COVID-19: States should bite the bullet and increase testing

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It is important for every State to take a leaf out of Maharashtra’s book and test large numbers each day unmindful of the rising fresh cases each day. Moving from a smaller number of targeted tests to increased testing in the community about two weeks ago has led to test positivity rate reducing from 35% to about 20% in certain areas in Chennai.

Five months after the World Health Organization declared COVID-19 as a Public health emergency of international concern and three-and-half months after it called it a pandemic, the spread of novel coronavirus no where seems to be slowing down globally. Instead, the number of people getting infected and the death toll continues to rise alarmingly.

After a sharp increase in March, the number of fresh cases reported has steadily increased, breaching the 10 million mark on June 29; the death toll too touched a grim milestone of 0.5 million. With the addition of each million new cases taking fewer days than the previous one, the pandemic is truly accelerating.

Did summer invigorate the virus?

As if the summer heat has invigorated the virus, June alone accounted for 60% of all cases reported so far. Except on three days, the second half of June has been particularly bad with over 1,50,000 cases reported daily, and a record 0.19 million new cases on June 26, the highest number reported on a single day since the virus outbreak began in China.

Three countries — U.S. (2.7 million), Brazil (nearly 1.5 million) and India (0.6 million) — have been driving the spike. Four States — Arizona, California, Florida and Texas — account for more than half of new cases each day. On July 1, the U.S. witnessed the single largest spike of nearly 50,000 cases, which is more than the total number of cases reported by Singapore, South Korea and other countries. The U.S. has been warned that it would see as many as 100,000 new cases a day if the outbreak trajectory remains unchanged.

The tale of three cities

Three As on July 3, India has reported over 0.6 million cases and nearly 18,399 deaths. The acceleration of fresh cases began in the first week of May and increased sharply in June. While Maharashtra has the most cases, the number of people infected in Tamil Nadu and Delhi has been steadily increasing. With over 93,000 cases, Delhi has surpassed China (nearly 85,000) while Mumbai (over 82,000) and Chennai (over 60,500) are close behind.

After months of low testing, Delhi increased the number of tests done per day to close to 20,000 a day with a concomitant increase in cases to reach a peak of over 3,900 before falling by nearly 40%.

Task cut out for Tamil Nadu

Though belated, Tamil Nadu has begun aggressively testing in hotspot areas in Chennai a fortnight ago. Moving from a smaller number of targeted tests to increased testing in the community about two weeks ago has led to test positivity rate reducing from 35% to about 20% in certain areas in Chennai. Test positivity rate of about 20% is highly suggestive of community spread in these areas. Equally important is tracing and isolating contacts to contain the spread.

Tamil Nadu, however, the lowest case fatality rate of 1.3% compared with 4.4% in Maharashtra, 3.1% in Delhi, and 5.6% in Gujarat. It is important for every State to take a leaf out of Maharashtra’s book and test large numbers each day unmindful of the rising fresh cases each day. Dithering on testing, tracing, isolating and treating will inevitably lead to to uncontrolled spread and increased deaths, which will show the government in much poor light.

India urges increased testing

The Health Ministry urging all States to facilitate and ramp up testing only underscores that it is concerned more about containing the pandemic than keeping the numbers artificially low through less testing. After all, China, Italy, and Spain have demonstrated that it is possible to bend the curve through a comprehensive approach that is centered around testing.

Published in The Hindu on July 4, 2020

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