No comfort in numbers

The shame is not in detecting cases,but in hiding deaths caused by the virus

West Bengal, which reported its first COVID-19 case in mid-March, has now recorded a total of 922 cases. The State has reported 48 deaths but had not counted 72 who died of comorbidities. Though it is India’s fourth populous State, it now ranks fourth lowest in terms of the number of those tested, and is also way lower than Bihar, Madhya Pradesh, Rajasthan and Uttar Pradesh. Against a national average of 721 tests per million, West Bengal has a dismal 212.6 tests per million. But what is disturbing is the general reluctance of the government to ramp up testing and to acknowledge deaths from the disease as such. This comes as a surprise given its initial proactive stand on several fronts to tackle COVID-19. It was the first State to move from containment to mitigation to contain the spread when it announced a complete lockdown before the Prime Minister announced it nationally. Chief Minister Mamata Banerjee was seen doing all the right things including demonstrating how social distancing is to be practised and setting up quarantine centres in every district. While it is not clear if testing has improved, there is clearly a reluctance to divulge the true extent of spread of the virus. The hesitation is pronounced on the issue of sharing mortality numbers.

At over 13%, the case fatality rate is very high in West Bengal while the detection rate continues to remain the same, which is a reflection of poor surveillance and a failure to actively look out for fresh cases. When surveillance is good and testing is ramped up, the number of cases reported is bound to increase, as was seen in Kerala, Maharashtra and Rajasthan, and even South Korea in particular. As Kerala has demonstrated, early detection of cases and tracing of contacts, quarantining and testing will not only help in containing the spread but also markedly reduce the case fatality rate. Trying to keep the numbers artificially low by testing fewer people or not divulging the actual numbers and tracing their contacts allows the virus to spread unchecked. At some point, poor surveillance and delay in testing will overwhelm the health system and result in even more deaths, something that no government would be proud of. A higher number of cases is only a reflection of how active the State has been in waging a war against the virus, while a higher case fatality rate serves as evidence of poor response. With the lockdown now extended by two more weeks, the government should follow the advice of WHO and cover lost ground by aggressively testing and isolating cases, and tracing contacts. Assembly polls next year should not be a reason for the Union and the State governments to politicise a public health issue that has been declared a pandemic.

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