Thread by @RijoMJohn

Has #Kerala miserably failed in containing #COVID19 pandemic?

This is a question I keep getting from various quarters. This thread is an attempt to explain it.
1/

Using the latest ICMR 3rd sero survey results during Dec 2020, we can see that #Kerala was able to identify & report one in every 5 cases, while all of India was able to identify only 1 in every 28 cases.

It shows the effectiveness of testing strategy used in Kerala
2/

Testing after good tracing & tracking would make it much more effective. This may result in higher TPR, but it's a cost effective use of testing infrastructure

Kerala has not only done nearly double the number of tests per million but it had a much better case detection rate.
3/

So far, #Kerala has detected 8.8% of its popn as COVID+ while India did 2.3%. It's fully vaccinated 12.8% popn while India did 6.1%.

If we assume the same under counting factor as in Dec 2020, it'd mean 48% in Kerala are infected but it's 64% in India (simple extrapolation).
4/

Then why the cases are still not falling?

Simple answer: Kerala still has a larger % of popn unexposed to the virus compared to India. This may be due to relatively better compliance with masking & social distancing despite high popn density.

More nuanced explanation below:
5/

We can see after the 1st wave too, Kerala had 2 months+ long plateau of cases with 50-60K avg. daily tests, ~5K cases & ~10-11% TPR.

It is the same now with a sustained ~10% TPR, but higher testing (1.2L-1.5L) & a higher plateau of cases at ~15K
6/

This is the whole idea of flattening the curve. Keep the cases at a low manageable level for the healthcare system as long as possible until the infection reaches a herd immunity threshold.

Even at the peak of the 2nd wave, Kerala had no serious shortage of oxygen or ICU beds
7/

The current level of infections at ~15K/day cases, is well within the capacity of the state's health infra to manage comfortably.

With one of the highest vaccination rates in India & keeping cases well within capacity, Kerala is still managing its pandemic reasonably well.
8/

Imagine, if Kerala had done the same number of tests per million population as WB, MP, Raj, UP etc., the state would not be reporting even a 3rd of the cases it is currently reporting & would've looked far better on paper. But, does that solve the problem? No.
9/

Unfortunately, in India, we got a system that rewards success based on officially reported numbers on paper. This incentivizes many states to "manage" the pandemic data more than the pandemic itself with the consequence being ever increasing missing deaths.
10/

This article by @Rukmini shows the extent of under reporting of COVID19 deaths in many states. It shows the under reporting of COVID19 deaths, although a concern, is arguably the lowest in Kerala.
11/
indiaspend.com/covid-19/death…

There is also a wide-spread misperception that Kerala was one of the states that started the 2nd wave of this pandemic. It is NOT true. 2nd wave started surging in Kerala more than a month after it had already started in a number of states in India.
12/

https://twitter.com/RijoMJohn/status/1415994089858686977?s=20

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