India was hoping that the extended lockdown alone might help it win the battle against the novel coronavirus , but the microbe has been spreading with renewed vigour. So much so that on July 16, the number of confirmed infections and deaths crossed grim milestones — one million and 25,000, respectively. If it took 109 days to reach 1,00,000 cases but just 15 days to double, the days taken to add each additional one lakh cases have been shrinking; the last two additions of one lakh cases to reach one million took just three days each. While the rising fresh cases reported each day could be ascribed to increased testing, the underlying reason for the case rise is undoubtedly the wide spread of the virus in the community. With surveillance not being commendable, the 10.3% test positivity rate nationally in the last few days shows that a very large pool of infections remains undiagnosed. Though the number of tests done daily has now crossed three lakh, the high test positivity rate underscores the need to increase the number of daily tests, by at least a few-fold. Any delay in tracing, testing and isolating the infected and their contacts will only lead to an unimaginable spread of the virus. As already seen in a few Indian cities, a cascade of events beginning with a delay in disease detection can overwhelm the health-care system to negatively impact the case fatality rate, which is currently very low.
Kerala, Karnataka and Andhra Pradesh, which initially appeared to have contained the virus spread, have seen sharp surges. If Bengaluru bucked the trend in the early stage, it has become a standing example of how the cookie crumbles when cases spike and the system is not fully geared for the challenges. Aggressive tracing and testing helped Chennai reduce the surge. But the coming days will reveal if its 12-day lockdown in June had greatly contributed to this. While Delhi appears to have hammered down the test positivity rate in recent weeks, over-reliance on rapid antigen tests, which have low sensitivity, raises concerns about true case detection. Maharashtra appears to have pulled off a coup in Dharavi through outstanding work, but like Tamil Nadu and Karnataka, the State has been witnessing a spike in other districts. With a 9.1% test positivity rate, Gujarat has made no attempts to greatly increase daily tests but instead appears to be disingenuously limiting the number of daily tests to keep fresh cases per day under check. Telangana too, with a test positivity rate of 18.4%, has made no great effort to increase daily tests, which have crossed 13,000 only in the last couple of days. Telangana defies the trend of rising cases during the pandemic, raising serious concern about its numbers. Examples such as New York have shown that it is never too late to bend the curve. But for that, States need to fight the virus, not manage the data.
