Kerala: Lower doubling time in five districts with high TPR

KOCHI: The doubling time of Covid-19 in the five districts, where the test positivity rate (TPR) is now over 5% is between 10 and 14 days. In places with TPR below 5%, the doubling time averages between 20 to 25 days.
The state health department has asked these five districts — Malappuram, Kasaragod, Thiruvananthapuram, Ernakulam, and Alappuzha — to increase testing to bring down the TPR below 5%, besides focusing on rigorous cluster contaminant strategies.TRP, that is an indicator of the virus spread, is 4.7% for Kerala.
Between August 1 and 7, TPR was highest in Malappuram, at 10.3%, with a doubling time of 13 days, followed by Kasaragod at 10.1% and 11 days. In Thiruvananthapuram, where the most number of cases are being reported in the state in the last few weeks, the figures were 9.2% and 14 days. In Ernakulam, 8.3% TPR and doubling time of 15 days while Alappuzha had a doubling time of 16 days and TPR at 6.1%. By contrast, in Kollam where TPR is lowest in the state at 2.1%, the doubling time is 32 days, followed by Kannur that has a doubling time of 36 days with TPR of 2.3%.
"This indicates that now in some districts there may be lots of undiagnosed patients spreading the disease," said Dr Padmanabha Shenoy, who has been analyzing the data on TPR in Kerala from the beginning of the pandemic . "This will lead to an explosion of cases which may result in overstrain on healthcare infrastructure."
The department has asked the five districts to increase testing to bring down the TPR. "It is desirable to maintain the TPR below 5%, preferably around 2%," the department stated.
The call is to establish systems for ensuring testing of all individuals with ILI symptoms, encourage more testing in the private sector, utilize the maximum capacity of RT-PCR based techniques (including TrueNat, Xpert), and judicious deployment of antigen-based tests in cluster containment zones.
However, a DMO from one of the five districts said that high TPR doesn't necessarily mean poor testing. "We are testing suspects and they are tested positive. This is not a black mark. TPR will increase and then decrease gradually," the DMO added.
In the five districts, not just FLTCs but even the ICUs are overflowing, especially in the government facilities. While in Thiruvananthapuram nearly 55% of FLTC beds are occupied, in Alappuzha it’s 70%, Ernakulam 54%, and Kasaragod 72%. However, in Malappuram, only 33% of FLTC beds are occupied. In most districts, 50% to 70% of ICUs in the government sector are occupied.