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India Covid-19 numbers explained: Kerala, the intriguing outlier in country’s flattening coronavirus curve

India's coronavirus cases numbers: Kerala has detected close to 30,000 infections for every million people. Only Delhi, Goa and Ladakh have higher numbers.

Written by Amitabh Sinha , Edited by Explained Desk | Pune |
Updated: February 22, 2021 12:40:20 pm
People wearing masks as a precaution against the coronavirus alight from a bus in Kochi. (AP Photo/R S Iyer)

Once celebrated as a success story in containing the spread of coronavirus epidemic in India, Kerala saw its confirmed cases go past the one million mark on Sunday. It is only the second state, after Maharashtra, to have recorded so many cases.

On Sunday, the state reported 4,611 new infections, which took the total number of confirmed cases to 1,004,135 (ten lakh four thousand one hundred and thirty five). That would mean that one out of every 35 persons in the state has been found to be infected with the virus till now. For India as a whole, this number would be one in about 135 people.

Put differently, Kerala has detected close to 30,000 infections for every million people. Only Delhi, Goa and Ladakh have higher numbers.

The state has the highest number of active cases right now, almost half of the entire country. As on Sunday, the state had 63,484 active cases, out of the total of 1.37 lakh in the whole country. On most days of this year, the state has contributed between 45 to 45 per cent of all the new detections in the country.

Active cases in Kerala

Under criticism, after being hailed initially, the Kerala government has been pointing to the relatively lesser number of deaths to argue that its main focus has been to avert deaths, and serious ailments, and ultimately that is what is going to matter, not the number of infections. While it is true that Kerala has a relatively low case fatality ratio (number of deaths out of number of confirmed positive cases) of 0.4 (four people out of every 1,000 infected have died), the number is not so flattering if we take the population size into account.

Kerala has so far recorded 4,033 coronavirus-related deaths, including the 48 that the state has classified as those attributable to co-morbid conditions. That would calculate to about 120 deaths in the state per million population. That is roughly equal to the number for whole of India as well. While several states, including Delhi, Maharashtra, Andhra Pradesh and Tamil Nadu, have fared much worse, a number of large states, like Bihar, Uttar Pradesh, Gujarat, Madhya Pradesh or West Bengal, have far more impressive figures.

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Kerala has witnessed the most unusual trajectory of the epidemic in the country. It was the state where the first coronavirus case in India was detected, on January 30 last year. For the next six months, it seemed to be the model state as far as containing the spread was concerned. Even as infections proliferated in the rest of the country, Kerala recorded very few cases. For several days in the first half of May, when the lockdown was relaxed for the first time, leading to a rise in cases in several states, Kerala reported zero cases. Its daily count had remained within 100 till the first week of June. By that time, Maharashtra had begun reporting more than 2,000 cases a day, and states like Delhi and Tamil Nadu were finding more than 1,000 cases every day.

Daily new cases in Kerala

But then came the turnaround, and a bewildering rise in the number of cases in Kerala that has continued till this day. It was on September 11 that Kerala became the 13th state where the coronavirus cases had crossed one lakh. At that time, Andhra Pradesh had recorded close to 5.5 lakh cases, Tamil Nadu had close to five lakh, and Karnataka about 4.5 lakh. Even states like Bihar, Odisha, Telangana, Assam and Gujarat were way ahead of Kerala. While almost every other state began to slow down the third week of September, Kerala continued to grow.

On October 10, the state recorded as many as 11,755 cases in a day. No other state, barring Maharashtra, has ever discovered as many cases in a single day.

On most days this year, Kerala has contributed between 45 to 50 per cent of all the new detections in the country.

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Total cases in Kerala

The intriguing thing is that there is no good explanation available for what is happening in Kerala. The plausible explanations offered are not very convincing. Like the fact that because Kerala had managed to contain the spread in the initial period, it was left with a much larger proportion of people who were uninfected, and thus susceptible to the virus. Or, the fact that because Kerala is almost entirely urbanized, cases are being reported from almost every corner of the state, unlike several other states where the reporting from the rural areas is not very robust. Or, it could be case of people being more reckless about wearing masks and following physical distancing norms compared to other states.

India’s detection of new cases has been on a steady decline since the middle of September. The daily numbers have come down from a peak of more than 98,000 to a range of 10,000 to 13,000 now. But the decline has stagnated for the last two months or so, mainly because Kerala, and Maharashtra, have been reporting fresh numbers at a steady rate, accounting for almost 70 per cent of all the cases in the country. In fact, in the last few days, Maharashtra numbers have actually shown signs of increasing. On Sunday, the state reported more than 4,000 cases for the first time in more than a month. Kerala has been consistently reporting between 5,000 and 6,000 cases a day since the start of this year.

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