By failing to scale up testing coronavirus, India may have lost crucial time

Let’s hope it doesn’t happen, but if a mass explosion of coronavirus is upon us, it will be because of the Indian government’s refusal to test a large number of suspected patients.

Medics screen patients as part of a precautionary measure against novel coronavirus | Representational image | PTI

It hasn’t been perfect, but India has done a reasonably good job on most counts: airport screening, quarantining, public awareness, and even contact tracing in most places. Yet it is feared that the community transmission of coronavirus could be upon us, a mass explosion of cases that India is not well-equipped to handle.

Let us hope that does not happen. But if it does, the main cause will be want of testing facilities. And we don’t know why India has been so slow in scaling up testing facilities. Was it lack of resources, complacency, or an effort to artificially keep the number of positive COVID-19 cases low? Perhaps it was all of these.

The Indian Council for Medical Research (ICMR) says it has found no positive case of coronavirus in 500 randomly collected samples of respiratory disease patients in ICUs. That sort of thing is hardly a justification to not test people with symptoms. A friend of mine who thinks he has coronavirus symptoms called a government helpline all day and after finally getting through, was told to reach Ram Manohar Lohia Hospital. At the hospital, dozens of people, including him, were refused a test because they had no travel history or immediate known contact with anyone who had a travel history to severely affected countries.

But what if even one of these has coronavirus? She or he could be spreading it and not taking adequate precaution, thinking that s/he can’t have the virus since the government doesn’t even feel the need to find out.

Why mass testing is key to containing

This is the sort of mistake that every country which is now witnessing a mass explosion of cases has made. The reason Turkey has had only two coronavirus-related deaths so far, despite sharing a border with Iran, is because it has been proactive with testing. The reason the United States is seeing an exponential rise in the number of cases is that it didn’t take testing seriously. (Curiously, India banned travellers from Turkey but not the US.)

Countries and regions that have so far been able to contain, mitigate or delay the spread of coronavirus have all done so by scaling up testing. These include South Korea, Taiwan, Singapore, Japan and Hong Kong. Of course, they were also ready with the infrastructure to deal with those who tested positive, such as quarantining them and protecting health workers and doctors.

Early and mass testing makes all the difference because, in many cases, coronavirus can be asymptomatic. Put simply, the virus may have entered your body but you do not show any symptoms at all. Unaware that you have coronavirus, you go around spreading it, making the vulnerable, such as frail and elderly people, very sick.

South Korea’s mass testing has proved that young people are getting coronavirus in large numbers but showing mild or no symptoms. By identifying and isolating such people, countries like South Korea have been able to contain the spread of the virus and keep their mortality rates low.

The importance of testing to isolate asymptomatic patients has now also been established through a mass experiment in Italy. The 3,300 residents of the small town of Vo were tested twice — all 3,300 of them. Those carrying the virus were isolated. By doing so, the spread was stopped. The number of new cases, as a result, is zero.

India is refusing to test those with symptoms. South Korea is testing even those with no symptoms.

Short of vaccination, mass testing is the best we can do, and we can do it through mass testing. It is like a race between humanity and a virus. Humanity is far behind, and we can play catch up only through testing. The silver bullet — vaccination — is more than a year away.

No data, no problem 

So why is India not testing more people? Looks like it is not about capacity. According to the Associated Press, India has the capacity of testing 8,000 samples a day and yet it is testing only 90 a day — as of 18 March. This is most strange for a country that has already seen three deaths.

Such lethargy in testing may be taken as a sign that the Narendra Modi government does not expect coronavirus to reach the stage of community transmission. But it clearly does reach that stage. The Ministry of Home Affairs (MHA), mostly busy with the implementation of draconian citizenship laws, went back on its promise of giving a compensation of Rs 4 lakh for every coronavirus-related death. This suggests that the government fears a mass outbreak. Why, then, is it so reluctant to prevent a mass outbreak by mass testing?

The Modi government has ordered a million test kits from Germany and the ICMR has been slowly expanding testing. These measures were taken this week. They should have been taken latest by February, when it became clear that the epidemic was spreading worldwide, or at most by March first week, when it became clear that coronavirus was not going to be limited to one or two cases in Kerala.

Sadly, the Modi government has lost crucial time. The effort to contain or mitigate coronavirus pandemic in India will not look like the efforts taken in South Korea, Singapore, Taiwan or Turkey.

In the United States, President Donald Trump has been heavily criticised for being behind the curve on testing. The US media has investigated the reasons for it. In India, the media is an arm of the Modi government and the opposition doesn’t exist.

Perhaps the Modi government thinks it can overcome coronavirus by fudging or hiding data, and what better way to do so by not testing people? After all, the Modi government hides farmer suicide data, consumer spending data, or simply stops using the word drought to pretend it doesn’t happen anymore.

If denial is the strategy, we are in for a rude shock very soon. Narendra Modi may want to wait for a few weeks before trying to look like a global leader at the forefront in the fight against coronavirus.

The author is contributing editor to ThePrint. Views are personal.