Not allowing testing is endangering citizen’s lives; and they have a fundamental right to have themselves tested
Given the sustained rise in Covid-19 infections—from 606 on March 25 to 2,16,000 on June 4—despite a fairly strict lockdown in which most offices/shops were shut for 68 days, any responsible government would dramatically increase testing to identify the highest at-risk people/areas in order to prevent the spread of the infection. This means a ramping up of RT-PCR tests for individuals as well as pooled tests of communities and extensive serological surveys to test the levels of antibodies in people in different parts of the country.
Even though the central government has ramped up testing levels, the current levels are far from those in other countries—India does 3,077 tests per million people versus 57,814 in the US, which, as it happens, probably needs much less tests given the density of population is nowhere as high as India’s. Indeed, despite the Indian Council for Medical Research (ICMR) saying that 70-80% of those with Covid-19 were asymptomatic, its guidelines were aimed at testing as few asymptomatic people as possible.
The guidelines may have made sense when the number of testing kits were in short supply, but they make little sense today. The guidelines say that symptomatic people can be tested, as can those with Severe Acute Respiratory Infection, etc, and say “asymptomatic direct and high-risk contacts of a confirmed case to be tested once between day 5 and day 10 of coming into contact”. Why a distinction was made between asymptomatic ‘direct’ and ‘high-risk’ contacts is unclear.
If the ICMR guidelines made little sense in a situation where the bulk of those infected are asymptomatic, the Delhi government decided to make these even more stringent. Its June 2 guidelines removed any reference to ‘asymptomatic’ people who had come into contact with a Covid patient and replaced this with “direct and high-risk contacts”, and this was defined in parentheses as those who were “diabetic, (had) hypertension (or were) cancer patient and senior citizen”. To put this in context, if a 40-year old male contracts Covid-19, his wife—who is roughly his age—cannot be tested if she is asymptomatic and does not have diabetes, hypertension, or cancer.
With such guidelines, it is hardly surprising Covid-19 has spread so fast in both India and Delhi. What makes matters much worse in the case of Delhi is that, as our front-page story points out, the capital gets around 20 new cases for every 100 new tests it carries out. The number jumps to around 38% if you go by data given to the High Court: why Delhi is allowed to present two sets of data is another area of concern since incorrect data makes any accurate forecasting impossible.
And yet, despite all evidence pointing to the need to ramp up testing in a big way, the Delhi government has issued a show-cause notice to eight of the city’s 40 private labs for testing asymptomatic people; some have been asked to shut down their Covid testing immediately. As it happens, Delhi accounts for 10.7% of India’s Covid-19 infections, but just 5.6% of its tests.
If infections keep rising at the current rate—Delhi registered a daily growth rate of 6.3% since June 1—the capital will have 8 lakh cases by July end. Even if 60% of those are active, there will be 4.8 lakh cases. With a 22% hospitalisation rate, Delhi will need 1.06 lakh beds and 3,353 ventilators; even if you assume, incorrectly, that all hospital beds in the capital can be used for Covid-19 patients, CDDEP data puts Delhi’s hospital bed capacity at 42,000.
Given every citizen has a fundamental right to know whether she is infected – are dengue and cholesterol tests to be banned next? – the ICMR and Delhi rules need to be challenged in the Supreme Court at the earliest.