There is no point reading too much into the slight dip in fresh cases on Monday - from three consecutive days of 100-plus cases to 91 - than into a long distance runner slowing down a bit in the middle of a run.

It is the most vulnerable who are returning - the aged, those with serious ailments and pregnant women - and the numbers are bound to rise. Now, 2,005 cases have been confirmed and of this, 1,174 are active.

The Health Department itself has estimated that daily cases would burgeon to around 350 by August. Since May 4, 1,506 new cases have been reported and 1,352 of them have a travel history, meaning they have come either from high-risk foreign countries or from other parts of the country where the virus has spread badly.

'Orphan' cases on the rise

Till now, only 154 of the 1,506 new cases since May 4 are residents who had acquired the virus through contact with an infected person. This is just 10.22 per cent of the cases, and is officially considered safe.

Problem is, the source of infection in at least 40 of these 154 is still a mystery. Though they are generally called 'contact patients', it is not clear whether they had come into contact with any of the returning Malayalis. Likelier possibility is, they could have got the infection from the local community where the virus thrives unseen.

Superspreaders among health workers

Among the 154 are 24 health workers (two were declared positive today) - mostly nurses, paramedics and field workers - who possibly got infected in the line of duty. In some of them, lazy adherence to safety protocols, like the improper way of donning PPE kits, could have put them in danger. Health workers not only get infected but are also potential superspreaders.

A Health Department study had found that an ASHA worker in Chathannoor had transmitted the virus to five others. From where the virus got into her, the study was unable to find out.

At least 20 of these 24 health workers who were found positive in the last one month were active even after they were randomly picked up for tests. They, like the Chathannoor ASHA worker, could transmit the disease to at least five others.

"We can find their transmission rate if we do a detailed epidemiological study like it was done for the Chathannoor ASHA worker by doctors in Parippally Medical College. But with numbers growing, I don't think it is possible at this stage," a top Health Department official said.

Galloping death rate

Kerala's COVID-19 death rate has also gone up. With three deaths in the last three days - former footballer Hamza Koya, 87-year-old Engandiyur native Kumar, and 43-year-old Dinny Chacko - total deaths now stand at 18; 14 of them happened within a month.

Kerala government acknowledges just 16 deaths, and therefore the death rate it claims is 0.8 per cent. But if Mahe native Mehroof who died in Pariyaram Medical College and a Telengana migrant worker who died in Thiruvananthapuram General Hospital are also taken into account, as the Centre has done, Kerala's death rate would be 0.9.

Health officials said a higher death toll was expected. "It is the most vulnerable among Malaylis who are now returning. The government has made it clear that the old, the ill, pregnant women and those who have lost their jobs should get priority to return. These are also the people who are more likely to contract the virus," the official said.

Here's the district-wise break-up of today's cases:

Alappuzha - 5

Ernakulam - 3

Kasaragod - 8

Kannur - 4

Kozhikode - 13

Kollam - 5

Kottayam - 3

Malappuram - 14

Pathanamthitta - 3

Palakkad - 1

Thiruvananthapuram - 3

Thrissur - 27

Wayanad - 2

Of them, 73 have come from abroad. UAE-42, Kuwait-15, Oman-5, Russia-4, Nigeria-3, Saudi Arabia-2, Italy-1 and Jordan-1

15 persons came from other states. Maharashtra-6, Tamil Nadu-6, Delhi-2 and Karnataka-1.

One contracted the disease through contact.

Two healthcare workers in Thrissur district too have tested positive for COVID.

COVID cases in Thrissur crossed 100 as 26 more tested positive. The district now has 123 active cases. There are two healthcare workers among the new positive cases. 

Of the 14 new cases reported in Malappuram, 12 are returnees from abroad while the remaining two came back from Chennai and Bengaluru. There are three pregnant women among them. 

Four more cases were reported in Kannur which has 118 active cases. Three of the new cases are returnees from abroad and one from Mumbai. 

All the five new cases in Kollam are returnees from abroad. There is a staff nurse who came back from Dubai among the infected. 

Of the five cases reported in Kozhikode, four belong to a family. A woman who returned from Abu Dhabi on May 31 and her three daughters have tested positive. A 50-year-old Dubai returnee is the fifth infected. 

The three new patients in Ernakulam are returnees from Nigeria, Kuwait and Abu Dhabi. The returnee from Nigeria is a native of Chennai. 

Three more cases were reported in Kottayam. Two of them returned from Kuwait and one from Saudi. All are women. 

The lone patient who tested positive in Palakkad is a Chennai returnee.

Recoveries

11 persons were cured of the disease on Monday.

Here's the district-wise break-up of today's recoveries:

Kasaragod - 5

Kannur - 2

Palakkad - 2

Wayanad - 2

So far, 814 people have been cured of COVID-19 in the state.

A total of 1,97,078 people are under observation in various districts. Of these, 1,95,307 are under home-quarantine and 1,771 are in hospitals.

211 people were admitted in hospitals on Monday.

So far, 85,676 samples have been sent for testing. Of these, 82,362 samples tested yielded negative results.

In addition, as part of Sentinel Surveillance, 22,357 samples were collected from priority groups, such as health workers, guest workers, social contacts.

Eighteenth COVID death

Another COVID death has been reported from Kerala.

The deceased has been identified as Dinny Chacko, 43, who hails from Chalakkudy in Thrissur district. He was undergoing treatment at Thrissur Medical College Hospital.

Dinny had arrived from the Maldives with his wife, child and mother-in-law. They were in institutional quarantine. On the third day of their return, they developed symptoms. Dinny was the first to test positive. The other three, too, tested positive later, but they have outlived their symptoms and are now said to be stable.

Dinny, who had diabetes and kidney-related ailments, was on ventilator for the last six days.

This is the third COVID death being reported from Thrissur.

With this, the number of COVID deaths in the state has risen to 18.

Hotspots

Six more regions have been converted into hot spots.

The new hot spots are Shornur in Palakkad, Murukanadu, Kuruva, Kalpakanchery, Edappal and Vattamkulam in Malappuram district.

There are currently 150 hot spots in the state.