Why India emerged as a pandemic center despite the early blockade

Given that the United States and Brazil are the closest to India in terms of total numbers, there may be a temptation to look at the three countries and their right-wing leaders alike, and thus their response. Still, India’s Prime Minister Narendra Modi is quite different from US President Donald Trump and Brazilian President Jair Bolsonaro in responding to a pandemic. Trump and Bolsonaro have consistently rebelled against social distance, mask wear, and lockdown since the outbreak of the pandemic, but Modi quickly adopted mask wear, with over 500 confirmed cases in India. We announced a strict nationwide lockdown quite early on. Still, India was unable to curb the pandemic despite its early start. There are five reasons.

1) Lockdown is not a magic wand

Giridar Bab, an epidemiologist at the Indian Public Health Foundation and a member of the Indian Medical Research Council, said lockdown will not eliminate the country’s case. ICMR’s Task Force on Monitoring and Research. The government initially argued that a blockade was needed to thwart the case. At a press conference on April 24, VK Paul, who heads the government’s enthusiastic task force, impressively presented a slide showing that the number of incidents in India had been reduced to zero by May 16. The government has since restricted claims that lockdowns have made the case lower than it really is. On Tuesday, ICMR Executive Secretary Balram Bhargava reiterated this at a press conference. [from Europe] And we distributed the curves in a way that would not result in such a large number of deaths. And it was scientifically the cause of the very effective lockdowns that took place during the months of March, April and May. “

According to Bab, the countries that successfully used the first blockade were those that guaranteed that the incident would not spread to the region during the blockade and those that prepared a rapidly growing health system.

2) Dense housing

Researchers have begun conducting serum surveillance studies in several Indian cities to test for the presence of antibodies that help determine true exposure to the SARS-CoV2 virus. In Mumbai, Pune, and early national-level serum studies, the data show that the prevalence of antibodies is much higher in slums than in non-slums.

Contact with the household was the most common method Spread the virus, Analysis of data on sources of infection from Tamil Nadu and Andhra Pradesh [] Indicated. The lack of a personal toilet in particular is a strong predictor of seropositive. “Slam penetration can be due to population density and shared facilities such as toilets and water stations,” said one of Mumbai’s principal investigators for serum research and a scientist at TIFR. Uras Corser said.

3) Unmanageable

There is increasing evidence that many states have not prepared medical facilities for an oncoming pandemic during a lockdown.

“Tamil Nadu and Karnataka have introduced central oxygen lines in government hospitals, but since they hadn’t, this is an important step to take and could partially explain the low mortality rate. There is, “Bab said. Currently experiencing Acute lack of oxygen, Like any other city that is currently facing a surge in cases.

According to Bab, not only the medical infrastructure, but also the labor shortage and the management of supplies such as ventilators, oximeters and drugs are difficult.

In addition, India is struggling with non-medical tools to combat pandemics. Contact tracking should be a key pillar of a government’s containment strategy, but even well-managed cities struggle to track contacts in the event of a surge. News report from Mumbai reported in late May The city’s contact tracking staff is overwhelmed and the exercises are delayed.

Bengaluru followed an important part of lockdown preparation and made technology-led contacts, Munish Moodgill, an IAS officer in charge of the ardent war room in Karnataka, said in an interview. In fact, according to ICMR data, the city tracked a large number of contacts in May for each confirmed case, with Karnataka having the highest contact tracking in any state. However, when the surge struck the state in late June, contact traces stalled at IT power plants, primarily via Bangalore.

When the ICMR published a study based on its test data in late May, the majority of people tested did not have data on symptoms, travel, or contact history. This data is still lacking. A senior adviser to the Government of Delhi demanded anonymity, “every night we receive a list of people in the state who tested positive from ICMR.” The name is just the first name. Vinay, full stop, “he said indignantly.

4) Test trouble

During the first months of the pandemic, criticism of India was that it had too few tests, and India is still only 115th out of 193 countries in terms of testing per million people. Test Positive Rate (TPR)-the number of tests performed that are positive-is an indicator of whether the area is well tested compared to the size of the outbreak. In heavy-duty states such as Maharashtra, there are oversized TPRs that have grown over time.

Then there is the test issue that the state is using. Many states are now conducting faster antigen tests daily than RT-PCR tests, as the June ICMR Recommendation requires states to use rapid antigen test kits to enhance their tests. .. Antigen testing is faster, cheaper, and easier to perform. However, they are also much less sensitive than the gold standard RT-PCR test, so they are much less likely to pick up positive cases. To combat this, the ICMR guidelines state that all symptomatic individuals who test negative for an antigen test must be retested with an RT-PCR test. However, in many states, there is no administrative capacity to follow up on these symptomatic negatives. At a press conference last week, the Ministry of Public Health’s Secretary of State Rajesh Boushan said many of these people were missing and could be involved in the spread of the virus. Even in Delhi, less than 1% of the 70,000 people who took Antigen test Indian Express reported that it was retested.

5) Limited national relief

Some medical authorities have begun to blame “discipline” for the spread of the case, especially as cities have begun to “unlock.” However, given the impact of pandemics and blockades on the lives of the poor in the country, it may be unfair to shift the burden to individual responsibility. Nearly 120 million people lost their jobs in April 2020, according to data from the Indian Economic Monitoring Center, but some of these jobs may have returned. The government announced in parliament on Monday that between April and September, the number of people seeking work under the Mahatma Gandhi National Rural Employment Guarantee System increased by almost 40% year-on-year. State support is limited in the country. In contrast, Brazil under Bolsonaro has expanded its welfare system and added emergency assistance to raise 40% of the country’s poorest income.

Modi may have taken the virus seriously, but there were many other things that India couldn’t or couldn’t do to stop the virus.

* Rukmini S. is a Chennai-based journalist.