Public’s reluctance to test could prove costly for Kerala

Lax contact tracing worsening matters, say health experts

Published - January 26, 2021 01:31 am IST - Thiruvananthapuram

Public health experts are anxiously watching the State’s COVID-19 case graph, which, after a period of lull, has been steadily rising and seems all set to climb further. With human behaviour primarily driving the current trend, improved surveillance and better communicative strategies are needed to convince the public that the pandemic curve is rising again.

The State’s graph of active COVID-19 cases peaked in October with 97,417 active cases. Kerala, with over 70,000 active cases, now accounts for nearly 40% of the country’s active case burden.

Public health experts strongly believe that lax public behaviour aside, laxity in contact tracing and follow-up of COVID-positive cases in the field is worsening matters. The impact of family get-togethers during the New Year season and large-scale indoor and outdoor gatherings are beginning to show.

The opening up of schools and entertainment arenas all at once, the withdrawal of police from all contact tracing exercise and the arrival of vaccines seem to have driven the impression that the State was past the pandemic.

“We need to be able to study the local pattern of disease transmission and spread in the State better, to pick up initial trends and to act upon it without delay. This will not be possible unless the State releases more granular district-level data,” a senior epidemiologist pointed out.

From the public health perspective, science says that investing more on RT-PCR tests, which are resource-intensive, not easily accessible and which have a high turnaround time will not contribute much to fast case detection and quick containment of disease spread in the community (Rethinking Covid-19 Test Sensitivity — A Strategy for Containment, M. Mina, NEJM Nov 2020).

Rapid antigen tests

Despite the low sensitivity of rapid antigen tests, by widely deploying these tests, the State could be picking up more people who are actually infectious (those with high viral load will have high antigenic response and if more such people can be picked up, that can reduce disease transmission in the community).

The current problem of the Health Department is that all across districts, people are refusing to test themselves for COVID-19. With asymptomatic infections contributing to disease transmission in a big way, this can backfire.

The Health Department will have to devise a better communicative strategy to address this issue immediately.

The State succeeded in delaying the peak of the epidemic so that the health system was not overwhelmed. This essentially meant that the epidemic will be prolonged and more agonising in the State. It raises the spectre of fatigue and laxity setting in amongst the public as well as the system, which over a period could lead to increased mortality — a phenomenon which is currently in play.

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