Indian Council of Medical Research

Growing worry on Corona in Bengal: Has the horse already bolted?

(This is a reprint from NewsBred).

All this while, we have been fretting upon Mumbai and Delhi. It now seems Kolkata was ignored as the wool had been pulled over our eyes.

No less than 264 containment zones now figure in the teeming city of Kolkata itself after Centre came out with its Red, Orange and Green classification list on Corona Virus on Friday.

Kolkata is only a microcosm of worrying state of affairs in West Bengal where no less than 10 districts have been classified into Red Zone though typical of its chief minister Mamata Banerjee, she contests it to be only four districts.

The trouble is, so much water has flown under the Hooghly in the last few weeks that Mamata’s assertion only helps to grow the band of skeptics over her utterances.

West Bengal till Friday was officially announcing the fatality figure in the state to be 33. It had arrived at this figure by un-clubbing co-morbid cases from Corona fatalities. Ms Banerjee’s state was not only flying against the norms of India’s apex medical body, Indian Council of Medical Research (ICMR), but also against the guidelines laid down by the World Health Organization (WHO).

West Bengal, as per WHO norms, had 105 fatality due to Corona Virus till Friday. It had 831 cases which gave West Bengal a fatality ratio of 12.87% compared to national average of 3.19%, four times India’s overall ratio.

Initially, things appeared in control after Bengal reported its first Corona case on March 17 and a state-wide lockdown was announced on March 23 on the heels of its first Corona death. Ms Banerjee marking “social-distancing” circle on the roads was a timely optics.

But then the first hint of trouble was the assembling of thousands of migrant workers at the Howrah Station on March 25. On April 2 and 3, the state government didn’t release the official bulletin on the pandemic. Between April 4 to 6, the health bulletin seemed to miss the Corona-related deaths before the anomaly was sorted out on April 7.

Things were hardly getting better though. On April 11, West Bengal Doctors’ Forum wrote to Ms Banerjee and pleaded with her to be transparent on Corona Virus. On April 13, the National Institute of Cholera and Enteric Diseases (NICED), the designated testing facility of ICMR in Kolkata, rued that “West Bengal government is not sending enough samples for Covid 19 testing.”

Growing worry led Indian Medical Association and seven other medical organizations to approach the chief minister to release “real-time Covid 19 data in West Bengal.”

The broken healthcare system of West Bengal, a victim of four decades of apathy under the Leftist/Trinamool Congress regimes, apparently can no longer be masked. Videos began emerging of disturbing conditions inside hospitals. It led to mobile phones, including the ones of medical staff, being banned in wards of the hospitals. A Kolkata-based oncologist had an FIR slapped against him for his social media posts on lack of medical kits. His mobile was confiscated, returned only after Calcutta High Court intervened.

Whenever media questioned, Ms Banerjee shot back with the advice to “behave properly” or her government could be forced to take action under the Disaster Management Act.

Lately, healthcare workers in the state are testing positive. It includes 20 of Kolkata Medical College. On April 26, a senior health officer of the state department became a Corona fatality.

Ms Banerjee seems averse to Centre offering advice or help, but for financial aid of course. She was unhappy when the Inter-Ministerial Central Teams (IMCTs) visited Bengal. IMCT has subsequently expressed concern over the paucity of protective equipment, ventilators and quarantine facility. The testing is low and test reports too are taking longer time than it should.

The spurt in fatality rates suggests that cases are being admitted in the hospitals only after the positive cases have turned grave. Law enforcement is lax. There is a real fear of community transmission.

Most would pray that Kolkata doesn’t suffer from a widespread infection of Corona Virus. Doubters believe it already is suffering from community transmission. The coming days would hold key for the state, which by extension would mean the nation itself. Arrogance and denial is no way to run the state when the lives of lakhs of its citizens are at grave risk.

 

 

Is India testing enough? Or is there a method in this madness

(This is a reprint from NewsBred).

These are bad times for jokes but the one by India’s premier health agency looks particularly awful when it says it’s “testing” less than it could.

India is doubling the count of its Corona Virus patients twice every week and 40 have perished in the last 24 hours but the Indian Council of Medical Research (ICMR) simply hasn’t cast its net wide enough to assure an anxious nation of a billion plus.

India is dawdling at 190,000 tests put together as on Sunday which bears a sorry comparison with the United States (2,700.000), Italy (1,000,000) and Spain (350,000), three nations reeling the most under the unforgiving pandemic.

India today isn’t short of hands or testing kits. It’s good enough for 20,000 tests a day. It also isn’t shy of promising 100,000 tests a day soon. So what’s stopping it from showing its full hand to the growing footprint of the killer virus?

Specific and not random tests

It would seem India’s strategy is more by design than neglect. India has so far preferred to do tests only on those who have shown symptoms. Such information is either being relayed by patients themselves or a confirmed case is being followed up. In no case, suspects are allowed to visit nearby designated hospitals on own.

It appears there is a corollary to such caution. A nursing home in Washington made headlines for being the biggest harbinger of disease to nearby community. The Virus arrived on the host-patients and spread itself on staff, security and residents without distinction. Wuhan in China bears reports on patients calling up on routine health issues and ending up infecting those unfortunate to be around them.

The red flag of mass testing is obvious too. How do you do it? By rounding up people and allowing the disease to hop and spread to the last man in the queue? Instead, India’s healthcare is opting to swarm around hot-spots in the country of which they have identified a few dozens. It’s here that they are rolling up sleeves and getting into combat mode. Mass testing with lockdown in place doesn’t quite make much sense to them.

No community spread yet

India still maintains it’s in Phase Two of the spread, that it is still local and not communal which would’ve set alarm bells ringing. It went into a lockdown mode when there were still only 150 cases on the chart. Italy, Spain and France in contrast shut itself up at least 7-10 days prior but their cases–and fatalities–were already in thousands. The horse had already bolted.

India could also take comfort that out of its 707 districts, only 325 so far are in the infected list. It’s fatality roll of just over 300 isn’t cause for panic yet. The people have so far stoically borne the pains of a lockdown. Indeed, they are bracing for an extension of lockdown without quite throwing up.

It’s not to say India is out of woods yet. It’s a long summer ahead. Slums remain a major worry. Dharavi, one of Asia’s biggest in Mumbai, is racking up patients steadily. Delhi, India’s capital, has sealed off at least two dozen of its infected pockets. The western state of Mahrashtra which houses India’s commercial capital Mumbai, accounts for nearly half of India’s total deaths. India hasn’t turned the corner yet.

India, for sure, would ramp up tests in coming days. It’s also almost given that more cases and more fatalities would show up. It would hope it’s still manageable. And that its’ strategy of testing visitors, and enforcing lockdown when the numbers were still low, was a clincher. Else, it would rue it didn’t test enough when the time was still on its side.