The COVID-19 situation in Kerala is quite volatile and evolving fast and the next two weeks could see the case numbers explode to a level wherein the State’s oxygen requirement could rise sharply and supply can fall short, public health experts have warned .
“The volatility of the situation is extreme and Kerala has crossed that critical point when policy interventions could nip the growth of the pandemic. A two week lockdown right now can reduce the force of the epidemic and give the State an opportunity to stall the transmission. Or else the absolute numbers are just going to keep climbing,” a senior public health professional who has been working with the government, said, on condition of anonymity.
At present, containment efforts on the field has not had a major impact on disease transmission, which is growing exponentially because of the wide circulation of three virus variants which are highly infective and has increased virulence (death hazard associated with the B.1.1.7 variant is 61% more than the wild-type virus)
He said that the government has been apprised of the dangerous turn ahead.
The government has been reassuring continuously that the current situation did not warrant panic, the reality in the field is quite different, doctors said.
“In many hospitals, the ICU and oxygen beds have all but filled up. There are plenty of patients in the field requiring transfers to hospital beds with oxygen on a daily basis . ICUs cannot run by itself. Human resources are critical element for opening up more ICUs on demand. We are woefully short of support staff and unlike in the first wave, we have a huge number of non-COVID patients too who are really sick and need our care,” a doctor in a private hospital at Ernakulam said.
He said that the oxygen shortage in the State is going to be likely due to the supply and distribution issues in the field, rather than a shortage in production in State
Disease modellers and epidemiologists are quite reluctant to bandy about State’s case projections because too many variables are in play now.
“Two days ago, it was reasonable to project that the State could expect between 75,000 to one lakh cases per day in another two weeks when the epidemic peaks and that the active caseload would reach explosive levels. But the change in the State’s discharge policy (mild and moderate patients are let off sooner from hospitals than before) could mean that the active case pool of the State will shrink, even when the actual number of COVID-affected rises exponentially. The other variables confounding projections are the number of those in the vulnerable category and those in the 45 -60 age group who are vaccinated and are fairly protected,” says T. S. Anish, a public health expert.
The health system is under severe strain now even when just about 9% of the active cases are currently hospitalised. Healthcare workers fear that once the system starts collapsing, it will have a chain effect across districts and that the blame will soon be on doctors and hospitals.
“The focus should be on improved management of those COVID patients at home to ensure that they do not end up in hospitals. Also, there should be a centralised system to monitor hospital bed/ICU occupancy and oxygen requirement and manage logistics at district level,” a senior Health official said.
Public health experts are quite worried that the counting day on May 2 could turn out to be a day for high disease transmission, the impact of which might be evident only two weeks later .
Though victory parades and celebrations have been banned,the day being a holiday, people are bound to gather around televisions inside homes and party offices .
“This virus primarily spreads indoors and indoor gatherings are a huge risk for disease transmission. It is easy to blame the virus variants for the current situation but the real variant is the human behaviour,”said Rajeev Jayadevan, vice-chairman of IMA’s research wing.
