Thiruvananthapuram: When daily COVID-19 cases are consistently high, Monday also saw 82 new cases, feverish concern might settle to seem like a new normal. And when daily recoveries nearly match fresh cases, 73 were cured on Monday, there is reason to feel even relief.

However, the 21st COVID-19 death in Kerala, that of 67-year-old S Rameshan who died on June 12 but whose sample tested positive posthumously on June 15, and the increasing number of primary infections have once again emphasised old fears.

Thiruvananthapuram native Rameshan Nair's source of infection could turn out to be one of COVID-19's enduring puzzles. He had been in the General Hospital for three days from May 23 to 25 and for the same number of days in the Medical College from June 10 to June 12. Though he had shown telltale COVID-19 symptoms, his sample was not taken for testing at both these hospitals when alive.

It was drawn only after his death on June 12, and that too not because there was suspicion but because it was protocol. Indian Council of Medical Research protocol has recently laid down that all deaths, whether in a hospital or outside, should be tested for COVID-19.

It is highly likely that he, like 77-year-old Father K G Varghese, would have acquired the infection from hospitals.

The attempt to trace the source of infection of the other two deaths in Thiruvananthapuram - 68-year-old Abdul Azeez and Father K G Varghese - have led nowhere.

Community health experts say this is a clear sign of community transmission in the capital district.

Health-care nightmare

Startling numbers of virus-carrying health workers are getting picked up as the random testing process is widened. Four health workers in Thiruvananthapuram, two of them in the Medical College, have tested positive. Nine health workers in Chavakkad Taluk hospital had tested positive. Five in Palakkad and Kannur district hospitals were found positive.

None of their sources could be traced, and this is seen as further sign of community transmission.

Primary woes

The health workers' plight had already raised a scare but what has still evaded notice is the incremental swell in primary contacts. These are local residents who contract the virus from people coming infected from outside.

On Monday, for instance, the grandparents of a boy who had returned from Delhi and was in quarantine in Alappuzha tested positive. In Kottayam, the parents of a youth who had returned from the Gulf had also tested positive on Monday.

Is this an indication that room quarantine, on which Kerala wants to build its Covid slayer reputation, is floundering? Are rigorous room quarantine restrictions virtually impossible to observe? Experts say there is nothing to worry as primary contacts are less than seven per cent of the total cases.

Among the new cases, 49 infected persons came from abroad (UAE-19, Kuwait-12, Saudi-9, Qatar-5, Oman-2, Nigeria-2) while 23 came from other states (Maharashtra-13, Tamil Nadu-4, Delhi-3, Rajasthan-1, West Bengal-1, Telangana-1. Nine individuals contracted the disease through contact.

District-wise distribution of new cases

Ernakulam 13
Pathanamthitta 11
Kottayam 10
Kannur 10
Palakkad 7
Malappuram 6
Kozhikode 6
Alappuzha 5
Kollam 4
Thrissur 3
Kasaragod 3
Idukki 2
Thiruvananthapuram 1
Wayanad 1

District-wise distribution of recoveries

Kannur-21
Palakkad 12
Kollam 11
Malappuram 10
Thrissur 6
Kozhikode 4
Kasaragod 4
Thiruvananthapuram 3
Ernakulam 2

The state currently, has 1,348 active cases. 1,174 patients have recovered from the illness so far.

As on Monday, 2,47,641 people have returned to the state from abroad and other states (By air – 75,656, by sea – 1,621, by road – 1,42,388, by train – 27,976). Of them, 1,29,971 people have completed their 14-day mandatory quarantine. There are 1,20,727 people in quarantine now. Of them, 1,18,704 are home/institutional quarantined and 2,023 in hospitals; 219 hospitalised today.

Of the 1,14,753 samples sent for tests, results of 1,996 are awaited. Samples of 31,424 people among priority groups were tested as part of sentinel surveillance. Of them, 29,991 have turned negative. So far, 1,51,686 samples have been sent for tests.

Ernakulam reports highest number of cases

Most number of cases were reported in Ernakulam today -- 13. Nine of them came from abroad and four from other states. The patients include natives of Maharashtra, Tamil Nadu and Rajasthan.

There are 83 COVID patients undergoing treatment in the district. Of them, 78 have been admitted to Kalamassery Medical College and Angamaly Adlux. Five undergo treatment at INHS Sanjeevani.

Eleven cases were reported in Pathanamthitta today. Seven of them returned from abroad and four from other states. Two of the infected are natives of Chenneerkkara and two from Elanthoor. The remaining infected are natives of Kalanjoor, Kulanada, Naaranammoozhi, Ezhamkulam, Thottapuzhassery, Naranganam and Kokkathode.

In Kottayam, 10 cases were reported. Five of them came from abroad and three from other states. The remaining two are the parents of a youth who had tested positive after he returned from abroad. The patients include a pregnant woman who came from Thoothukudi on June 4.

Of the seven cases reported in Palakkad, three came from abroad and two from other states. The remaining two contracted the disease through contact. A 10-year-old boy and 11-year-old boy at Pathirippala contracted the disease through contact with their grandmother who had tested positive on June 9. A one-year-old girl who returned from Saudi Arabia is also among those tested positive.

In Malappuram, three of the six who tested positive are returnees from abroad. Two came from other states. A lab technician at Manjeri contracted the disease through contact with a colleague who had tested positive on June 5.

In Alappuzha, five tested positive. Three of them came from abroad and two contracted the disease through contact. Those who contracted the virus through contact are a couple, aged 72 and 66, at Champakulam. They had come in contact with a child who came back from Delhi on May 30 and tested positive on June 12.

5 more hotspots

Five more regions have been converted into hot spots. The new hot spots are Alagappa Nagar, Vellangalloor, Tholur in Thrissur district; Kinanoor-Karinthalam in Kasaragod district and Thalassery in Kannur district.

Two hostpots were removed from the list. These are Vandazhi and Puthunagaram from Palakkad district. There are currently 125 hotspots in the state.

Meanwhile, the Kerala government on Monday eased travel and quarantine restrictions for those visiting the state for emergency purposes.

Individuals visiting the state for priority needs such as education, business, healthcare, property management and court visits may register at the Covid-19 Jagratha portal for e-passes, the order issued by the government stated. This pass will have a validity of seven days. The order said these travellers need not undergo the mandatory 14 days of home quarantine.