‘The strategy was simple: to use the lockdown to ramp up infrastructure to fight the virus’.
New Delhi: Government of India, in coordination with various state governments, has used the 50-plus days of lockdown to combat the novel coronavirus, to prepare for the eventuality when the lockdown is lifted, even though cases soar. Sources say that the government’s advisers, using various data, have advocated the lifting of the lockdown.
“The strategy was simple. Use the lockdown to ramp up the infrastructure to fight the virus so that when the lockdown is lifted, we will not be ill-prepared to handle the cases even if they rise astronomically,” a senior government functionary told The Sunday Guardian.
Government officials in multiple ministries with whom this newspaper interacted, said that the economic cost of the lockdown was too huge and that the country cannot withstand any further lockdown without the economy going into a major recession.
India, as per multiple experts and reports, has lost close to $200 billion because of the 50-plus days of lockdown during which all economic activities came to a standstill. As per Barclays Research, India was losing $26 billion per week due to the lockdown.
International rating agency Nomura earlier last week further lowered India’s GDP growth rate to -5.2% from its earlier predicted -0.4%. The agency has further predicted that the lockdown has caused an output loss of more than 8%.
TESTING: BEFORE AND AFTER
On 17 March, one week before the lockdown was announced, as per the Indian Council of Medical Research (ICMR), India had just 72 laboratories capable of doing Covid-19 tests. These laboratories were testing a meagre 1,400 Covid-19 samples a day.
On 14 May, India had 507 laboratories that were testing Covid-19 samples, including 351 government laboratories and 140 private laboratories. Officials told The Sunday Guardian that by the end of this month, at least 50 more laboratories will be given permission to carry out the tests.
A senior Ministry of Health and Family Welfare (MoHFW) official said: “By this month end, we will have more than 550 laboratories. We are aiming for at least 1 lakh tests per day by the end of this month, which is around 85,000 per day as of today. From 1,400 tests to 1 lakh tests in 50 days is a quantum jump. Similarly, we had done around 25,000 tests on 24 March; today we have crossed 2,030,000 tests. Be it the number of laboratories or the number of tests being done daily, we have improved the numbers considerably.”
According to him, the new kits that have been developed by government and private enterprises are now taking considerably less time to give results, which has also given the government the confidence that it is ready to lift the lockdown with the number of laboratories and testing capabilities “sufficient” to identify new Covid-19 patients within an acceptable time limit.
When the lockdown was imposed, India was testing 0.015 per 1,000 people or 15 per 10 lakh. Now, it is 1.334 per 1,000 people or 1,344 per 10 lakh, almost the same number the United Kingdom was testing on 24 March. The population of United Kingdom is 6.7 crore, India has around 130 crore. Indonesia with a population of 27 crore and about 14,500 cases, is testing 0.438 per 1,000 people. India, as on 13 May, is seventh when it comes to doing Covid-19 tests across the world.
Advisers to the government have pointed to the positivity rate of Covid-19 in India while advocating the lifting of the lockdown.
Doctors and epidemiologists believe that the positivity rate, which means the number of patients testing positive per 100 samples, is a better indicator to ascertain the spread of diseases in the community. A higher positivity rates indicates a faster spread of the infection.
India, which has now tested almost 2 million people, has a positivity rate of 3.8%. In the middle of April, the positivity rate in India stood at 4.5%.
An official with the Health Ministry, who is not authorised to speak to the media, said: “We are expecting the positive cases to rise once the lockdown is lifted. However, the numbers, going by the positivity rates that we have witnessed so far, will be inside the acceptable limit. We have already carried out almost 20 lakh tests to assume things safely. The key is to understand that as the number of tests increase, so will the positive cases in absolute numbers. If every 130 crore Indian is tested, going by the current positivity rate, we will get roughly 40 lakh Covid-19 cases, which is a huge number if you do not see in the context of things.”
However, a few states and union territories have reported a higher positivity rate, with Delhi, Chandigarh and Maharashtra having almost double the positivity rate than the national rate. For example, the positivity rate in Delhi is about 7.38%, while in Maharashtra and Chandigarh, it is over 8%.
Comparing India to other countries where the virus has hit the hardest, India stands at a far better place when it comes to the extent of the spread of the infection in the community.
The United Kingdom, which has about 226,000 confirmed Covid-19 cases as on 13 May, has one of the highest test positivity rates in the world. One out of every 3.5 persons, being tested for Covid-19 in the UK, is turning out to be positive.
The United States, which till May has reported 1,476,489 positive cases, has a positivity rate of 15%. Italy, one of the other hardest hit countries, has also reported a positivity rate of about 15%.
In India, the MoHFW, with an aim to monitor the prevalence of Covid-19 infection at the district level, is also launching a population-based sero-survey (testing of blood serum) across all the districts of the country.
The sero-survey will be conducted on population groups categorised into high-risk and low-risk groups. In this survey, 100 samples of high-risk groups, which include the health workers, will be collected every week from each district and 50 samples each from low-risk groups, which include outpatient attendees and pregnant women, will be collected every week from each district.
The MoHFW will collect 400 samples of healthcare workers, 200 samples each of outpatient attendees and pregnant women per month.
This exercise will be conducted in addition to the regular testing for Covid-19 being done by the ICMR and the National Centre for Disease Control, in collaboration with key stakeholders and state health departments.
IMPROVED HEALTH INFRASTRUCTURE TO DEAL WITH RISING CASES
As on 10 May, India has 7,740 dedicated Covid-19 facilities that include Covid-19 dedicated hospitals, dedicated Covid health centres and dedicated Covid care centres in the 483 districts across the country.
India now also has 656,769 isolation beds, 305,567 beds for confirmed cases, 351,204 beds for suspected cases, 99,492 oxygen supported beds, 1,696 facilities with oxygen manifold and 34,076 ICU beds.
India, which did not manufacture a single PPE kit and N95 mask, which are worn by healthcare workers handling Covid-19 patients or suspects for their protection when the country was under lockdown, is now manufacturing 3 lakh PPE kits every day and around 2 lakh N95 masks today.
Apart from hospitals, the government has also turned railway coaches into quarantine/isolation coaches to house Covid-19 patients. As part of the plan, one railway coach will have 16 beds for isolation. A total of 20,000 coaches, which can accommodate up to 3.2 lakh beds for isolation/quarantine needs are being readied in four phases, with more than 70% of them already converted into isolation centres. These mobile quarantine centres can be taken to any place in case of a mass spread so that they can augment the existing medical infrastructure in that state.