danger persists. Even when confined to a room, they may go out and interact with others, since most are asymptomatic. But they may turn out to be positive later, and that could spell trouble.
The risk factor is always there, irrespective of whether it's house or institutional quarantine. We must maintain a strict vigil. The moment anyone exhibits symptoms, he or she would be tested and hospitalised.
Another major area of concern is age. The state accords a lot of importance to reverse quarantine, which can greatly reduce the number of deaths. If people are in quarantine at home, the elderly must not be allowed anywhere near them. If possible, they should be moved to relatives' homes. This is not always possible. So the next best option is to move the ones quarantined at home to institutional quarantine.
Now with more number of people in quarantine, one cannot expect five-star facilities. They will have to be content with limited available facilities.
The other day you said that the government is not considering private quarantine facilities. But the state government affidavit in the High Court mentions private quarantine
Initially no, but now, we are considering that possibility too. If someone want to opt for paid accommodation in a hotel, the entire hotel should be taken up for the purpose. We can't let them stay in one room, while the hotel carries on with its routine functioning. Health officials and volunteers would be deployed to oversee persons quarantined in such places.
Won't that be an additional burden on the government, as we will have to deploy more staff for the purpose?
Yes. That's why we didn't think about it at first. No final decision has however been taken in this regard, though it is under active consideration.
You mentioned about asymptomatic people testing positive, and reverse quarantine for the aged. Has the state started looking into possibilities for herd immunity through a controlled spread?
Herd immunity is a continuing process and is attained over a period of time. If more people are affected and there are no deaths, then herd immunity is a possible option. But with no vaccine in sight and a prognosis yet to be made, opting for herd immunity would then lead to a situation similar to the one in US. Our focus has always been to save lives. So restrictions will continue.
We cannot, however, continue with people being locked-in for long. So in places that do not fall under the red zone, people can gradually ease back into their normal routine. Like farming activities can resume, with social distancing norms in place.
So can we say that the state is banking on attaining herd immunity?
We are gradually moving in that direction but for now we are not planning for a controlled spread. A spike in cases can lead to an altogether different scenario. We used to think that only the aged and those with co-morbid conditions are vulnerable. But several youngsters have succumbed to the virus. This shows that the virus' activity in the body has not yet been fully assessed.
With the arrival of people from abroad, different strains of the virus could enter the state. In India, so far only three strains have been identified. How is Kerala planning to deal with it?
In India, virus strains from Wuhan, Italy and Iran has been found till date. The Italian strain proved by far the more dangerous variant. But with regard to other strains coming in, there are umpteen aspects to be looked into. After the consolidation of facts, we implement the ones that can be practically done so.
The state has been facing a shortage of antibody test kits. ICMR has already stopped using the ones sourced from China.
We haven't got sufficient antibody test kits. Though not the final confirmatory test, these help in sentinel surveillance. Once we get, Kerala will use them. As far as PCR tests are concerned, Kerala has done better than most states. Symptomatic testing is being done. Those asymptomatic in the high-risk category are tested in a random manner. All such random testing done here turned out negative. We tested samples of 40 unnatural/sudden deaths. The bodies were released only after PCR tests were done. That's why we are sure that at present, there's no community spread.
Any expected time-frame for the state to come out of Corona scare?
It's clearly unpredictable. This virus may last for a long time. But we will gradually become used to it and people will resume their normal lives. But this won't happen overnight. Some say it will come to an end by June-July. Others say it could last the entire year. Only if the virus attack slows down in the entire country, can we hope to recover in 4-5 months time from now.