Analysis and Prediction of COVID-19 Spread in Ernakulam District, Kerala

The world is witnessing a pandemic of SARS-CoV2 infection since the first quarter of the twenty-first century. Ever since the first case was reported in Wuhan city of China in December 2019, the virus has spread over 223 countries. Understanding and predicting the dynamics of COVID-19 spread through data analysis will empower our administrations with insights for better planning and response against the burden inflicted on our health care infrastructure and economy. The aim of the study was to analyze and predict COVID-19 spread in Ernakulam district of Kerala. Data was extracted from lab data management system (LDMS), a government portal to enter all the COVID-19 testing details. Using the EpiModel package of R-mathematical modeling of infectious disease dynamics, the predictive analysis for hospitalization rate, percentage of patients requiring oxygen and ICU admission, percentage of patients getting admitted, duration of hospital stay, case fatality rate, age group and gender-wise fatality rate, and hospitalization rate were computed. While calculating the above-said variables, the percentage of vaccinated population, breakthrough infections, and percentage of hospitalization among the vaccinated was also taken into consideration. The time trend of patients in ICU showed men outnumbered women. Positive cases were more among 20–30 years, while 61–70 years age group had more risk for ICU admission. An increase in CFR with advancing age and also a higher CFR among males were seen. Conclusions: Analyzing and predicting the trend of COVID-19 would help the governments to better utilize their limited healthcare resources and adopt timely measures to contain the virus. © 2023, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.

Analysis and Prediction of COVID-19 Spread in Ernakulam District, Kerala

The world is witnessing a pandemic of SARS-CoV2 infection since the first quarter of the twenty-first century. Ever since the first case was reported in Wuhan city of China in December 2019, the virus has spread over 223 countries. Understanding and predicting the dynamics of COVID-19 spread through data analysis will empower our administrations with insights for better planning and response against the burden inflicted on our health care infrastructure and economy. The aim of the study was to analyze and predict COVID-19 spread in Ernakulam district of Kerala. Data was extracted from lab data management system (LDMS), a government portal to enter all the COVID-19 testing details. Using the EpiModel package of R-mathematical modeling of infectious disease dynamics, the predictive analysis for hospitalization rate, percentage of patients requiring oxygen and ICU admission, percentage of patients getting admitted, duration of hospital stay, case fatality rate, age group and gender-wise fatality rate, and hospitalization rate were computed. While calculating the above-said variables, the percentage of vaccinated population, breakthrough infections, and percentage of hospitalization among the vaccinated was also taken into consideration. The time trend of patients in ICU showed men outnumbered women. Positive cases were more among 20–30 years, while 61–70 years age group had more risk for ICU admission. An increase in CFR with advancing age and also a higher CFR among males were seen. Conclusions: Analyzing and predicting the trend of COVID-19 would help the governments to better utilize their limited healthcare resources and adopt timely measures to contain the virus. © 2023, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.

Analyzing COVID-19 mortality in Ernakulam district of Kerala: A retrospective review of death reports.

Background: COVID19 pandemic caused considerable mortality and had a huge impact on the health system and the world economy. In this context, it is important to characterize the demographic and clinical features of the fatal cases and to have a basic understanding on the additional burden caused by COVID19 on the health care system. Methods: Mortality reports of 408 patients who were diagnosed with COVID-19 in Ernakulam district during the period of 28th March 2020 - the day which reported the first COVID19 death in the district- till 28 February 2021 were collected using a uniform reporting format prepared by the district COVID19 surveillance unit. Results: Out of the 408 fatal cases 260 (64%) were males. The mean age of the cases was 69 years (SD:12, IQR:16-102 years). 31% (n=124) of the patients were admitted to more than one facility for treatment before the death. The median duration between the documented date of onset of symptoms to death was 11 days (IQR:0-46). Mean duration between the onset of COVID19 suspected symptoms to the collection of samples for laboratory test was 3 days and the duration up to the admission to a treatment facility was 4.5 days. The median duration between the admission to a facility and death was 7 days (mean 10, SD:7) with a range 0 to 40 days. The mean duration of hospital stay was 10 days for females and 8.5 days for males. Most frequent symptom at presentation was breathlessness 50% (n=211), followed by fever 43% (n=179). 96% of the cases were reported to have any comorbidity and among those most common was Diabetes mellitus and stroke 60%, followed by Hypertension 54%. However, there was no significant difference in duration of hospital stay and survival period across age group, sex or number of comorbidities which may need further analysis. Conclusion: 6 out of 10 of the fatal cases were males and the mean age was 69 years, Though the mean age was similar for both sexes, median age was slightly higher for females. The proportion was found increasing as the age advanced. One third of the patients were admitted and treated at more than one facility and moreover 6 out of 10 utilized government facilities for treatment. Median duration of survival was 11 days while the median duration of hospital stay was 10 days. Symptomatology was found similar to cases reported worldwide. More than 9 out of 10 had reported at least one comorbidity and the most frequent comorbidities reported were Diabetes mellitus and Cerebrovascular accident. Most frequently observed combination was of a triad of Hypertension-Diabetes-Stroke. This data is of prime importance as Kerala is at an advanced level of epidemiological transition and demographic transition compared to other Indian states and emerging infections like COVI19 could be a double burden to the community.

