New Delhi: Ramping up Covid-19 testing is more beneficial and much more economically feasible than imposing lockdowns to tackle the pandemic, a study conducted by Indian researchers has stated.
Titled ‘Transmission dynamics of the Covid-19 epidemic in India and modelling optimal lockdown exit strategies’, the study was conducted by researchers from AIIMS-Delhi and Bhubaneshwar, and Indian Institute of Science Education and Research (IISER), among others.
It was published on 3 December in the International Journal of Infectious Diseases.
The study found that in the initial days of the pandemic, the basic reproduction or infection rate of the virus — called the R0 value — for India was 2.08.
The rate of transmission (Rt), meanwhile, reduced to 1.16 on 22 April, about a month into the nationwide Covid-19 lockdown. This means that the lockdown proved to be effective in controlling the spread of the disease.
But considering the fact that India has a large population of migrant workers and a widely spread economical inequity, unplanned lockdowns can cause economic damage, said the study.
“A large proportion of India’s labour force works as daily wage labourers or migrant workers, and are especially affected during such times, making lockdowns untenable without parallel social support,” the study said.
It also said that due to problems like malnutrition, lack of proper healthcare and chronic diseases, premature withdrawal of lockdowns without adequately planned interventions for the post-lockdown phase may lead to re-emergence of the disease later.
The study holds significance as various state governments had resorted to imposing lockdowns after a spike in the number of Covid cases. The Gujarat government had imposed a 57-hour curfew in Ahmedabad last month after the city saw a sharp rise in Covid cases.
Cost of increased testing will be lower than lockdown
The study used data on testing and different R values, and ran simulations on it in different scenarios to come up with several suggestions.
The findings of the simulation suggested that if testing is ramped up instead of imposing strict lockdowns, the cost of increased testing will be lower than that of a complete lockdown.
Giving the example of South Korea and Taiwan, the study mentioned that their suggestions aligned with the scenarios of these countries where with the use of aggressive testing, the need for a complete lockdown wasn’t felt.
The study also advocated blanket testing of healthcare workers.
It said that considering India has a dearth of healthcare workers, an effective way of protecting them and their patients will be to test them rigorously instead of keeping them away into isolation.
‘Contacts should ideally be tested at end of quarantine’
Talking about asymptomatic cases, the study said most asymptomatic cases go under the radar due to increased focus on testing of symptomatic cases, which could possibly be the reason for the spread of the disease.
“With emerging evidence of infectious asymptomatics, it is prudent to modify the public health response to address these concerns. Thus, all contacts should ideally be tested at the end of quarantine irrespective of symptoms,” it said.
The study also found that detecting asymptomatic cases through testing will delay the transmission to an extent where the total number of cases and symptomatic cases will reduce.
“This finding will increasingly approximate reality if asymptomatics play a larger role in transmission,” said the study.
Advocating the need for pooled testing, the study said: “Pooling can also be used for community surveillance and has the potential to drastically increase detection capabilities while saving costs and resources. Pooling should be used wherever possible, while also enhancing research to boost pool size and accuracy.”
The study also emphasised on the need to have “highly effective and disruptive interventions” in places and communities with high infection rates.
“Highly effective and disruptive interventions should be targeted to areas with active hotspots and high community transmission. It will be essential to build robust disease surveillance systems to assess the relative impact of each intervention in real-time and reduce the time delay to response,” it stated.