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Monday 27 July 2020

COVID-19 as fatal as ever, warns Narendra Modi; despite increased testing, curbing spread remains tricky

It's been eight days since India reported a single-day spike of over 40,000 new coronavirus cases, and the spread of the pandemic has shown no signs of slowing down despite ramped up testing and precautionary measures, along with a fourth-month-long lockdown.

This grim situation was underlined by Prime Minister Narendra Modi in his Mann ki Baat speech on Sunday, when he said, "COVID-19 is as fatal as it was in the beginning."

According to Union health ministry data on Monday, a record number of 49,931 new cases were reported, taking the total number to 14,35,453. On the other hand, the number of recoveries rose to 9,17,567, the ministry said.

On Sunday, Modi warned the public against relaxing precautions against the threat of the virus and reiterated the importance of wearing masks and maintaining social distancing.

"At many places, the virus is spreading fast. We need to be extra vigilant. We have to bear in mind that the virus is as fatal today as it was in the beginning. Which is why we have to be cautious," Modi said.

Modi also advised those feeling discomfort while wearing the masks to remember the burden and sacrifice of those in the front lines of the battle against the virus.

"There are times when masks cause inconvenience," Modi said. "When one feels like removing them from the face, especially during a conversation. When a mask is required the most, we tend to remove it. At such times when you feel your mask is bothering you and you want to remove it, remember our coronavirus warriors. Remember the doctors and nurses."

India overtook Russia to become the third-worst hit nation by the pandemic on 5 July and the infection has spread exponentially since then.

Evolution of COVID-19 testing in India

While experts advise stringent precautionary measures like social distancing, wearing masks, and washing hands meticulously, many had also pointed out that India's range of testing for coronavirus was lacking vis-a-vis its population.

The Centre has since consistently increased the scale of testing.

In March, the Centre opted for a reserved approach to testing, in a bid to "avoid indiscriminate testing and reducing panic and optimally utilise the resources of the country and scale up facilities for testing".

Testing was prescribed only for three groups of symptomatic people — international arrivals, contacts of a COVID-19-positive person, and health care workers.

In the initial stages of the pandemic in India, private companies hadn't been brought in to conduct testing and the ICMR was working to expand the network of labs conducting the tests.

"At the end of March, it gradually expanded testing to include hospitalised patients with severe acute respiratory illness (SARI) as well as asymptomatic contacts of cases. The new focus ran alongside the agency’s first surveillance method — testing SARI patients to see if any were positive for COVID-19," The Indian Express reported.

In May, the testing was significantly increased with one lakh tests being conducted per day. On 6 July, over one crore tests had been conducted in total

As of 6 July, ICMR has approved about 1,105 COVID-19 testing labs in both the public (788) and private (317) sectors. This includes RT-PCR labs (592); TrueNat Labs (421) and CBNAAT Labs (92).

The Brihanmumbai Municipal Corporation, introduced an unprecedented testing strategy on 7 July to curb the rising cases of coronavirus in the densely-populated city.

In revised testing guidelines, the municipal body did away with the requirement of a prescription to get tested for COVID-19. "Home swab collections for COVID-19 testing (only RT-PCR) are allowed and no prescription is required for the same,” the advisory said.

It also said that no self-declaration is required for COVID-19 testing for symptomatic or asymptomatic individuals.

"Laboratories are free to conduct RT-PCR test for any individual in accordance with the ICMR guidelines. However, no prescription or self-declaration is required for COVID-19 testing of symptomatic or asymptomatic individuals," The Hindu quoted the BMC as saying.

"Rapid point-of-care (PoC) antigen detection test for diagnosis along with RT-PCR can be used in containment areas or hospital settings as per ICMR guidelines," the report added.

Specifically, the relatively quick curbing of the COVID-19 pandemic in Mumbai's Dharavi area has been hailed by experts, including the World Health Organisation (WHO).

One of Asia's largest slums, Dharavi became a point of concern for authorities after it reported its first case on 2 April and subsequently became a hotspot.

In July, the daily spike of new cases has been restricted to single-digit figures, and on 26 July, only two cases were reported in the area.

NDTV quoted authorities as saying that "they relied on four Ts — tracing, tracking, testing and treating".

Experts warn of long battle ahead for India

However, despite pockets of success against the pandemic, experts in India and around the world are anticipating a long battle in the coming months for the country.

Both, the Centre and state governments are facing a set of obstacles before the curve flattens: the uneven distribution of cases across the country, issues with coordination between governments, and the drawbacks caused due to the initial lag in testing.

When the 'Janata Curfew' was imposed on 22 March and the nationwide lockdown on 24 March, only 6,500 samples had been tested. Additionally, the testing capacity at this time was 1,400 samples.

Business Standard quoted experts as saying that a "wave of peaks" is more likely than one nationwide peak.

"While most epidemiologists have predicted a peak of infection in late July-August, many feel the concept of a national peak is nebulous. The three states — Maharashtra, Delhi, and Tamil Nadu — with highest case-counts are slowing down, but infections in eastern and southern states are surging," the report said.

"I do not see a national peak soon, but I see a wave of peaks cascading through the nation in the next two months. It simply depends on how we behave and how policies are implemented," Business Standard quoted Bhramar Mukherjee, a professor at the Michigan University as saying.

The Union health ministry has said that over 80 percent of the total COVID-19 cases in the country have been detected in only 10 states, hence it is an "uneven spread".

The report also said that it is "not possible to predict the total of number of cases that India will witness in its first peak and consequently whether it will achieve any herd immunity by then".

Meanwhile, The New Indian Express quoted experts as saying that "contact tracing, clear treatment protocol are key" in the fight against the virus.

With inputs from agencies



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