Kerala Wuhan Virus Update: Mismanagement Alert

The epidemic situation in Kerala is now officially getting out of hand. Yesterday’s (29 June) figures show that the test positivity and case counts have risen, the cumulative positivity is not declining at anywhere near a satisfactory rate, testing levels are not rising, and, almost uniquely, the mortality rate of the second wave is higher than that of the first. This has significant national implications.

This is the position as on date (29 June):

From the top of the chart above, we see that testing levels (purple curve) continue to stagnate around the one lakh samples a day mark. This is against the bare minimum of 1.5 to 1.75 lakh tests a day which Swarajya has been advising for months. In addition, testing is noted to take a break on weekends, with levels dropping by a third or more.

The daily case counts, too (red curve), have been stagnating around the 10,000 mark for a fortnight now, instead of decreasing sharply as they should. This means that tracing and isolation efforts by the Chief Minister Pinarayi Vijayan government are unacceptably inadequate. To make matters worse, Malappuram district is back again yesterday (29 June) to reporting by far the most cases in the state.

The test positivity ratio (TPR, green curve) in Kerala remains dangerously high at over ten per cent. In fact, a rising trend is seen over the last week (marked by the yellow arrow).

As a result, the cumulative positivity (orange curve) has remained above an extremely unhealthy 15 per cent for well over a month now.

Such inability to contain the epidemic has led to a situation where Kerala now accounts for a quarter to a third of all cases in the country:

Deaths have been declining in step with the ebbing of the second wave. However, a detailed analysis of the data reveals an anomaly: the mortality rate of the second wave is higher than that of the first and rising.

This doesn’t make sense since data from much of the rest of the country uniformly shows that mortality rates of the second wave are lower than that of the first. The reason being that vaccinations have had a hugely beneficial impact in preventing more deaths.

But not in Kerala. As chart 3 above shows, the red curve, which is the mortality of the second wave, should have run below the blue curve – which is the aggregate mortality since the epidemic began. This deviation from national trends brings death reporting by the Kerala government under a cloud yet again (it has been the bane of the state’s mismanagement, along with lethargic testing and tracing).

Readers would recollect that the one other state where a similar anomaly was noted is Rajasthan, and there too, the issue was of serial undercounting of deaths. However, as Swarajya pointed out earlier this month, the numbers there make no scientific meaning for an entirely different set of reasons.

In Kerala, there is an additional anomaly which brings mortality rates under question: the reporting of deaths takes a dip on weekends (see black line in Chart 1. It is next to impossible for such cyclicity to be a natural phenomenon. Now, we can understand a slackening of testing by the Comrades over weekends (even if that is absolutely unacceptable and detrimental to the fight against the Wuhan virus), but this pattern of deaths frankly defies science.

So, either the Communists need to hastily bone up on how to undercount deaths more creatively, or the Vijayan government has a lot of explaining to do.

The bottom line, therefore, is that mismanagement of the epidemic in Kerala is now reaching critical proportions, and time is approaching for the central government to step in. This is because Kerala, along with Maharashtra, rather than controlling and eradicating the second wave, is forming the breeding ground for the third wave everyone dreads.

It has been well-established after eighteen torturous months of the epidemic that a state may be deemed to be in the clear when its cumulative positivity (and not the TPR) declines to below the 4-5 per cent band.

However, as a comparative chart below shows, the cumulative positivity in Kerala is not just declining swiftly enough (bold, black line) but actually lingering in a dangerously high plateau. For that matter, the cumulative positivity even in Maharashtra (dotted black line) is on the persistent decline. That is why it is rated as a lower risk than Kerala (though not by much).

The basic reason for this state of affairs in Kerala (and in Maharashtra) is that testing is just not being raised to requisite levels. This deficiency is being compounded by an inexplicably hesitant approach to tracing and isolation on the ground. In the process, an already-stunted economy is also being further emaciated.

Consequently, it is no longer wise to let this situation continue unchecked. It cannot be that the economy reopens in the rest of the country, after having valiantly weathered a horrendous second wave, only for a third wave to engulf us once more, just because the Kerala government hid its mismanagement behind the fig leaf of federalism.

No doubt, it may be politically difficult for the central government to actively take charge of matters in Kerala and set things right; in that case, the centre may have to seriously consider shutting down travel into and out of Kerala until the cumulative positivity is brought down to requisite levels.

Numerous states, large and small, have shown that this can be done within a span of three to five weeks. But the Marxist government of Kerala has, instead, demonstrated a sustained inability to bring the crisis under check. Now, they may cite provisions of the constitution to ward off ‘external’ interference, but the epidemic situation there is getting too critical, with national consequences, to be left to the clueless caprice of provincial leadership.

So, either CM Vijayan demonstrates a swift, aggressive approach to controlling the epidemic within the coming week, or the centre would need to step in. All of India is now being placed at risk by the incompetence of one state government, and we simply can’t afford that.