As Kerala battles COVID-19, focussing on intensive surveillance and containment measures, it is investment in real science and evidence-based medicine which will have an impact on the course of the epidemic in the coming days.
SARS-CoV-2 is a new virus, which is evolving and about which newer bits of information are emerging.
It is high time the State took a second look at the virus’s behaviour in Kerala against the backdrop of new scientific information and assimilated it into all control and containment strategies, public health experts say.
“When we compare what has been happening in the Western world, where the virus has ravaged communities, its behaviour has not been along the expected lines in Kerala so far. It is just a curious observation but the transmissibility of the virus and its infectiousness in our community has been much milder than we expected,” points out a public health scientist.
Cases so far
In the second wave of COVID-19, when the first positive cases of a family of three from Italy were announced in Pathanamthitta, the State was bracing for a public health crisis of explosive proportions.
However, only six immediate family members tested positive.
Though scores were quarantined, even those in the primary contact list did not contract COVID-19. In the case of the Wuhan-returned medical students too, even the parents of the students did not contract the infection.
Take the rest of the cases reported in Kerala – even where massive clustering was expected, as in the case of the group of foreign tourists camping at Munnar, only a few of the group contracted COVID-19 from the primary case. Is it the warm weather and tropical climate? Is there something inherent in the immune systems of the population here that helped resist the infection? Could it be that there are innumerable cases of mild, subclinical infection of COVID-19, but we are just picking up the ones that are coming to the surface?
Another possibility is that the virus has not yet begun to circulate amongst people who could potentially develop serious diseases, like those with hypertension, diabetes, or lung disease in whom it might exhibit more virulence. “It is way too early to float any theory and it could be a combination of factors. It is possible that we are missing widespread silent community transmission of COVID-19. Epidemiological studies which involve serological investigations (blood sample studies) to detect IgG or antibodies of the virus alone can tell us if the community has already been exposed to the virus,” a senior scientist at the Rajiv Gandhi Centre for Biotechnology (RGCB) says. (The presence of IgG indicates an earlier infection by the particular pathogen and determines community prevalence.)
The RGCB is launching serological studies to detect IgG levels to coronavirus amongst health-care personnel in the State hospitals.
“In Kerala, very little information on patient profile, clinical course or patient recovery is in the public domain. This epidemic is a huge learning experience which should be exploited thoroughly,” he adds.
