India will have sustained transmission in different areas at different points in time, says leading epidemiologist Giridhar R. Babu.



New Delhi: Giridhar R. Babu, a leading epidemiologist in India and Professor and Head Life Course Epidemiology at the Public Health Foundation of India (PHFI), spoke to The Sunday Guardian on the progress of the spread of the Covid-19 pandemic in India and what it is likely to be the road ahead. Excerpts:

Q: As India currently has over 1.3 million Covid-19 positive cases, can we say that we have now reached the peak of infection?

A: I think this is a myth that there will be a nationwide peak and then it will come down. The reason I say this is because the varying numbers of Covid-19 positive cases are coming in from different parts of the country at different points of time; so in my sense, we will have more of a plateau than a peak. Unlike many other countries which are small and have defined populations, India will have sustained transmission in different areas at different points in time since we have varied characteristics and varied travel mechanisms and as the states have opened up the lockdown in different points of time. Let me give you a small example. The states and cities which followed strict lockdown in the beginning did not get the local circulation established very early on and those who did not implement the lockdown well then, had more cases in the beginning. On the contrary, the states and cities which are opening up now are seeing an increasing number of cases.

Q: So, have we reached the stage of plateau or when are we reaching there?

A: It is very difficult to answer this, since Bihar is peaking now, bigger states like Uttar Pradesh and Madhya Pradesh are altering how the pandemic is shifting and remember these are very densely populated states. Until the epidemic plays out in these three states, we will not be in a position to know where we exactly stand. On the other hand, if we do a Seroprevalence survey (Seroprevalence survey uses serology tests to identify people in a population or community that have antibodies against an infectious disease) everywhere, then we will know.

Q: India now has done more than 1.60 crore tests for Covid-19 so far, but given the population of India, do you think we are testing enough?

A: In terms of testing, I think we have done considerably well, given how we started, but there is definitely scope for improving it.

Q: The government is focusing on increasing the number of rapid antigen tests across the country, but as experts say, it cannot replace RTPCR tests. Do you think it can be an alternative?

A: Rapid antigen test is very useful, but, of course, it cannot replace RTPCR tests and I think the government has never said that they will replace RTPCR with antigen tests. Rapid antigen test is useful and important because its specificity is very good, but its sensitivity is not up to the mark and, therefore, all the symptomatic patients who have tested negative should be again tested in RTPCR for confirmation. There are a lot of challenges with the RTPCR test; it is time-consuming doing RTPCR, results come late. Antigen test is a saviour and it should be scaled up and we should be doing as many tests and in as many places as possible across the country.

Q: Many states are once again going for lockdowns. Do you think it is prudent for imposing another set of lockdowns for slowing down the rate of infection?

A: The earlier purpose of the lockdown was to slow down the rate of spread of the infection and also for the government to prepare. Now, I don’t think any lockdown anywhere in the country is done with the purpose of slowing down the infection. It is mostly being done for the purpose of coordinating the finer steps of the administration and implementation. There is no scientific basis for it, but I think states should have that independence of doing what they think is best for them.

Q: Do you think it is time for the government to open up international air travel since domestic operations are already on?

A: Well it depends on where we are travelling. The first set of flights should be done mostly from places and countries which are relatively safe to start with and I would recommend a gradual opening of international flights in a phased manner.