Covid-19: To avoid lockdown, states must step up RT-PCR testing; Centre must free up vaccine pricing


If the spread isn’t brought under control soon, the healthcare capacity in Mumbai, and likely the other areas seeing exponential rise in cases, could run out entirely.

Given how daily new cases of Covid-19 in the country have shot up sharply—up nearly 3.3x between February 28 and March 30, from 16,572 to 56,211—the Union government has rightly flagged it as a “huge worry”. A rising trend in new cases has been reported for 10 states, but Maharashtra alone accounts for over 55%. Worse, the fast rise in new cases is already straining healthcare capacity; the situation in Mumbai gives a snapshot of this, with availability of hospital beds, ICU beds and oxygen beds in the city having fallen from 77%, 67% and 81%, respectively, on February 6, to 26%, 26%, and 25% on March 29.

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If the spread isn’t brought under control soon, the healthcare capacity in Mumbai, and likely the other areas seeing exponential rise in cases, could run out entirely. It isn’t surprising, therefore, that CM Uddhav Thackeray is reported to be strongly considering a lockdown—there are already many restrictions in high-incidence districts in the state—political and popular opposition notwithstanding.

The CM, however, needs to keep in mind the economic costs of this, and the likely larger toll it would exact from the people of the state, and indeed the economy of the country. India, leave alone Maharashtra, can ill afford to have another several thousand enterprises, especially in the MSME segment, going out of business and hundreds of thousands losing their livelihoods.

The state, as also the others, must instead pay heed to the Centre’s advice on ramping up testing and doing contact tracing with greater rigour. Maharashtra’s positivity rate is a staggering 23%—Punjab, the state with the next highest positivity rate, is registering 8.82%—compared with the all-India figure of 5.65%; this shows the state is simply not able to get testing right.

While the state’s test-numbers have increased sharply, data from Brihanmumbai Municipal Corporation shows that, over the past 10 days, the increase in Mumbai has largely been on the back of rapid antigen tests (RATs). RATs’ share jumped from just a quarter at the start of March to more than 50% over March 22-28. The data also shows that while RAT-positivity is around 7%, that for RT-PCR is close to 25%.

This means continuing with increased deployment of RAT will mean that a large number of cases get masked, and the state gets set up for another surge once restrictions are eased. States, including Maharashtra, must now ensure a 75% share for RT-PCR at the very least in their testing (as recommended by the Centre). Rigorous contact tracing of positive cases—especially in areas with a high degree of RAT positivity, which means a high likelihood of a great many number of cases getting missed—will also need to be done.

Beyond this, the states need to step up vaccination efforts, especially in high-incidence districts. As per Our World In Data, the seven-day rolling average for daily vaccine doses administered in the country was 1.8 million on March 29; at this rate, covering the remainder of the population would take more than two years!

To that end, the health ministry did well to speak of the need to increase private sector involvement in its weekly briefing on Tuesday. But, the fact is states have little maneuvering room on this, since the Centre’s price capping—vaccination costs are capped at `250 in private hospitals—and reluctance to leave distribution to the open market act as serious disincentives for the private sector to be invested in the effort. This is where the Centre must get its act together.

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