Since India has jumped more than three thousand cases of Novel Coronavirus (nCoVID-19) infection since 19th March 2020, many researchers, medical health experts, doctors, bureaucrats, and WHO officials have criticized India for conducting an inadequate number of tests in comparison to its neighbours, or other nations around the globe with spurious cases of transmission. With testing rates amounting to less than 2%, i.e. 1280 per million in a day, officials in India have reasoned this phenomenal anomaly as judicious use of testing reagent kits.
This judicious use has actually resulted from an updated, yet highly ambiguous set of protocols released by Indian Council of Medical Research (ICMR), under which a patient can be eligible for being tested for nCoVID-19. According to the revised guidelines, a patient is eligible for testing if a) they are asymptomatic, but have been in direct contact with high-risk patients; b) have been to a foreign country in the last 14 days and showing major symptoms listed under nCoVID-19.
With ambiguity shrouded over the rigid specificity of the verbatim, it seems that with WHO’s regulated and real-time rolling updates about the changing nature of the novel strain virus, India is trying its best to stay primordial, to say the least. In fact, India is yet to release a guideline for suspected patients who show all the symptoms of nCoVID-19, but do not have a travel history, nor direct contact with an infected person.
On March 30, 2020, officials from ICMR and Ministry of Health and Family Welfare (MoFHW), in a bid to dissolve any rumours of explosive contamination, gave a press brief that the virus has been found in cases of local transmission, controlled under Stage 2, and is far away from community transmission, i.e. Stage 3. As the terminology highlights, local transmission is a highly localised case of contamination where the virus keeps on spreading between extremely closed/intimate circles i.e. members of the same family. This is also suggestive of the reason why the central government is least willing to extend a lockdown beyond April 15, 2020. Terming a highly transitive virus local will allow the legislatures and law enforcers to trace and identify the pockets of localisation, hence physically barricading it from the rest of the environment/surrounding around it, majorly notwithstanding the fact that the virus is both air and surface borne. However, how much of that will be successfully effective is speculative.
Nonetheless, a worrying trend has suggested that ever since the lockdown, cases have been rising at an average of 100 per day, which is a visible sign of traces of community transmission, if we consider China, Italy, Spain, and the US as a statistical example. Unfortunately most of it, and I emphasise, is or will be a result of undetected cases or the government’s unwillingness to test both symptomatic and asymptomatic cases, sans history of contact and travel, which is then rapidly multiplying before it can be pinpointed through rigorous contact tracing. According to the director of Abdul Jameel Latif Institute of Diseases and Emergency Analytics, extensive tests and isolation are the need of the hour, and any country doing an alarmingly less number of tests is currently overlooking at least thousand mild to severe cases in a million. Now, why do I say so? Why have I been emphasising on more number of testing and an interventionist upgradation in testing policies?
Let us look at one major case study. March 30, 2020 saw one of the highest, and explosive spikes in coronavirus infections, with 200 plus confirmed cases, where the death rate also increased sporadically to 43, pan-India. One might ignore it as an exception, but not the Brihanmumbai Municipal Corporation (BMC). Since health, quarantine, and medication is still a state subject, BMC allowed certain private labs to equip themselves to test more people for nCoVID-19. According to BMC, this step is carried out as a preventive, since Maharashtra (especially Greater Mumbai), along with Kerala has registered the highest number of nCoVID-19 infections in India, currently at 238, and 234 respectively.
This policy intervention added a staggering number of 47 cases to Maharashtra’s total tally of infections, highest for any state, as per March 30, 2020. One might then again ignore it as a minor weekly accumulation resulting from slow detection, and lengthy testing procedures. Nevertheless, BMC has admitted that the rise in cases is a result of vigorous contact tracing and enhanced testing in public and private labs. Thus, any enhanced testing procedure will only add on to more cases in future if faster, more efficient, and cheap reagent kits hit the market, with contacts tracing to horrid levels of transmission if not kept under undeniable check by the government as soon as possible. Moreover, ICMR claims to be currently testing randomly accumulated samples to check community transmission. However, it repeatedly has avoided the question on the method of randomization, and source of accumulation of samples. This, as many iterate, makes the samples statistically non-representative.
It has been underlined time and again, that India is a demographic time bomb, where a lot of people are crammed up in tight spaces, which is inseparable by the notion of social distancing and isolationism. The separation from home, the pangs of hunger, and the unavailability of financial stability at disposal have made such concepts a luxury of the bourgeoisie in India. A bright example of that is the entire (un)organized workforce pouring into bus stands in major part of the country to rush back home to safety amid a pandemic, which has made their employer not to care for them, even in the face of a gazette order. Furthermore, medical statistics on a basic level puts us at the lower spectrum of handling this pandemic, once the government decides to lift the veil of administrative and statistical denial. As per reports, India does not have basic 21st Century medical infrastructure, beddings and equipment in case of a major outbreak. In the end, the rudimentary policy of testing patients, breakable quarantine procedures, lack of non-rhetorical contingency, third world problems arising out of daily lockdown only adds on to the woes of India handling this crisis in coming future, if not radically revamped in a need to an emergency basis.