At a time when other parts of the country are reporting daily Covid case counts in double digits, Kerala has been consistently clocking over 10,000 cases everyday.
The southern state, which has been lauded in the past for its best practices in Covid management, is now contributing about 40 per cent of positive cases in the country daily.
In the week that ended Sunday, Kerala reported 1,10,593 cases with an average positivity rate of 11 per cent.
Student leader Eric Stephen went on protest fast for eight days in Thiruvananthapuram to protest APJ Abdul Kalam Technical University's decision to hold offline exams for about 2.5 lakh students. Over 35 students are reported to have tested positive after the exams.
"Test positivity rate is high and rising... Many students tested positive due to this and I blame the chief minister's management for this," he said. "They want to show everything is normal, so they are insisting on offline exams whereas the situation is far from that.''
Though the the state is vaccinating at a rate much faster than the rest of the country, its sero-positivity figure is lower.
About 20.9 per cent of the 18 + population in Kerala has received both shots of the Covid vaccine, much higher than the national average of 9.9 per cent. The fourth ICMR sero-survey, however, shows that only 42.7 per cent of the state's population has antibodies -- the national average is 67.6 per cent.
Health economist Rijo M John has an explanation. "Kerala still has a larger % of popn unexposed to the virus compared to India. This may be due to relatively better compliance with masking & social distancing despite high population density," he tweeted.
Dr Santosh Kumar, Deputy Superintendent of Government Medical College, Thiruvananthapuram, says it is perhaps time to look at a new composite index to know where we are in the pandemic.
"TPR has been between 10-12 for the last 6 weeks, everyday, 10,000-15000 cases, gradually increasing. Total cases over one lakh. But hospitalisation... for example, in Thiruvananthapuram medical college, it was 800-1000 but now it has reduced to 250-300. This is a significant decrease."
"If you see occupancy of beds across Kerala, less than 50 per cent. ventilator 50 per cent, ICU also 50 per cent occupancy. What we feel is the effect of vaccination is showing. So more patients are in domiciliary care than is hospitals.''
Kerala Health Minister Veena George told NDTV that the Covid numbers the state is reporting is not unexpected.
She said a similar trend was seen in the first wave too and termed the phenomenon "dragging the wave".
"The second wave started in our state by the middle of April. We had our peak on May 12 -- that was around 43,000 cases on a single day. It was quite expected in our strategy. We have always tried to keep the number of cases below the state's healthcare capacity threshold...We tried to delay the peak and now we are trying to drag the curve," she said.
The health minister pointed out specific challenges in Kerala like high density of population -- almost double the national average --, huge proportion of senior citizens and high rate of diabetes.
The worry though is that more transmission, even if not too many cases become severe, could lead to more variants. So experts say more genomic surveillance is necessary.