The recent surge in COVID-19 cases in the state of Kerala in India has been studied in this article. The dynamics of virus spread, sero-survey results, health index, and herd immunity concept have been applied. Kerala, with the highest score on the health index among all the states of India, is most susceptible to the SARS-CoV-2 virus. Kerala has nearly the same number of cases as Germany. The “Health Index Theory” established in this review article first has explained well the surge in the cases. Briefly, the concept of COVID-19 herd immunity has also been tested first.
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