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Is it a wonder that Covid is surging? PDF Print E-mail
Wednesday, 07 April 2021 00:00
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Low/poor pace of testing & vaccinations contributed to the problem and now lockdowns will hit the nascent revival  
 
There can be little doubt that reckless behaviour from a Covid-fatigued nation—it has been more than a year since the first lockdown—along with the more virulent UK and South African strains that are now in the country have played a big role in the current surge in Covid-19 cases. What is more worrying, though, is how poor policies of the central and various state governments have contributed to the current mess and will make it worse.
Indeed, there is a possibility that, as the current cases cross the earlier (September 17) high of 98,000 fresh daily cases, there will be more local lockdowns like the one in Maharashtra — to ‘break-the-chain’ — and that will ensure the slight move towards normalcy will again get derailed and millions will continue to remain unemployed.
 
The first lockdowns, imposed by the Centre, were brutal in their impact on livelihoods, but were perhaps unavoidable. No one knew that what they were dealing with—at one level, we still don’t—and while it is easy to now point out that India has less deaths than other countries, the fact is that deaths were rising in both Italy and US. The case fatality rate in Italy was 9.3% on the day the Janata curfew was announced last year in March, and 2.8 million people have died of Covid so far, of which 5.5 lakh are in the US alone.
And while the case fatality rate may be 1.3% for India as a whole, it was double for Mumbai on April 5; it was 3.1% on March 25. Hospitals in the city are running short of critical capacity. In 10 days from March 26 to April 5, ICU bed availability fell from 527 to 148 across both public and private hospitals, and from 271 to 63 in the case of ventilator beds.
How fast India will be able to deal with the current surge is not clear—some virologists say the current peak may be over by mid-April—but it will take time to revive the fatigued state machinery. To cite one number for Mumbai, when the city had 20,209 active cases on May 23 last year, it had 2,614 buildings that were sealed; on April 5, with 68,052 active cases, the city has just 748 buildings that are sealed. Some part of this, of course, could be the result of better Covid management, including creating of isolation centres for those infected.
Worse, even while it was always clear that India needed to really ramp up testing, this was an early casualty. Indeed, while cities like Mumbai have stepped up their testing, once you normalise this by the size of its population, it turns out the city’s testing is 40% that of Delhi and Bengaluru. Ironically, the city’s dashboard talks of how “Mumbai is one of the leading cities in tests per million compared to other cities”; this may have been true a year ago, but it far from being the case today. Maharashtra, which accounts for over half the country’s daily cases also tests less—on a per capita basis—than Gujarat, Kerala and Tamil Nadu.
What makes things worse is the high proportion of rapid antigen tests (RAT) being used even today. RAT tests are inefficient compared to the traditional RT-PCR—Mumbai’s RAT tests show a ‘positivity’ of 12% versus 38% for the RT-PCR, and the gap was higher a few days ago —so when half the daily tests are RAT, this ensures a large number of those infected are not detected and are free to roam around and infect others; for some days last month, RAT outnumbered RT-PCR tests. RAT’s shortcomings have been known for a long time, but most states continue to use high RAT. Just 15% of Telangana tests are RT-PCR right now, 20% for Odisha, 36% for Kerala, etc. If the states are too cash-strapped and so use the cheaper RAT, surely the Centre—which wants the RT-PCR share in tests to be at least 70%—could have given them monetary assistance?
Unlike the early days of the pandemic, the world—and India—now has vaccines to lower the intensity and spread. Yet, with the government keeping a very tight grip on who can get vaccinated, and an even tighter control on prices, vaccination in India remains painfully slow. Decades of disastrous consequences of price control in the pharma sector, it would appear, has taught the government nothing; so, even though the private sector is involved in vaccinating people, it is not an enthusiastic participant and, as a result, India’s latest peak is 4 million vaccinations in a day. At this pace, vaccinating even half the population will take over 300 days. In the case of a surge in infections, as now, it is hardly surprising that local governments are thinking of lockdowns. 
Price controls to prevent vaccination-makers from ‘profiteering’ goes down well with the electorate, but the loss for the country is unimaginable. Assume prices for two shots of vaccines rise by Rs 1,000 per person if they are freed; so if 100 crore persons are vaccinated, the citizens would ‘lose’ Rs 100,000 crore. Even a 1% slowing in GDP growth, on the other hand, will cost us over double that. Let’s just do the maths.  
Last Updated ( Wednesday, 07 April 2021 15:59 )
 

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