High numbers of new Covid cases in Kerala are not a worry if only because hospitalisation and mortality are under control, says Dr T Jacob John, retired professor and head, departments of clinical virology and microbiology at CMC Vellore, and former director of ICMR’s Centre of Advanced Research in Virology,

His observation comes even as Kerala has been accounting for over half the daily new Covid-19 cases reported in the country at 22,000-plus and 150+ deaths on Tuesday and Wednesday. In fact, a controversy rages in Kerala over the mortality numbers as well.

Speaking to Business Line over the phone from Vellore, Dr John said his observations were despite the controversy with the Opposition in the state releasing cumulative death toll based on an RTI response at a higher 23,486 as on Monday (cited by the Local Self-Government Department) than the 15,871 put out by the Chief Minister's Office.

Blame it on Delta

All over India, there has been a disparity between civil registrations and reported Covid deaths. This is normal because of the sudden spike in spread and death, he said. But that disparity is probably the lowest in Kerala which is now finding more mild or moderate cases than severe cases.

The scenario changed overnight with the delta variant coming into play. It is of such virulence that it has to infect a large proportion of people. “The only realistic intervention here is the vaccine, which the state doesn’t have in required number. Use of mask can only slow down the spread,” he said.

Jacob John said he is ‘quite happy’ with what Kerala has been doing. Infection is the product of the proportion of susceptible people and the presence of the delta virus. Delta virus is like a heat-seeking missile. It will seek out uninfected people, the eminent virologist cautions.

Population density

The recent sero survey corroborates this citing a prevalence of about 44.4 per cent for the state, the lowest in the country. “This leaves almost half of the state’s people vulnerable. And Kerala has its own inbred disadvantages. After all, it has India’s highest population density. And this variant spreads by a magnitude of population density.”

People get infected without even going out of home, the virologist said. Reports from entire families suggest that they had never ventured out to get infected. The second disadvantage is the extended life expectancy, which is the maximum in India, Jacob John pointed out.

“Therefore, the proportionality of people above 35, 55, or 65 years of age is the maximum in Kerala. Under these circumstances, nobody is spreading the virus deliberately. So, somebody has to take a call on striking a delicate balance between what is good for the general population and what is not.”

Original virus and delta variant

This, according to Jacob John, is subject to various interpretations by those vouching for what the decision-making authorities have done and those who are arraigned against. Anybody can find fault with these decisions taken in the best interests of public health. Fault finding is a rule than an exception.

The virologist sought to make a difference with the ‘original virus’ that triggered the pandemic and the delta variant. In the case of the original virus, the face mask reduced the speed of the spread drastically. This is not the case with the delta variant, which is of a class of its own.

“This variant emerges out of your mask into the air and slips in between the crack of the mask and the skin unless you wear a space suite-like wear. And it does not differentiate its target whatever one chooses to do, wherever one is, and whichever country. If it doesn’t kill or fell you, what’s the worry?”

Poor vaccine allotments

So, all boils down to the issue of slackness in vaccine distribution, he said. Kerala has been doing an excellent job otherwise with panchayats going home to administer the vaccine. “I strictly go by hospitalisation and death. That’s my yardstick. Whatever the State government could possibly do here, I guess they already have. It’s very easy to sermonise and say you should’ve done this and done that.”

Kerala deserves, therefore, a maximum supply of the vaccine. It should be given number one priority in terms of distribution. But unfortunately, this has not happened, and the state is running out of stocks at a time when it needed them most. Kerala’s predicament is not its own fault, Jacob John said.

Commenting about a recent controversy, he said that a draconian lockdown is not suitable for people, students, children or adults. “We are social animals, and social contact is very important. Again, there’s a judicious balance that needs to be struck.” Any decision on facilitating it can be interpreted differently.

Change for better by August-end

The State government is locally present and interested in people’s welfare locally. And lockdown is a very harsh measure. Asked about a third wave, he said his intelligent guess is that Kerala may be able to breathe free before the end of August. “This is half guess, and half projection,” he added.

“I’m not worried over whether Kerala or the country at large is going to have a third wave where children are going to get affected. All this is speculative, and not necessarily an authoritative public health projection.”

A victim of its own success

Kerala does not go along the way in line with the rest of the state. The graphs of the first wave and the second waves represent two symmetrical variations. The up and the down phases are mirror images representing a stage when the virus grows by itself. Distortion of the shape tells you how human interventions reduce the virus spread. This shows how Kerala has been a victim of its own success.

Instances when returning migrants were tracked down efficiently during the first wave, are almost legendary. But the situation spun of control when their numbers jumped exponentially with inbound Vande Bharat Mission flights. This is being reprised a year later by a rampaging delta variant.

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