Profile of health care workers infected with SARS-CoV-2 infection in a central district in Kerala with focus on infection control practices.

There were reports of severe acute respiratory syndrome coronavirus 2 infection cases among health-care workers from all around the world. We did a cross sectional study among 533 COVID19 affected health-care workers. About 87.43% of participants were involved in duties not directly related to COVID-19 management. About 19.6% contracted the disease from their colleagues. About 15% of the affected health-care workers had at least one comorbidity and diabetes mellitus was the most common (5%). 57% of participants presented with fever followed by body ache in 40%. Only 0.4% of the participants needed ventilator support during treatment. 36% of the participants reported household transmission from them. Adequate personal protective equipment (PPE) usage and functioning infection control committee in their hospital were reported by most of the participants. The study points towards the need of adequate PPE use in the nonCOVID settings and the need for periodical assessment of infection control practices.

COVID-19: Situation analysis in the district of Ernakulam.

Context: Corona Virus Disease 2019 (COVID-19) has become a pandemic causing millions of deaths and causing a devastating blow to the global economy. Like all other countries and territories, the Ernakulam district (Kerala, India) is affected by COVID-19. When the number of COVID-19 cases reported in the other states started coming down, the Ernakulam district continued to record a large number of cases. Aims: To analyse the situation of the COVID-19 pandemic in the district of Ernakulam, Kerala. Material and Methods: The authors were part of the COVID-19 surveillance unit of Ernakulam district, and hence, had access to the data collected. The available data were analysed in the following phases of the pandemic: First phase: From the reporting of the first case in Kerala in January to the reporting of the first case in the Ernakulam district. Second phase: Cases reported mostly in those with a travel history and their contacts to the period of community spread. Third phase: From the start of community spread. Results and Discussion: As of July 5, 2021, the Ernakulam district reported 3,60,345 cases of the COVID-19 infection with 1,317 deaths and the recovery rate being 96.45%. Despite factors like high human development index (HDI), access to the Internet and social media, access to affordable healthcare, etc., factors like high population density, airports, seaports, railway stations, container terminals, IT parks, major highways, tourist spots, beaches, large shopping malls, large floating population, a huge number of migrant labourers, a large proportion of the elderly population, high prevalence of non-communicable diseases, etc., are the some of the major challenges. The preparedness of the fight against COVID-19 included the training of all healthcare workers, ward level rapid response teams (RRT), upgradation of health facilities, district-level patient management system, provisions to manage biomedical waste, etc., The containment zone strategy is currently based on the local self-government area-wise weekly test positivity rate (TPR). The cluster containment is focused on the early identification of clusters. Currently, the Ernakulam district reports one of the highest numbers of COVID-19 cases in India. This is mainly because of the high number of tests (five to six times to national average) and targeted testing strategy. This is scientifically proven by the very low case fatality rate (0.35%), low-bed occupancy rate of the COVID treatment facilities and the latest seroprevalence study by Indian Council for Medical Research (ICMR). Conclusions: So far, the Ernakulam district could excel in its efforts to fight against COVID-19. But even now, when we are moving forward with the immunisation of the healthcare workers, front-line workers, elderly population, our main strategies to prevent COVID-19 remain the same-proper social distancing, hand hygiene, use of masks, avoiding unnecessary travels and gathering, early identification of cases and treatment.