Covid-19: Signs of slow decline in states with high positivity rate

Five states with positivity rates ranging from 5 to 20 per cent may be the outliers of India’s overall Covid trajectory, but experts point out that the big picture is beginning to show a slow declining trend for most of the states, except Mizoram.

The high numbers have kept officials on edge who have warned the whole country of taking all precautions from October to December, since the threat of Covid has not left yet.

Against a national positivity rate of 1.6 per cent for the week ended October 6, the weekly positivity rate in Mizoram touched 21 per cent, while Kerala’s stood at 13.7 per cent, followed by Sikkim at a little over 12 per cent, according to the health ministry data.

For the same period, Manipur’s positivity rate has exceeded 7 per cent and that of Meghalaya is over 5 per cent.

Experts believe that the Covid second wave was delayed in these states. In Kerala, for instance, while the seropositivity was 44 per cent in June, it has increased to 82 per cent in the latest survey.

Since the middle of May, Kerala has been consistently clocking more than 10,000 daily cases and over 100 deaths per day, sometimes even contributing to over 70 per cent of the fresh cases reported in the country. More than half of the total cases reported last week were from Kerala.

“From the second week of September, the numbers in Kerala are steadily coming down. Everywhere else, the second wave was over on July 27, but Kerala managed to spread the second wave over a longer period of time, instead of having one tower like graph,” said Jacob John, former head of the Centre for Advanced Research in Virology and retired professor at Christian Medical College, Vellore.

State officials also stress that Kerala’s immunity is more vaccine-induced immunity as compared to infection-infused immunity seen in the majority of the northeast states. “Vaccines will not prevent infections, but it will reduce its severity,” said Anish T S, a member of the Covid management committee in Kerala and assistant professor at the Department of Community Medicine, Thiruvananthapuram Government Medical College Hospital.

He said the reporting standard is not as systematic in the majority of the northern states as Kerala.  

In Mizoram, where the positivity rate is the highest in the country, the situation has to be watched closely since cases have not yet achieved a downward trajectory. Like Kerala, Mizoram insists that it is testing much more aggressively compared to northern states, but the state is worried about an increased number of infections among children which makes up for 30-35 per cent of the total cases. 

“We did very well during the beginning. We are seeing a peak in cases because the community has not gained immunity...Another factor is our culture, we are a society which is closely linked with our neighbours,” said Eric Zomawia, deputy director, department of health in Mizoram.

On the positive side, the fatality rate has been less than 1 per cent in these states. “Delta will reach everywhere. Idea is to prevent deaths,” John said.

Meghalaya is another state that is seeing a rise in the test positivity rate despite the death ratio being as low as 0.33 per cent. “Cases are steadily coming down. We have a three-prong strategy — containment, vaccination, and Covid-appropriate behaviour,” said Ram Kumar, director of Meghalaya’s National Health Mission.

Meghalaya is also among the states where the vaccination coverage is lagging behind the national average. The state has vaccinated around 54 per cent of the eligible population with the first dose and around 25 per cent with both the doses.

In Manipur, where the test positivity has come down from the peak level of almost 19 per cent in mid-August to around 6 per cent in the last week, the vaccination coverage is also less than 60 per cent for the first dose recipients.

For Sikkim, while the health ministry data said the weekly positivity was over 12 per cent for week ending October 6, the data on covid19india.org shows the positivity rate has been in the range of 5 to 9 per cent since October 1 as per the seven-day moving average. The state is showing a declining trend in cases and is among the top states in terms of vaccination coverage having covered its entire adult population with one dose and 79 per cent with both doses.