Re-Shifting Focus To Smart Testing And Tracing: Lessons For Kerala

It has been nearly a year since Kerala registered the first cases of the novel coronavirus in India, with its first positive case reported on January 30, 2020, when a student living in Wuhan returned home. Although Kerala had the initial head start in quelling the surge of active coronavirus infections, which earned the government worldwide accolades, the flagrant complacence during Onam and continuous mismanagement thereafter has been a cause of distress among epidemiologists and health authorities.

With the detection of new mutant strain of Covid-19 and the steady spurt in the number of  cases in Kerala adding to the woes --- especially when there is a rapid decline in the overall fresh infections across the country, calls for a thrust on a smart testing and tracing strategy which is effective and equitable. As Kerala now stands at the fifth position in the list of states with highest confirmed cases and tops the chart with the highest number of active cases in the country, the government ought to up its game and move towards a strengthened approach to manage the pandemic.

Mishandling the crisis

The government’s ineptness to control the pandemic has resulted in the gradual increase of fresh infections in the state. The recent spike in the caseload can be ascribed to the just-concluded local body elections at the district level where the turnout was reported to be approximately two crore.

But, this was not the first time where the government lost sight of the plausible increase in cases. Before this, it had failed to control the infections during the Onam celebrations and repatriation operation as the strategy and technology deployed by the government to curtail its first wave was ineffective in the subsequent times.

Fabrication of data

To conceal its failure, the government is also reported to have indulged in the fabrication of the Covid-19 data as evident from the numbers presented below. The figures uploaded on the state dashboard are manifestly incongruent with the data released by the district collector’s office in several districts.

Taking examples of Pathanamthitta, Malappuram, Wayanad, and Kasargod districts- the state dashboard has ignored more than 400 deaths in these 4 districts as evident from the discrepancy in the data released by the district authorities and the state government.

Apart from the glaring discrepancies pointed out in the reported data, a group of local volunteers led by a general physician have collated a datasheet which suggests massive undercounting of Covid-19 deaths by the government. The data bank which is exclusively based on reliable news reports suggests that Kerala’s actual death toll is at least 4,396 (as on December 29, 2020). It is pertinent to note that these volunteers were able to track only media reported deaths and that there is a great likelihood that the data for many more deaths is absent from public glare. This investigation has even led a former bureaucrat to confess the under reportage which completely strips away the transparency that the government vouches for.

Quality of tests

The state is reportedly leveraging antigen kits to test its populace, even when its reliability is low as compared to the RT-PCR tests. As of January 5, 2021, the antigen tests constituted approximately 66 per cent of the total testing samples taken by the Kerala government. Since these kits are stated to be more prone to indicate false negatives, the official data released by the government remains questionable. 

Need for an increased and equitable testing

In October 2020, the government was planning to enhance the testing numbers to one lakh per day but have not yet done so. As of January 6, 2021, Kerala has cumulatively tested 81,60,890 samples which accounts for roughly 23 per cent of the population. While on one hand, states like Delhi, Maharashtra, Karnataka and Tamil Nadu have kept their testing consistent, Kerala still lags behind with its testing numbers going down sharply on weekends and the numbers oscillate between 30,000 and 65,000. To add to this distressing situation, private labs in Kerala continue to charge Rs 2,100 for RT-PCR tests (at the time of writing) while other states like Delhi, Maharashtra, Rajasthan, etc. have significantly slashed the prices to Rs 800. This has enabled more people to take tests on a voluntary basis making tests accessible and reliable.

Testing still crucial as India gears up for vaccination

As India gears up for the rollout of vaccines, testing will remain crucial in detecting the new cases of coronavirus. Since at the outset, we plan to vaccinate healthcare and other frontline workers, it is essential that tools of testing and tracing are continued for the rest of the population, especially in cluster zones and rural areas. Additionally, the new strain of coronavirus with greater transmissibility has made it patently clear that the virus will continue to mutate and may potentially pose challenges to the current crop of vaccines.

Even if the vaccines prove to be safe and effective against the virus and the new strain, it must be supplemented with a robust testing and tracing strategy to achieve health equity. This synergy will aid in identifying populations predisposed to facing a greater risk of infection, making smart testing and tracing our best bet to save our healthcare system and country from further collapsing.

(The author is a Lok Sabha MP from Kerala)