State’s case graph shows sliding trend

Citing the pattern of the curve elsewhere and the disease nature, experts warn against lowering guard too soon

For the first time since the pandemic curve started its upward growth in Kerala in September first week, the COVID-19 case graph in Kerala is on the decline.

Current disease trends show the effective reproductive number (R) to be less than 1, meaning that the cases will continue to decline. (R is the average number of secondary cases per infectious case in a population made up of both susceptible and non-susceptible hosts). However, it might be way too early to assume that the worst is over.

“Going by the nature of the disease and the pattern of the curve seen internationally, every time there is a dip, another crest is just beyond the corner. This pattern of a dip-plateau-crest will continue in repeat cycles till the case numbers really go down,” a public health professional says. He does not expect life to normalise before March next.

After a dip during September first week (the dip was in the post-Onam period when testing had also gone down), Kerala’s case graph has been growing continuously. The first dip following that surge is being witnessed now.

Epidemiologists point out that in many districts, the weekly case growth, when compared to the State’s weekly moving average in the current week, has been in the negative. Also, the State’s active case pool has not been growing, as the number of new cases added on daily is being stabilised by as many or more number of recoveries.

The graph has been definitely on the way down in Thiruvananthapuram and Kollam at least for the past 10 days, while Pathanamthitta, Ernakulam, Kozhikode, Kannur, and Kasaragod have also been reporting negative growth. However, Malappuram and Palakkad reported over 10% growth last week than in the previous week.

World over, cities have borne the brunt of the COVID-19 crisis, with the transmission focussed in urban areas first and then slowly moving to rural areas. The pattern has been similar in Kerala too, all five districts with maximum cases have city corporations.

The cases are more in the Malappuram-Palakkad belt now. Soon, the “visible” disease transmission hub will shift to Malappuram, while transmission at a lower intensity will continue throughout the rural areas in all districts, it is projected.

“The current disease dynamics, however, will sustain only if we maintain our general vigil,” a senior epidemiologist says.

The epidemic curve will naturally come down once a chunk of the susceptible population is affected but now that almost all cases are locally acquired infections, it will not take much for a local cluster to form and the disease curve to rise again.

The State will have to maintain high vigil as the upcoming Sabarimala pilgrimage and local body elections are definitely two events which will in all likelihood change the trajectory of the epidemic curve, experts warn.

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