Kerala to ascertain if double mutant variant is driving transmission

TPR at 15.63%, active case pool crosses 1 lakh for the first time

Updated - April 20, 2021 12:14 am IST

Published - April 19, 2021 09:39 pm IST - Thiruvananthapuram

Heading home: Migrant workers waiting to board outstation trains at the Aluva railway station on Sunday.

Heading home: Migrant workers waiting to board outstation trains at the Aluva railway station on Sunday.

The Core Group for COVID-19 Management, chaired by Chief Secretary V. P. Joy, on Monday directed the Health Department to take immediate steps to ascertain if the double mutant variant, or the SARS-CoV-2 lineage B.1.617, is indeed driving the disease transmission in Kerala. The State is awaiting the results of the samples it had sent to national institutes for genome sequencing.

A meeting of the group termed this a priority, given the intense pace of disease transmission in the State and the fact that vaccine breakthrough infections are being reported increasingly in health-care workers who have received both doses.

The B.1.617 lineage is defined by two spike protein mutations, E484Q and L452R, which are involved in immune escape (which renders the virus capable of escaping the immune system’s response) as well as increased infectivity. The variant, which wreaked havoc in Maharashtra havoc, could have easily reached Kerala through domestic travel, experts point out.

The core group directed the department to conduct a second round of augmented testing on April 21 and 22, with three lakh samples as the target. The department has been directed to focus the testing in local bodies where the test positivity rate is high and to trace and test as many contacts of patients as possible.

The meeting directed the Principal Secretary (Health) to take a relook at the State’s discharge policy for COVID patients. Kerala is perhaps the only place where patients are discharged only after they test negative in a rapid antigen test.

The Chief Secretary directed the IT Department to ensure that the Lab Diagnosis and Management System, the portal where COVID testing data is uploaded, is working smoothly. The glitches in the system these past two days had created much delays in uploading sample details. The meeting also directed the department to ensure that medical oxygen, testing materials, essential drugs and hospital beds are available in adequate quantities in the State.

13,644 new cases

The results of the augmented COVID-19 mass testing drive in Kerala are still trickling in and on Monday, when the results of 87,275 samples analysed in the past 24 hours were released, the State reported 13,644 new cases. The test positivity rate (TPR) registered on the day was 15.63%.

The State went past the the active caseload it had during the first peak of the epidemic in October last and now has a pool of 1,03,004 active cases. During the first peak, the active caseload had been 97,417 cases.

Hospital admissions now number 12,281. On Monday, 2,506 persons were admitted to hospitals. ICU admissions are on the rise in all districts. On Monday, the proportion of critically ill patients requiring ICU care crossed the levels of the first peak. The State now has 889 patients requiring ICU care, with the number of patients requiring ventilator assistance rising to 248.

Doctors are still astounded by the sheer pace of the current disease transmission, as family clusters are being reported in large numbers, something that was not so noticeable during the first wave of COVID. As vaccination is yet to penetrate to the 18-45 age group, who are very mobile working adults, the prospect of them transmitting the infection to the partially vaccinated adults in the family (in whom the vaccine-generated immunity will be weak) has been high, it is said.

The increasing number of reinfections among previously infected persons and infections reported in fully vaccinated health-care workers are again hinting at the possibility that factors other than just laxity shown by the community may be at play. The sooner the State starts documenting these cases, as well as genome sequencing every one of these cases, the better, as it is important to know the enemy that the State is battling against, public health experts say.

21 deaths

The cumulative case burden of the State has risen to 12,53,068 cases. The disease transmission in northern districts has been intense and the active case pool in Ernakulam (15,854), Kozhikode (14,959), Kannur (9,159), Malappuram (9,293) and Kottayam (8,195) is rising fast. Twenty-one recent deaths were added to the official list of COVID-19 fatalities on Monday. The total COVID-19 death toll is 4,950.

Thiruvananthapuram and Kannur reported five deaths each, Alappuzha four, Ernakulam, Thrissur and Kozhikode two each, while three each, Kollam, Kottayam and Malappuram two each, while one death was reported from Kottayam.

Kozhikode reported 2,022 new cases, Ernakulam 1,781, Malappuram 1,661, Thrissur 1,388, Kannur 1,175, Thiruvananthapuram 981, Kottayam 973, Alappuzha 704, Kasaragod 676, Palakkad 581, Idukki 469, Kollam 455, Pathanamthitta 390 and Wayanad 388.

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