Why bureaucratic control over Covid-19 testing is counterproductive as India ‘unlocks’

In episode 491 of #CutTheClutter, Shekhar Gupta explains why government cannot control tests, and how the monopoly is affecting three major cities in the country.

Medics collect a swab sample for Covid-19 | Representational image | PTI

New Delhi: The ‘babugiri’ or bureaucratic control over who can and cannot be tested for coronavirus must end as India opens up despite the rising cases, ThePrint’s Editor-in-Chief Shekhar Gupta said in episode 491 of ‘Cut The Clutter’.

With over 2.65 lakh total coronavirus cases, India has now surpassed Italy to become the sixth worst-hit country by the coronavirus pandemic.

As India starts to ‘unlock’, Gupta said that it was time for a change in the testing strategy to ensure that regular citizens — not just politicians and bureaucrats — can get themselves tested.

Relaxing the bureaucratic control over testing will not only ensure that the virus spread is controlled, but lives can also be saved by giving people early treatment.

“This tough, strong draconian state control over testing where some bureaucrat decides who can be tested and who cannot be tested has to end now,” said Gupta.

“The virus doesn’t respect any bureaucracy,” he added.

Rising cases in India

As Gupta had explained in episode 490, the test positivity rate is rising in India. It is now at 8.02 per cent, twice as much as it used to be until about a month back.

More worryingly, the situation in Mumbai, Delhi and Ahmedabad look much worse than before.

“In Delhi, the fatalities have shot up in the last 10-12 days. It could be because now there is a much better audit of deaths in hospitals. So it’s now difficult to write off Covid deaths as something else,” Gupta said.

These are also the cities which have the bulk of India’s rising cases and fatalities.

In Delhi, the number of deaths per million is now 44 and this metric is still rising. In Maharashtra, it is about 24 per million, but Mumbai has recorded 126.5 deaths per million.

Gujarat has the third highest fatality rate in India at more than 16 per million, and the bulk of its cases are in Ahmedabad.

“So, the lesson we now learn is that the national effort somehow has to focus on these three big cities. Because if you can do that, you can save a lot of lives instead of spreading it out everywhere,” Gupta said.

“Hyderabad is also a city of concern because we don’t even know what’s going on there,” he added.

Need to relax restrictions on testing 

At the beginning of the epidemic there was a lot of clamor for testing, when the number of infections was very few. However, at the time, enough tests kits were not available.

“Now India has half a million tests a day available, but still, India is testing only about 1.42 to 1.46 lakhs a day, which is less than a third of India’s capacity,” Gupta said.

Testing everybody who can afford it, however, is still not a feasible option. During an epidemic, it is important that each person who tests positive reports themselves for a centralised database, so their contacts may get traced.

Maintaining this central database may become a problem if everyone starts getting themselves tested.

On the other hand, testing strategy also needs to be relaxed to address what the data tells us, Gupta said.

“In Mumbai, for example, preliminary analysis shows that 60 per cent of the people died within four days of arriving at the hospital,” Gupta said.

“What this means is that the patients are getting medical attention too late,” he added.

By the time the patients are diagnosed and hospitalised, too much time is lost.

“They suffer from hypoxia, lack of oxygen in their bodies, and they come with organ failure, which the body cannot repair any longer.”

Testing will help safely open workplaces

Social distancing may be a challenge in most workplaces, so employers need a way to ensure that it is safe to call everyone back to work.

“Mass testing at their own level is the best way for workplaces to open up. Those who test positive can either self isolate if they’re asymptomatic, or get early medical treatment if they are showing symptoms of breathlessness etc,” Gupta said.

Employers can bear the cost of these testing and also ensure that data is fed to a centralised data base.

“So effectively, the employers will also become Corona fighters, they will become partners in this fight,” Gupta said.

The government has the right to know what is happening, but to control these tests and to keep them all under the thumb of the state has to stop, he said.

“Today the bureaucracies and politicians are working in cahoots to keep the overall numbers of positive cases low. That is self-defeating in many different ways,” Gupta said.

As seen in Mumbai, low testing is preventing people — particularly the poor — from getting medical care early. This will get worse because medical care and hospital beds will now become more and more scarce.

This is leading to silent spread of the infection, and now there is no point in denying that it has spreading through several communities.

In Delhi, Mumbai and Ahmedabad, there are congested sections where social distancing is not possible. When factories open up this problem will get compounded.

So, let the private sector employers also become part of this test, trace, and isolate process — you cannot just do it under bureaucratic rule.

Power to test lies with bureaucrats

Right now, the power to decide who will be tested and who will not be tested lies with the bureaucrats.

“This means if my uncle is a civil servant or a politician, then I will get tested,” highlighted Gupta.

For example, the defence secretary of India could get tested even though he was not symptomatic. He tested positive and is now isolating at home.

“But he’s the defense secretary of India. When there’s a crisis on the border, he would have been attending every meeting of the Cabinet Committee on Security. He’d be meeting the Prime Minister, the three chiefs if this had gone on,” said Gupta.

If he had not been tested because he was asymptomatic, we could have been in a situation where the Prime Minister, the defence minister, the external affairs minister, the home minister, the finance minister — along with a lot of other key people in the military and defence establishment would all be quarantining themselves.

“I’m exaggerating, but this is not an impossibility. It is not even an improbability if he had not been tested.”

Similarly, the head of the press information bureau tested positive. While he has been hospitalised, it turns out that three key ministers — Nitin Gadkari, Prakash Javadekar and Narendra Singh Tomar — attended a press conference with him sitting nearby.

In this case too, the PIB chief was tested only because he is a civil servant.

So the time has now come for the central and state governments to make use of what’s available and shift the strategy.

If this monopoly of the bureaucracy and the government in testing people for coronavirus continues, the first institution that might pay the price for it will be the State itself, Gupta said.

Watch the latest episode of CTC here: