Right now, there were two possibilities in his mind. The first was that the Elf those guys worshipped was alive, but in an inactive state. Someone who was frozen, for example.
Or that he was simply in a state of inactivity where waking him up required a bloody ritual.
This is not far-fetched. There are stories about characters who have been thawed out after a long time. The most famous cases belong to the Ancient Continent. It is said that the entire continent may have been completely thawed, as there are stories of various gods from that place in the distant past.
Although it is possible that these are just tales and that they have now chosen to follow the same ancient stories and traditions, simply for appearances' sake, they remain rumors that are possible.
The other possibility is that he is dead and they have to bring him back to life through bloody rituals.