A fresh spike of more than 1,000 cases each on Tuesday and Wednesday (May 31 and June 1) in Kerala, more or less coinciding with reopening of schools and the onset of the monsoon, has generated a cause of concern for public health administration officials.

Elsewhere, Maharashtra is grappling with a rise in daily new cases while Tamil Nadu and Telangana too have witnessed transmission, though at a lesser scale, according to statistics put out by the Ministry of Health and Family Welfare. On Thursday, the number of daily new cases had come down to 548 in Kerala while Maharashtra reported 557.

Maharashtra, in fact, has put private hospitals and testing centres on alert, bracing for a spike in cases during the monsoon and the Chief Minister is said to have called for a meeting of the Covid-19 taskforce, on Thursday. The country reported 3,712 new cases in the last 24 hours, up to 8 am on Thursday, and zero deaths for the second time in recent months. Five reconciliations (or backlog reporting of deaths) were reported from Kerala. 

Active cases up in Kerala

On Wednesday, Kerala had added 734 cases with the total number of active cases at 6,129. Six deaths were reported the same day of which two were declared based on appeals. The latest surge in number was noticeable from May 25 onwards accompanied by death numbers in steady two-digits, mostly based on appeals.

The time now is more appropriate for the virus to strike again, according to Rajeev Jayadevan, Co-Chairman, National IMA Covid Task Force and Past President, Indian Medical Association. Respiratory viruses including Covid-19 and influenza spread more efficiently when people mingle more.

TPR rebounds to over 8 per cent

Test positivity rate (TPR) in Kerala sprung back to 8.77 per cent (way beyond the tolerable three per cent) as on Wednesday. The Health Department blames the ‘business-as-usual’ approach towards public health and breaking of Covid protocols with impunity as proximate reasons for the spike in numbers. Reporting may be higher also because the number of tests have been raised since the onset of the monsoon and as a precautionary step against seasonal afflictions. In the light of the emerging situation, the Education Department has made face masks mandatory for students. Schools must also ensure adequate sanitising facilities for them.

Public messaging must

Speaking to BusinessLine, Rajeev Jayadevan too pointed to prevailing humid conditions in the State following the arrival of the monsoon are ideal for aerosol spread. “Besides, many people say that the pandemic is over. When this happens on a population scale, it aggravates spread. Clear public health messaging is crucial,” he opined.

Asked whether this spike was expected, he replied in the affirmative. “These viruses travel from person to person in tiny weightless vehicles called aerosol droplets, typically less than 5 µm in diameter. The physical, chemical and biological properties of these droplets have been much studied. In optimal humid conditions, droplets survive longer. Thus, the reach of these droplets (and the virus) will be greater, translating to infecting larger numbers. Besides, when people crowd indoors, spread worsens,” he pointed out.

No need to close schools

There is no need to close down schools unless a new variant comes up, unusual symptoms or large-scale outbreaks. All schools must have a readymade plan to tackle small outbreaks effectively at the outset. This will lead to better handling. “In other words, an outbreak at school should not come as a surprise,” Jayadevan said. (An outbreak is defined as a small number of cases occurring in a limited area, while an epidemic involves a larger region).

Hybrid immunity advantage

India has already achieved a high level of adult vaccination coverage, (close to 90 per cent have had two doses) and of older children. Vaccination, along with abundant levels of immunity from multiple rounds of natural infection, has generated hybrid immunity. Adults who have not received a vaccine must take a dose. Those who are vulnerable may receive a booster dose. Unfortunately, vaccine protection against infection is short lived, although protection against severe disease is long-term. Non-pharma measures must continue. Indoor masking and avoiding large indoor gatherings are important.

First strike in metros

As to spikes elsewhere in the country, especially Mumbai, Jayadevan said outbreaks are typically first detected in large metros because they are crowded, with greater mobility and better testing facilities. As people travel, in the subsequent weeks it spreads to smaller towns and villages. Genomic surveillance for new variants is important in decision making, he added.