Coronavirus testing in India needs to be expanded exponentially, strategically, Lancet says

Coronavirus photo 1-Optimized

While acknowledging that India was “quick to close its international borders and enforce an immediate lockdown”, the editorial published in The Lancet today (April 25) says that the lockdown is already having the “desired effect of flattening the epidemic curve”. It is also critical of the low testing rates, the hasty manner in which shutdown was ordered and the neglect of public health.

It has highlighted the most frequently discussed issue of low testing rate (0·28 per 1000 people as of April 20) in India compared with other countries. “Capacity issues, absence of political will, and operational feasibility have been to blame.

With the COVID-19 national lockdown now being extended till May 3, the British medical journal The Lancet has in an editorial published today (April 25) has pointed out the challenges India faces in keeping infections at manageable levels even as it faces unique challenges.

The editorial begins by saying “India was quick to close its international borders and enforce an immediate lockdown, which WHO praised as ‘tough and timely’.” The lockdown has given precious time for India to “prepare for a possible surge in cases when the pandemic is forecasted to peak in the coming weeks”.

With nearly 65% of the population being young (less than 35 years), the pandemic appears to have been “less severe” than what was feared. “The lockdown is already having the desired effect of flattening the epidemic curve,” it says.

It has highlighted the most frequently discussed issue of low testing rate (0·28 per 1000 people as of April 20) in India compared with other countries. “Capacity issues, absence of political will, and operational feasibility have been to blame. However, efforts to reverse the situation are underway as hundreds of thousands of testing kits have become available, and more testing companies and laboratories have been approved. Testing needs to be expanded exponentially as well as strategically as a tool to provide epidemiological evidence,” the editorial says.

It comes down strongly against the hasty manner in which the lockdown was announced on March 24 evening saying it is has disproportionally affected a section of the population that already vulnerable. “There has been a mass exodus of migrant workers and concerns are rising about starvation among people who work in the informal economy,” it says. Referring to an April 9 report in Aljazeera, it says: “Reports suggest that the government’s efforts to provide financial support and a measure of food security to ease these pressures will be insufficient to meet demand. But better planning and communication could have helped avert this crisis.”

It has highlighted about the spread of misinformation and fake news, violence against healthcare workers and COVID-19 outbreak being given a communal colour. “The pandemic has also been used to fan anti-Muslim sentiment and violence, after a gathering connected to the group Tablighi Jamaat was identified as being responsible for many cases,” it says.

The editorial rightly points out that preparedness and response to COVID-19 has differed from one State to another. Kerala, Odisha and Maharashtra come in for special mention for the efforts to contain the virus spread. After mentioning about “extensive testing, contact tracing, and community mobilisation to contain the virus and maintain a very low mortality rate” in Kerala, it says highlights Maharashtra’s use of drones for monitoring physically distancing during the lockdown.

In has criticised the centralisation of control asking the union government to instead “loosen its control and give States more autonomy over their funding and decision making”.

It calls upon the government to pay “much greater attention to the health sector and recognise the importance of having strong public sector capacity, especially in primary care and at the district level”. It goes on to add that the pandemic could act as “much needed wake-up call to the necessity of long-term changes to India’s health system”.