Destroying Models
Opinion
and truth, make a strange couple. Opinions, are created. It can even destroy
truth. Loud anchors and doctored visuals
dish out facts distorted beyond recognition, tell-tale marks intact, persuading
us to believe. As truth lie buried deep, opinions cloud our thoughts and
dictate our actions. Welcome to the world of prime-time TV discussions!
The prime-time
discussion one day was dedicated to the figures of seroprevalence in the country. Results of the fourth round of
national sero-survey conducted by the ICMR had just become 'known'. Some participants seemed genuinely concerned. One, visibly upset, was breathing fire.
“Look at the serosurveillance figures! Kerala
is the lowest in the country! Their immunity is the lowest. One of the smallest
states, the biggest contributor to covid cases in the country, more than half
the country’s cases from there.”
In
another outburst on a regional channel a self-depreciating participant lamented,
“The Kerala model, touted
as the best was an illusion.”
A
state, acknowledged for its efficiency in handling epidemics, was under intense
criticism.
People
with poor immunity? Super spreaders?
What is
the Truth?
Speaking Figures
Yes; Kerala really has the lowest seroprevalence figures in the country.
|
State |
Seroprevalence |
State |
Seroprevalence |
|
MP |
79.00% |
Punjab |
66.50% |
|
Rajasthan |
76.20% |
Telangana |
63.10% |
|
Bihar |
75.90% |
Jammu & Kashmir |
63.00% |
|
Gujarat |
75.30% |
Himachal Pradesh |
62.00% |
|
Chhattisgarh |
74.60% |
Jharkhand |
61.20% |
|
Uttarakhand |
73.10% |
West Bengal |
60.90% |
|
UP |
71.00% |
Haryana |
60.10% |
|
Andhra Pradesh |
70.20% |
Maharashtra |
58.00% |
|
Karnataka |
69.80% |
Assam |
50.30% |
|
Tamil Nadu |
69.20% |
Kerala |
44.40% |
|
Odisha |
68.10% |
|
|
Kerala is also reporting large incidence of daily new Covid infections. Kerala component exerts significant influence on the national figures.
On 3rd
Aug, of all the new cases reported in India, 55.54% was from Kerala alone, a
huge jump from 45.78% the previous day.
In all fairness to seething anchors, most of
them clearly with not-so hidden agenda, and party spokespersons, present solely
for pushing political ends, every word of the facts placed were indisputably
true. However, the inferences drawn and accusations being heaped were bordering
the ridiculous. Claims of great work by spokespersons of parties in power and accusations
of incompetence by others, both beg rebuttals. Commercial
and political compulsions demand rhetoric.
Implications of Seroprevalence
Seroprevalence indicates the population segment
that has developed antibodies. People develop antibodies to novel coronavirus, either
through infection or vaccination. One doesn’t necessarily have to fall sick
with infection to acquire antibodies. Asymptomatic and unreported infections
also produce antibodies.
According to the survey, 79% of the
population in Madhya Pradesh, as against just 44.40% in Kerala, has already
acquired the antibodies. As a corollary, it also means that above 65% of those
in Kerala are still susceptible to covid infection. States with high
seroprevalence are likely to have lesser cases of covid infections since they
may be close to achieving herd immunity.
Why does Kerala have such low seroprevalence?
Complacency?
Initial days of infection clearly overwhelmed
the infrastructure. There were countless heart wrenching stories of people
dying without getting beds in hospitals. Many having managed beds, faced
shortages of ventilators and even oxygen. Isolation of patients was the only
way to control the wildfire-like spread. Thus came the National lockdown,
followed by series of State controlled lockdowns. Everyone, everywhere was
shouting “social distancing” to ‘flatten the curve’!
The flat curve containment strategy aimed to slow down the rate of infection, preventing
medical facilities from being overwhelmed.
Kerala was the first state to report covid
infection. Given an estimated total population of 3,53,36,581as on 08 Aug 2021,
it has cumulatively reported 34.9 lakh cases of covid, second only to
Maharashtra, leaving all populous states behind! It means that only 9.88% of
its population has contacted covid! What about seroprevalence numbers? There is
a gap to be bridged!
The apparently low, 44.40% seroprevalence effectively means Kerala
succeeded in restricting infection and keeping about 65% of its population away
from infection even well into the second wave, no mean feat for the
densely populated state. The state actually flattened the curve and
successfully staggered the spread. By any standards, it is an amazing epidemic
control activity. Political animosity, inability to read and understand figures
should not diminish the sheen of a gigantic achievement.
