Some local lessons

Testing and tracing have been critical in containing the pandemic

India’s Covid-19 aggregate numbers are disturbing, in that the number of cases continues to climb steeply, crossing 1.1 million on Monday, setting a new record for the number of new cases in a day of over 40,000. There are new hotspot states — on Sunday, Andhra Pradesh became the third state, after Maharashtra and Tamil Nadu, to report over 5,000 new cases in a single day. Over 20,000 of Andhra Pradesh’s 50,000 cases were reported in just the last week.

In this context, it is important to learn from those areas that have had some success in containing the Covid-19 spread and fallout. Kerala’s actions have received international attention, and for good reason. However, it is worth noting that it has not completely managed the infection — on Sunday, Kerala too reported its highest single-day number of new cases so far. These are clustered in Thiruvananthapuram and Ernakulam districts, where it is feared that the community spread stage of the pandemic has already begun. It is necessary to learn, therefore, from what Kerala got right — aggressive contact tracing in the early stages of the pandemic, particularly during the first weeks of the lockdown — as well as what it got wrong. In that category falls, probably, the unwillingness of the state government to involve the private sector sufficiently in the management of the pandemic, as well as the failure to ramp up testing capacity, alongside the contact tracing effort. The state also refused to test mild and asymptomatic contacts of patients, which meant that imported cases eventually turned into community spread. Till recently, Ernakulam had a single facility for the gold standard RT-PCR tests, and there was a significant backlog in the number of samples awaiting testing. It is clear that even after its positive efforts early in the lockdown, the failure to create testing capacity has allowed the creation of hotspots, which threatens to undo all its good work.

Another location from which lessons can be drawn is the Dharavi area of Mumbai, which was an early hotspot in the city. Its crowded conditions and subpar sanitation meant that rapid and exponential spread was likely. Yet the spread in Dharavi appears to have been brought under control, with only 143 current cases, of a total of almost 2,500 test positives since the beginning of the lockdown. The suburbs Thane and Kalyan-dombivli have in fact overtaken central Mumbai as the epicentres of the pandemic in Maharashtra. It is fortunate that now other parts of Mumbai and its suburbs are seeking to replicate the Dharavi pattern of volunteer teams tracing and testing door to door, in some cases — such as Dombivli — using the manpower of local corporators.

Finally there is Delhi, which appeared to be headed for serious trouble a month ago but as of recent days has seen a dip in the number of Covid cases. This was the product of more focused effort on expanding capacity. According to the data available, the city had fewer than 10,000 Covid-care beds on June 14; a month later that number went up three times. While this sounds good, the fact also is that Delhi is no longer relying on RT-PCR tests but doing more rapid antigen tests, which often fail to pick up cases. Thus, Delhi might need to wait a bit before it declares victory. But it is clear that testing and tracing are critical in containing the pandemic.