The Kolhapur paradox: District with highest daily caseload has the most 45+ vaccinations

Experts are mulling over the curious case of Maharashtra’s Kolhapur district, which has vaccinated the most number of people in the age group of 45 and above among the state’s 36 districts, but is still registering the highest daily caseload in the state for the past three weeks

Experts are mulling over the curious case of Maharashtra’s Kolhapur district, which has vaccinated the most number of people in the age group of 45 and above among the state’s 36 districts, but is still registering the highest daily caseload in the state for the past three weeks.

HT Image

Kolhapur has administered 1.47 million vaccine doses to date. Of these, nearly 400,000 people have got both the doses or are fully vaccinated. According to data of the state public health department on July 4, Kolhapur ranked first in vaccination coverage of the 45+ population with nearly 70% having received at least one dose.

In contrast, only 1.6% of the age group of 18 to 44 years had received at least one dose – the lowest in the state. This has led experts to conjecture that Kolhapur’s surge is being driven by the unvaccinated, active, younger population.

“The younger population in Kolhapur is the most vulnerable and the infections are higher among them,” said Dr Shashank Joshi, member of the state’s Covid-19 task force. “There is also a lack of adherence to Covid-appropriate protocol and a need to strengthen the contact tracing and containment measures in the district,” he said.

“Crowd management has been a problem in the district, particularly in market areas. People are also not following strict home quarantine norms leading to entire families testing positive. For instance, recently a 24-year-old tested positive and was asymptomatic but eventually, all 11 members of his family also turned positive,” a local health official said.

According to state officials, the epidemic curve in Kolhapur also looked different compared to other districts. While most districts began to record a surge between February and March, Kolhapur’s surge began in April. For instance, when most districts had started recording cases in hundreds in March 2021, Kolhapur’s daily caseload hovered between 20 and 60. On April 7, the district recorded 233 cases, which steadily increased -- 393 cases on April 15 and 1,012 cases on April 30. On Monday, the district recorded 1,947 new cases; it currently has over 11,794 active cases, the second highest in the state after Pune (16,925).

“Due to the late surge, the peak in the district came later too,” said Kolhapur’s district health officer Dr Yogesh Sale.

To be sure, the number of tests in the district has also gone up. In May, the district was carrying out an average of 3,000 tests daily. The testing numbers now are between 15,000 and 18,000 daily. Nearly 60% of these tests are RT-PCR.

“Our positivity rate has now come down to 10% compared to 15% to 17% in the past few weeks,” said Dr Anil Mali, the civil surgeon in the district. A declining positivity rate indicates that the spread of the disease is stabilising. However, a test positivity rate of less than 5% alone means that the pandemic is under control.

The district administration will also send 100 samples to Institute of Genomics and Integrative Biology (IGIB) in Delhi, part of the Indian Sars-CoV-2 Consortium on Genomics (INSACOG), which was set up in December 2020 to monitor genomic variations of the Covid-19 causing coronavirus.

The results of the 286 samples sent by the district authorities in May and June are yet to come. According to data released by the Union health ministry last month, the Delta variant of Sars-CoV-2 was a major contributor to the second wave of infections that peaked in April and May. The new Delta plus variant (AY 1) has been detected in the samples from 10 states already, including Maharashtra, and experts said that it is also highly transmissible especially among vulnerable groups (unmasked and unvaccinated).

“We randomly select samples from the pool of samples received for testing, extract RNA and send it to IGIB for genome sequencing,” said Dr Smita Deshpande, the nodal officer for Reverse Transcription Polymerase Chain Reaction (RTPCR) testing in the district. “We have not been informed about any variants as yet.”

According to Joshi, the Delta variant that is predominantly in circulation in Maharashtra is likely the main variant in Kolhapur too. “The Delta variant is the more concerning strain, fittest to survive and spread,” he said.