Mortality and Infection
The numbers in the public domain are those
which the states officially report. It is commonly believed that all states,
despite vehement denials, underreported covid infection and mortality. Such reports
with statistics are in the public domain, though not officially authenticated. Interestingly,
even those reports reveal that Kerala has the least under-reporting!
Deaths, irreparable loss for those affected, do become statistics. Despite best efforts Kerala too reported many deaths.
Deaths, when considered as a percentage of infection, Kerala seems to have controlled, despite rising figures of infection. Primary health centres and the medical fraternity deserve credit.
The state’s covid mortality rate is also well
below the national average.
Achievements aside, why is infection increasing?
Policy flaws? Implementation deficit?
Is there something that we are missing out?
Price of Compliance?
Experts hold the aggressive delta variant
responsible for the return and increase in infection world over. If the delta
variant alone was responsible, then numbers would have shot up across India.
That is apparently not happening.
Why is Kerala then different from others?
Wide spread underreporting aside, it is possible
that the population in other states have already been exposed to the virus and
have already acquired antibodies. Therefore, they now show lesser numbers. Kerala
enforced masks amongst the population. Keralites who had taken instructions
very seriously now find themselves most susceptible to the virus! Numbers certainly
point to it.
With neighbours insisting on RTPCR tests each
time, ignoring vaccination certificates, crossing over into Tamil Nadu and
Karnataka has become a costly affair for Keralites.
Kerala seems to be paying a price for
compliance.
Boundaries of Science
The scientific community has consistently changed its opinion about
Covid and its spread. From ‘spread by physical contact’ that led to harsh
‘social distancing norms’, medical fraternity seems to have now settled for ‘aerial
route’ as the favoured mode of spread. The society has moved a long way from patient
victimization to home isolation and micro containment policies.
Accept it or not, it is very clear, that Covid is here to stay for good
and that we will have to live with it. Our survival so far, is less about our scientific and medical competencies
but more about survival compulsions of the virus itself. Corona virus is mutating fast, not for
acquiring more lethality, but with the aim of prolonging its own longevity,
which can happen only if its human host is alive.
Hold our pride and arrogance back, it is the existential compulsions of
the virus that grants us the mercy of survival. We need to augment our efforts
in that direction. Hitting herd immunity at the earliest is our best escape
route.
We, The Herd
Coronavirus is not bound by geographical,
political or religious boundaries. It does not differentiate between caste,
creed, colour, gender, and doesn't bother for any reservation schemes. Politicians
can manage data and manipulate visibility. But the virus seems to deliberately
ignore them and prove all divisive theories wrong. The only effective way forward is to consider
all the people around as part of the same herd. Faster the herd attains immunity, better it is for each member of the herd. This is possible only through very
aggressive vaccination programs and not by sustained isolation.
Vaccine Management
Vaccination may not prevent infection. but as
of now we know, it protects. It hits even those vaccinated but with relatively
less severity.
The most susceptible region as of now is
Kerala. Authorities must move in quickly and vaccinate each one in Kerala. It’s
a tall order considering the current process of vaccination. As on 08 Aug, only
62,69,657 people in Kerala have received both the doses. It makes just 17.74%
of the population. That leaves the authorities a humongous 82% of the
population to be protected.
In absolute numbers, considering the total
requirement of 7,06,73,162 doses for 3,53,36,581
people, a total of only 2,13,03,626 doses (1,50,33,969
first & 62,69,657 second) have been administered till 6th
Aug. It leaves the administration with the burden of administering 4,93,69,536
doses more. Considering the state’s vaccination abilities, (5,06,397
doses on 24 Jul and 4.91 lakh doses on 24 Jul) the target is not
difficult to achieve. If Kerala can earnestly adhere to four lakh shots a day,
it will still take 124 days to cover the population.
The Challenge
The
Health Minster has a challenge on her hands. The real challenge is vaccine availability.
That rests with the Central Government. It will be prudent for the central government
to push the maximum quantum of vaccines to Kerala, with lowest seroprevalence. With an efficient network of primary health
centers and medical workers at par with the best in the world, the task can be considered
accomplished.
[i] All figures used for the graphs here have been culled from the government site in the public domain. The figures against 23rd Jul have been shown as zero. However, the figures of 24th show substantial spike indicating likelihood of the two days figures getting added.
