In a somewhat strange response to a leading news channel, Dr Raman Gagankhedkar, Head of Epidemiology at Indian Council for Medical Research (ICMR), sounded quite sceptical about going for more tests for COVID-19, on the ground that, more testing wouldn’t yield desired results as this may give rise to identification of more COVID-19 positive cases.
And furthermore, those individuals who have tested positive might not submit themselves for getting quarantined, as they may give false name and identity and become untraceable thereafter. Ridiculous isn’t it?
The whole exercise is not about building a fake profile of achievement for the Government as regards containing the COVID-19 outbreak but taking concrete measures on the ground, so that, the outbreak is indeed controlled.
So, the point is actually it needs to be clear about how to deal with this fatal outbreak? And amongst all of this, the most important aspect is our coronavirus testing strategy.
About 12,000 tests have been conducted in India since February. South Korea has conducted over 2.5 lakh tests so far, which is 10,000 tests per day. And as per reports, India has conducted about 5-10 tests per million people, whereas South Korea has conducted more than 4,000 tests per million people.
According to ICMR, ‘Symptomatic Testing’ is the correct approach for now and which means only those are tested who have travelled from countries affected by high rate of coronavirus infection or those who have come in contact with those who are tested positive for COVID-19. Amongst them only those showing symptoms of Coronavirus infection like dry cough, fever, shortness of breath are prioritised.
So, the problem remains in the fact that, since we are not going for adequate tests, we may not be in a position to identify all the positive cases that might be existing or that might be coming up. And this shall indeed mean inviting a situation which shall be even worse than Italy.
However, as per reports, Italy started with three cases of corona-positive cases on February 15 and South Korea with 28 cases but little did anyone know then that, Italy will pose as a class apart with over 30,000 positive cases and over 2,500 dead. And the country will be under full lockdown. However, as of now South Korea has less than 9,000 positive cases, and less than 90 dead, which is distinguishably lesser than Italy.
Arguably, what Italy didn’t and South Korea did do, was lot of testing. In Indian context it shall be prudent if we follow the South Korean example and test all, with any of the symptoms of flu associated with COVID-19 infection.
However, South Korea enhanced its testing capacity from January onwards, so that large numbers of the population can be tested but Italy lagged behind in that field and showed deplorable lethargy in the conduct of mass testing, quarantining people and the result is before us.
The argument from some quarters is not encouraging enough since a view is doing rounds that we are such a large population and only around 200 cases by now have tested positive, but the point is how can we be so sure about the positive cases since we are not doing enough tests.
Say for example America, in the beginning, the situation there was not so alarming and the administration was not serious about self-quarantine and testing. Now the case in US is quite precarious, it has over 6,500 cases, and out of which about 120 dead.
Coming back to India, the present state of the infection in India is at stage two, which is called ‘local transmission’ or from affected person to healthy persons. And this is the right momemt when we can take effective measures to control the outbreak.
When Stage 3 reaches, it shall affect large chunks of the populace, which is called, ‘community transmission’, and as per experts bringing things to control once the outbreak reaches stage three, is almost difficult and shall be out of bounds.
The stand of the Indian Government so far is, that it has conducted random tests among 1, 000 people with no travel or contact history and no one of them have tested positive for coronavirus, therefore, for now the Government shall adhere to its symptomatic testing policy.
However, what seems important is apart from social distancing and other precautionary measures, we need to build our capacity for going for tests with adequate human resources and testing facilities. According to reports if we conduct 6,000 tests per day, India would exhaust all of its testing kits in less than four weeks.
However, given the stand of the Government of India on the condition in which ideally one should go for coronavirus testing is adequately discussed above, which is in sharp contrast to the Ministry of Health’s definition of “suspect cases” of coronavirus, which says, “those with severe respiratory illnesses, that cannot be explained by any other cause must be considered as ‘suspect cases’ for COVID-19 even if they do not have any travel or contact history.”
But ironically, it has been the consistent statement that is coming from various Government agencies that, for the time being only those with a travel history of contact history are being put for testing, which is in sharp contrast to the Ministry of health’s position on the issue.
It is true that, though the number of COVID-19 positive cases is on a rising trend but so far it has not been on a meteoric upsurge as far as India is concerned. Therefore, we still have hope, but how long? Non-disclosure and non-determination of positive cases owing to our inability to cater to the requisites for conducting adequate tests shall be fatal for the nation. Can you imagine another Italy or China in India?
The essential take away is, we have to be responsible, no doubt, social distancing, no unnecessary movement outside our homes have to be strictly adhered to, but at the same time we need to rethink of our coronavirus testing strategy, that is to make it more diverse across the cross section of society, even if someone shows severe respiratory illnesses as defined by the Health Ministry irrespective of travel or contact history.
(The writer is a lawyer and he can be reached at sjyotiranjan3@gmail.com)