Only a proper data system can help India tackle Covid-19 better
India is witnessing a second wave of Covid-19 that neither the country nor the government was prepared for. There are reports of under-reporting the number of Covid-19 cases and resulting mortality by state governments, hospitals running out of beds and oxygen and RT-PCR testing being put on hold in several private and government facilities as they have huge backlogs and not enough staff or material to carry these out. One of the many reasons and certainly one of the most important ones behind this chaos and crisis is the failure to build an adequate data system that is transparent, evolves as per developments and is flexible enough to be moulded according to varying requirements across different states.
This pandemic has proved to be most unpredictable. Research and understanding of the infection and its trajectory is still evolving across the globe. With the spread of variants, there have been and continue to be cases that come up negative in the RT-PCR test only to be clinically diagnosed as positive after a CT scan or chest X-ray. But since a clinical diagnosis of this infection has not been defined yet, these cases are not recorded in government data or official bulletins. These cases occupy Covid beds in hospitals though, resulting in an obvious mismatch between the data published by the government and the actual numbers in the hospitals.
Deaths in many states are still counted on the basis of reporting from hospitals. This suggests that the deaths of patients while under home quarantine or while waiting outside a hospital for a bed, with or without a Covid-19 test report, are never included in official statistics. So while these bodies are cremated or buried following Covid-19 protocol, their exclusion from the official released numbers has made headlines in the media.
An approach to take by every state government is to track a patient from testing positive, both in the laboratory and clinically, till the outcome of the infection. If the status of the patient is recorded on each day from diagnosis (11-17 days), the official statistics would be closer to being accurate and the system transparent. This is also the only way for the government to assess and understand the gravity of the situation and use this data to make realistic projections of cases. This analysis can then be used for planning and preparations for the required infrastructure, equipment and manpower in the following weeks.
Unless a data system is designed, built and maintained to capture the reality and make realistic projections for the coming weeks and months, preparations in terms of infrastructure, provisions, equipment, drugs manpower and capacity will always be reactionary and, therefore, fall short of the requirements for the current situation.
Neither the pattern of spread nor the behaviour of the virus has remained the same as last year when the pandemic started. The system designed to capture this evolution objectively needs to adapt to these changes. Different states are witnessing different patterns of this spread. Consequently, the strategies and protocols for containment will also vary. The data system needs to be sufficiently flexible for the states to add details, introduce checks and create modules. This same system should be able to capture and monitor the implementation of vaccination efforts.
It is only through a comprehensive and evolving data system design, that accurate numbers can be shared with the people and the media, for internal calculations and for all preparatory purposes. Data entry, process, system and capabilities can no longer come second in the list of priorities.
The governments and the people need to realise that it is only through transparent, open, accessible and accurate data systems that accountability and responsibility can be established for pre-emptive and timely action. It is also the only means that remains to rebuild trust and hope in the government, going forward.