New Delhi: The novel coronavirus appears to be moving from heavy-burden regions like Maharashtra and Delhi to the Northeast, Covid-19 statistics from last week (30 July to 6 August) suggest.
From the Rt value, to daily growth rate of cases, and the daily test positivity rate, the eight Northeastern states have reported a surge in the last week. For example, Nagaland, which reported its first case on 25 May, long after most other parts of India, had the highest Rt value over the past week and a test positivity rate double the national average.
While Rt value, or infection rate, is a measure of the number of cases that are expected to emerge from a single patient, test positivity rate denotes the share of positive diagnoses among the number of tests conducted.
Experts say the trend emerging from the Northeast is in line with the natural course of the disease, but express concern about testing rates in the states, saying they don’t appear to be keeping up with the pace of transmission.
Officials dealing with the pandemic in the Northeastern states, however, claim otherwise. They say the higher number of cases is a sign of better surveillance, while also pointing a finger towards the returnees who have found their way back there since inter-state travel was allowed in May.
As of Friday, India had recorded 22 lakh Covid-19 cases with over 41,585 deaths and 14.27 lakh recoveries. The eight northeastern states — Assam, Sikkim, Tripura, Meghalaya, Manipur, Nagaland, Arunachal Pradesh and Mizoram — have so far recorded 68,660 cases, of whom 48,075 have recovered and 195 have died.
Rt value is considered a marker of an outbreak’s severity. Data from Covid Today India, a dashboard put together by iCART, a volunteer group of experts involved in research and development, reveals that India’s Rt value Friday was 1.08.
This suggests that every infected person can transmit the virus to another 1.08 people.
On the same day, five of the eight northeastern states — Nagaland, Sikkim, Mizoram, Assam, Manipur — recorded higher Rt values.
Nagaland recorded the highest Rt value in the country at 1.56. Sikkim’s Rt was recorded at 1.35, Mizoram’s at 1.29, Assam’s at 1.28, and Manipur’s at 1.25.
Among the remaining three, Tripura’s Rt value was 1.01. The other two states had an Rt of below 1, which generally suggests that the disease is at a stage when it can be eliminated. While Arunachal Pradesh’s was 0.99 Friday, Meghalaya’s was even lower at 0.82.
Daily growth rate
On Friday, India recorded the highest single-day spike so far with 62,538 cases. However, the Union health ministry said at a press conference on 15 July that the daily growth rate has shown a declining trend.
“If you see, the daily growth rate of Covid-19 cases in March was around 31.28 per cent, it declined to around 9 per cent in May and reduced further to 4.82 per cent by the end of May,” said Rajesh Bhushan, officer on special duty, Ministry of Health and Family Welfare.
In comparison, data from Covid-19 India, a crowdsourced dashboard, shows that the daily growth rate recorded in all eight NE states is higher.
On Friday, Nagaland’s daily growth rate was 9.3 per cent. Assam’s was 5.4 per cent, Sikkim’s 5.1 per cent, Mizoram’s 4.6 per cent, Arunachal’s 4.5 per cent, Manipur’s 4.1 per cent, Meghalaya’s 3.3 per cent, and Tripura’s 3.1 per cent.
Nagaland has also recorded a higher daily growth rate than each of the five states/union territories with India’s highest Covid-19 caseloads. Assam and Sikkim have surpassed four of these states/union territories.
The daily growth rate of the states/union territories with the highest caseloads was recorded thus Friday: Maharashtra (2.4 per cent), Tamil Nadu (2.3 per cent), Andhra Pradesh (7.2 per cent), Karnataka (4.8 per cent) and Delhi (0.8 per cent).
Daily moving average
A look at the five-day daily moving average (average of daily cases over five days) of the Northeastern states also reveals an upward trend. Data from Covid Today India shows that five NE states recorded a rise in their five-day daily moving average over the last week.
In Nagaland, the five-day daily moving average increased to 144 on 6 August, from 56 on 30 July. In Assam, the figure increased to 2,372 from 2,112. Tripura noted an increase to 169 from 149, while Manipur’s nearly doubled from 55 to 101. Mizoram’s daily moving average increased from 16 to 21 in the last week.
Only three Northeastern states saw a fall in their five-day daily moving average. Arunachal Pradesh’s daily moving average fell from 70 to 66, Meghalaya’s from 38 to 26, and Sikkim’s from 31 to 21.
Daily test positivity rate
As of Friday, the seven-day average of India’s test positivity rate stood at 8.8 per cent, which means around nine of every 100 Covid tests yielded a positive diagnosis.
Health economist Dr Rijo M. John told ThePrint over the phone that the test positivity rate is much higher in some of the Northeastern states, a fact he described as “worrying”.
According to data analysed by Dr John, Mizoram and Nagaland have test positivity rates double the national average, at 15.3 per cent and 17.1 per cent, respectively. Sikkim’s test positivity rate is close to the national average at 5.7 per cent.
Why the sudden surge in NE?
According to Dr John, the Covid-19 trend for the Northeast implies that the pandemic is moving out of the big states to the farthest corners of the Northeast.
“The virus is following its natural course and spreading across the country. But the high test positivity rate and the surge in the past week implies that the virus is spreading faster than testing,” he said.
“Testing needs to catch up, which is not happening. To curb the spread in the Northeast, testing and contact tracing need to be ramped up.”
Officials overseeing Covid-19 relief efforts in the states, however, said the Northeast is equipped to deal with the virus.
“Despite the fact that the Northeast states kept the strictest quarantine rules, returnees from other states led to a huge surge in cases. The return of armed forces and paramilitary personnel also added to the surge,” said Nagaland MLA Mmhonlumo Kikon, who serves as spokesperson for a high-powered government committee on Covid-19.
“Surveillance and testing have been ramped up and we have ensured there’s no community spread,” Kikon added.
Officials in Assam, which has the highest Covid-19 caseload among Northeastern states, said their “numbers are high due to increased testing using rapid antigen kits even in the remote areas”.
“In hospital settings, all rapid antigen test negatives are sent for RT-PCR (considered the ‘gold standard’ for Covid-19 testing) and, in community settings, only symptomatic negatives are sent for RT-PCR,” said a government official who did not wish to be named. “Our strategy is to track and test and find hidden cases. So, while cases may be more it only shows increased surveillance.”