Driven by the Omicron sub lineages (predominantly XBB.1, XBB.1.9.1 and XBB.1.16), COVID-19 cases have been showing a significant spike in the State for the past two weeks, and on Saturday, active cases in Kerala crossed the 10,000 mark for the first time after 189 days.
As on Saturday, Kerala has 10,609 active cases and for the fourth consecutive day, close to 2,000 new cases were reported
Despite the surge in case numbers, hospital admissions or Oxygen requirements are yet to send any alarm bells ringing.
However, the State has been recording a steady increase in COVID-19 deaths for the past two weeks, underlining the fact that even when the disease caused by Omicron is “mild”, certain categories of individuals — the elderly, those with chronic diseases and serious co-morbidities like uncontrolled diabetes or hypertension — will continue to be at serious risk.
“The virus may have become endemic, but endemicity is not necessarily a benign condition. Given the high burden of diabetes and hypertension in our population, the large proportion of elderly and repeated exposure to the virus, the State’s vulnerabilities are high. COVID-19 is going to be around, year after year, but an individual’s risk of developing serious disease or complications will differ. We can only try to reduce the impact on the population by taking special care of the at-risk group and encouraging respiratory infection-appropriate behaviour,” says R. Aravind, Head of Infectious Diseases, Government Medical College Hospital, Thiruvananthapuram.
Noncommunicable diseases (NCD) control is going to be crucial for Kerala to minimise COVID-19 deaths, something easier said than done, he points out.
Thus, while COVID-19 deaths have been rising in the State (some of which are reconciled deaths), almost all of the deceased have been the elderly or those with serious chronic diseases, Health officials say.
Doctors also say that in many deaths, COVID was an incidental cause, ie patients who were being treated for serious ailments were incidentally detected with COVID-19 too. The Health department has issued guidelines making masking mandatory for all in hospitals so that hospitals do not become transmission points.
“There is a definite surge in case numbers but we see few cases of pneumonia or those requiring oxygen. We prefer not to admit COVID-19 patients, unless they have serious risk factors like advanced age or comorbidities. For those high-risk patients with COVID-19 who present early, we are now administering oral antivirals , which reduces hospitalisation risk,” Muhammed Niyas, consultant, Infectious Diseases, KIMSHEALTH, says.
Public health experts also point out that unlike in the initial years of the pandemic, four respiratory viruses are in circulation now — RSV, Adeno virus, Influenza A (H1N1 and H2N3) and SARS CoV 2. Hence the syndromic approach is being adopted and all those turning up in hospitals are being tested on the basis of the severity of symptoms.
“All category C patients (severe symptoms) and pregnant women should be tested and Oseltamivir antiviral drugs started in the case of flu. We have advised flu vaccine and precautionary dose of COVID-19 vaccine for senior citizens, but there are few takers. Cases will surge in the next two weeks because of increased social interactions and because the public continue to ignore the advice to mask up in closed or crowded spaces,” a senior Health official says.
Health department officials also claim that they do not want people testing in panic and that the only red flag signs they intend to monitor are rise in severity of cases and increase in hospital admissions, which at present remains stable. COVID-19 testing, which used to be around 5,000/day has risen to almost 9,000/day these past two days in the State.
