At least 30 districts in six states continue to report weekly Covid-19 positivity rates of 10% or more, even as the national positivity rate shows a decline for almost five months now. As many as 13 of the 30 districts are in Kerala.

The weekly positivity rate has been less than 3% for 13 straight days nationally, health ministry data show. Positivity rates show the prevalence of the disease compared with the number of tests conducted.

Experts are therefore questioning the containment strategies in the high disease burden areas. “There clearly is something amiss as there is a high chance that these high disease burden districts are missing cases,” a public health expert said, requesting anonymity. “In Kerala, for example, we saw that testing, even though aggressive, was targeted only those contacts who were at high risk. Obviously, positivity will be high in that category. But, if we are not testing enough, then chances are we would miss many, especially asymptomatic positives, who would go around spreading the disease. That’s what seems to be happening.”

Another 18 districts in 11 states are still reporting weekly positivity rates of between 5% and 10%, which again indicate high rates of transmission of Covid-19 infections.

The World Health Organisation recommends a positivity rate of less than 5% for two weeks running to determine whether the pandemic is under control in a particular area.

Besides Kerala, Mizoram shows high rates in eight districts, Manipur and Arunachal Pradesh in three each, Sikkim two, and Meghalaya, one.

Kerala also shows the highest number of active cases. There are 1,44,075 active cases in the southern state, which is as high as 52.01% of all active cases in the entire country.

Five states have between 50,000 and 100,000 active Covid-19 cases. Maharashtra has 40,252 active cases, followed by Tamil Nadu with 17,192, Mizoram with 16,841, Karnataka with 12,594, and Andhra Pradesh with 11,655 cases.

The government has been issuing regular advisories to contain the spread of the disease ahead of the festival season.

“It is important to follow instructions strictly for the numbers to not rise further. The districts that are reporting high case load obviously are on our radar but other districts are at no less risk because of the interstate travel,” a government official said on condition of anonymity.

“It is an infectious disease and it keeps coming back whenever it sees an opportunity. We have to ensure it isn’t given that opportunity, and which is why government has been time and again advising states and issuing guidelines, to quell any chances of transmission going up.”

The central government has asked states to not allow mass gatherings in containment zones or areas that report 5% case positivity.

In other places, gatherings can be allowed with restrictions. These permissions should be reviewed based on weekly case positivity, the federal government recommends.

“Relaxations obviously do not help in curbing disease transmission and is one of the reasons for seeing increase in transmission rate, especially in areas that are already reporting higher number of new cases,” said Dr Tarun Bhatnagar, senior epidemiologist, National Institute of Epidemiology. “Zero Covid may not happen but we have to ensure that we bring down transmission to negligible levels.”

Although new cases are still being reported, the good news is that hospitalisations have fallen.