Unmindful of the high positive cases reported daily, Maharashtra has tested aggressively, while Delhi has done the opposite. Kerala, Karnataka and Andhra Pradesh have performed excellently, while Bihar, Uttar Pradesh, West Bengal and Telangana have been laggards. Gujarat remains an enigma.
On June 20, a month after 1,00,000 novel coronavirus cases were reported, India crossed a grim milestone of 4,00,000 cases. If it took 13 days to double to 2,00,000 cases, India added another one lakh cases in just 10 days on June 12. It is particularly sobering that almost all the nearly 2,50,000 cases recorded till June 6 had spread even when the nationwide lockdown was in place.
Rising test positivity rate, mortality
From 4.6% test positivity rate in mid-May, the rate has increased to 7.9% as on June 21, reflecting the wider spread of the virus in the community, particularly in the hotspot cities of Mumbai, Delhi, Chennai, and Ahmedabad.
The mortality figures too, which was initially low, has now been steadily increasing. The first death was reported on March 13 and crossed 1,000 only on April 28. But it has taken just three days for each additional 1,000 deaths after the toll reached 4,000 to reach 13,703 deaths as on June 21.
What low mortality numbers reflect
The lower mortality figures are a reflection of the low median age (nearly 27 years) of the Indian population, the stage of the pandemic in India, health-seeking behaviour and how strained the healthcare system is. While the low median age has indeed helped keep the mortality figures low, high prevalence of high-risk factors such as hypertension, cardiovascular diseases, diabetes and chronic kidney disease even among younger people might put them at great risk if infected with the virus.
The already strained healthcare system in Mumbai, Delhi, Chennai and Ahmedabad and delay in seeking care might lead to more deaths in the coming weeks especially if the virus spread continues unabated. With the lockdown lifted, now is the time for India to be more vigilant.
Three southern States shine
The three southern States of Kerala, Karnataka and Andhra Pradesh have done exceptionally well in containing the spread. If Kerala was fully geared even before the first case was reported, Karnataka and Andhra Pradesh truly utilised the early phase of the lockdown period to track and test people with travel history and trace the contacts. Nothing else explains why Bengaluru has bucked the trend while the three metros of Delhi, Mumbai and Chennai have become epicentres of the pandemic in India.
Maharashtra stands out
Likewise, Maharashtra, which has the most cases in the country (nearly 1,35,800), has done exceedingly well in testing a large number of people (over 7,89,000) unmindful of the large number of cases getting reported each day. The correct approach of aggressive, proactive testing enabled Maharashtra to achieve the remarkable feat of containing the virus spread in Dharavi slum. In stark contrast, till a few days ago, Delhi had used every ruse in the textbook to keep the number of cases and deaths low.
The low cases reported from Telangana, West Bengal, Uttar Pradesh and Bihar does not inspire confidence, and rises suspicion about their testing and counting. While many States have reported migrant workers testing positive on arrival from Delhi and Mumbai, it is inconceivable that Uttar Pradesh, Bihar and West Bengal, which have recorded the most returnees, should not see a spike.
Tamil Nadu’s challenge
Through fever clinics and testing of people with influenza-like illness in certain areas in Chennai that have high spread, Tamil Nadu is making up for lost time. But true containment will remain elusive till door-to-door surveillance and testing in these areas is undertaken on a massive scale.
Going by the cases reported, Gujarat seems to be the only place where the virus spreads to a definitive number of people every fortnight even when tests are increased incrementally.
India cannot gain the upper hand till the virus spread is truly contained in every State. This can be achieved only by aggressive tracing, testing and isolating the infected people and tracking their contacts and not by manipulating the data.