By Sunil Garodia
First publised on 2020-03-17 17:21:34
India would seem to have done well to have so few reported cases of Covid-19 (the operative word here is "reported" for in our country of 1.3 billion people, we do not know many are actually infected and how many more they are infecting on a daily basis as not enough testing is being done). The government would pat itself on the back and say that it took the right decisions at the right time to mitigate what could have been a monstrous disaster. But it would be a false and dangerous sense of complacency to think in that manner. We are a densely populated country surrounded by other densely populated nations and the international borders are porous. Although we have screened people who have entered India from official entry points and have kept tabs on infected persons or those who came into their contact, have we done enough testing to get the real figures? Cardio surgeon Devi Shetty, writing in The Times of India, has said that "Covid-19 is the most transmissible disease we have ever encountered" and that "every coronavirus patient infects three other people and they are contagious for two weeks". He adds that "the exponential spread of coronavirus in India will hit like a bomb because of the density of population".
It would seem that we are doing all the right things by checking the entry of the virus at entry points, keeping those infected or suspected in quarantine and closing down places like schools, colleges, malls, theatres and halls and encouraging social distancing by banning rallies, assembly of more than 50 people (or even four in places where Section 144 of the IPC has been invoked), encouraging work from home and restricting entry of visitors and people who are not required to be present at places like courts and government offices, it will not work if we do not conduct enough tests. Until now, India has tested just about 10000 samples. It has just 52 testing and 56 collection centres. Although testing is free for the public, the paucity of centres and kits make it difficult to test people with similar symptoms randomly.
The importance of random tests cannot be underplayed simply because it has been proven that asymptomatic persons have infected more people than those who actually showed Covid-19 symptoms and tested positive. The situation now across the country is such that we do not know who is infected or who is a carrier because the infection does not always show outward symptoms. We need to have more centres and more kits. The government has allowed 60 NABL-accredited private laboratories to join in the testing. It has also reportedly placed orders for 10 lakh testing kits. But the costs are prohibitive. While the government is now funding the cost at public testing centres, it is not clear who will bear the cost in case of private centres. Also, there are not enough protective gear for the medical teams who are most susceptible to being infected. Ideally, there should be a fully operational testing centre in each district of the country. The tests should be free for the patient at even the private centres. It is upon the government to see how it funds the operation as it is too much to expect the ordinary person to pay Rs 10000 (that is a rough estimate of how much the test could cost at private centres) for the test. But one thing is certain: if India does not speed up testing to know the actual number of cases and takes subsequent steps to mitigate the disease, there is a likelihood that it will not be able to prevent community transmission of the disease and then things will go out of control.