Call for new strategy as TPR-based restrictions fail to arrest Covid spread in Kerala

As situation hasn’t improved even after a month, experts propose parameters such as vaccination status & caseload in area to be factored in for a new approach on easing curbs
Call for new strategy as TPR-based restrictions fail to arrest Covid spread in Kerala

THIRUVANANTHAPURAM: The demand for a change in the test positivity rate-based lockdown strategy is getting louder. For, it has failed to contain the Covid spread even after a month of its implementation.

While the government acknowledges that a sustained lockdown would cripple lives and the economy, it seems to be in no mood to listen to its own experts on Covid management.

After a recent rebuke from the Supreme Court over lifting lockdown curbs before Bakrid, the state has decided to continue with the lockdown strategy based on TPR in local bodies and the total lockdown on weekends. 

Both these strategies are considered unscientific and do not serve the intended purpose.

As a result, the number of local bodies under triple lockdown (category D with a TPR above 15%) has increased from 24 to 271 in a month.

The seven-day moving average, which gives an accurate idea of changes over a period, of reported positive cases have increased by 22% during the phase. 

A classification based on TPR is fraught with problems as the numbers can be easily manipulated with the kind of samples taken. 

The testing strategy has also been questioned because most tests are conducted on symptomatic people and their primary contacts, since the peak of the second wave in May.

Health experts have also said that the number of families undergoing voluntary testing has come down and contact tracing has slackened.

“All these factors could increase the spread even if such cases are not reflected in the TPR calculation. It has now become an open secret that some of the ward members demand more testing on asymptomatic patients in the hope of reducing the TPR of the ward,” said a doctor.

An immunologist and public health expert, Dr Padmanabha Shenoy said the cases have increased because the control measures were ineffective.“The strategy has to be changed. Unfortunately, there is not even a discussion on that,” he said.

Health experts have mooted other parameters like vaccination status and infections in an area to be factored in for a new approach on easing lockdown. While the state struggles to flatten the curve, the delay becomes especially painful for the unorganised sections in society. 

However, even expert members on the Covid management committee are complaining that the government has not taken their advice for change seriously. 

“We had given other alternatives long back to classify locations as the TPR-based classification was not very helpful. But nothing much has changed on the ground,” said a member.

Another member of the Covid management committee, and an assistant professor at the Department of Community Medicine, Government Medical College Hospital, Thiruvananthapuram, Dr Anish T S took to social media with his idea of classification. 

“Any relaxation in restriction is likely to increase the number of patients. But it is important to know how the increase will increase severity and deaths. Those who have recovered from infection and those vaccinated may get infected again. But the chances of complications are less. Hence, the focus should be on the number of people with severe cases in hospitals and use of ICU and ventilators instead of the total number of infections. If things go out of hand, there shall be no hesitancy in containment lockdown,” he wrote on his personal page. 

The state chapter of the Indian Medical Association, which has always vouched for strong containment measures, have recently come out against the unscientific lockdown policies of the government.

It said that a sustainable and scientific approach was the need of the hour as the pandemic is going to stay in our lives for a couple of years to come.

Unlock strategy

Health experts want the government to consider alternative methods to classify regions for purpose of easing lockdown restrictions.

The TPR-based strategy has failed to check the spread as more local bodies have come under triple lockdown in a month. 

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