Increased COVID-19 testing has the effect of more people going out with powerful searchlights in the dark. It has been identifying positive cases, especially asymptomatic ones, that would have otherwise remained unnoticed.
With 5000-odd samples being tested daily on an average, there is hope that more such unknown virus carriers in the community would be picked up before it is late.
Still, in certain cases it appears it is already too late. There are silent positives who cannot be spotted even if Kerala were to treble its testing potential: individuals who had left Kerala after travel restrictions were eased.
There are unofficial reports that over 50 people who had travelled from Kerala were identified as positive when screening tests were done in other states and in the Gulf.
The government has also heard of such cases, but as rumours. "Neither the Tamil Nadu nor Karnataka governments have officially informed us of individuals who had tested positive after returning from Kerala," a top health department official said.
If the reports are true, it is trouble. "If people who had gone back from Kerala had tested positive, then we need to trace their local contacts, put them in quarantine and, if need be, the area where they lived should be made a containment zone. If this is not done, we would be perhaps allowing the virus to sweep through the community forming viral connections with abandon," the health official said.
A district-level health official told Onmanorama that details of some cases were indeed passed on by Tamil Nadu recently to district-level officials, and that some local contacts were traced and quarantined. "Since there is no constant or regular flow of such information, even these sparse figures have consolidated at the state level," the official said.
District collectors Onmanorama talked to said they had not received any such information from Tamil Nadu or Karnataka. "Moreover, Tamil Nadu and Karnataka do antibody tests, which are only indicative, and not the confirmatory RT-PCR (Reverse Transcription - Polymerase Chain Reaction) tests. A positive shown in an antibody test signifies nothing," said Thrissur Collector S Shanavas. In Gulf countries, too, antibody tests are the norm.
The collector said the timing of the tests was also crucial. "If the test was conducted some five days after reaching there, I don't think it will hold any value," he said.
Dr P K Jameela, the former director of health services (DHS) and a member of the COVID-19 expert committee, also said there was no official information from any of the neighbouring states about people coming infected from Kerala.
She surmised that it could be because antibody tests were not conclusive. "Antibody tests have high sensitivity but less specificity," she said. Meaning, it will show positive even if there are antibodies for other non-COVID illnesses like rhinitis.
"Certainty comes only after the RT-PCR tests are done. Perhaps, these antibody positives could have turned negative when the RT-PCR tests were done or confirmatory tests would not have even been conducted," she said.
There could be another possibility why neighbouring states have not got back. "These returnees who had probably tested positive after their return from Kerala could have been natives, not Malayalis," Dr Jameela said. "Even Kerala does not pass on information if the returnee who had tested positive is a Malayali. We share information only if the person is a non-Malayali," she added.
Nonetheless, the government's COVID-19 expert committee has taken the issue seriously. "We have already recommended that Kerala government should talk to its neighbours and ensure that information is passed on if those from Kerala test positive at their side," Said Dr K P Aravindan, another member of the COVID-19 expert committee.
