Saturday marks a month since India was put under a nationwide lockdown, a period in which it has substantially slowed the growth of the Covid-19 outbreak, officials said on Friday, even as many unknowns continue to make it difficult to determine how long the shutdown will need to continue to avoid a flare-up of the disease.
Across the country, 1,408new cases were reported and 57 more died on Friday – taking total infections to 24,404and fatalities to 778. On March 25, the first day of the lockdown, India had 606 cases and 10 fatalities before all transport was banned, offices and schools closed, and people told to stay indoors unless they were out for essential purchases or services.
“If we go back to March 21, cases were doubling in around three days. An important turn came on March 23, after the Janta curfew. The direction changed and the doubling rate increased to five (days). By then, we already put in place travel restrictions and had created an environment of social distancing. There were some setbacks in between but from April 6, doubling time started improving,” said VK Paul, Niti Aayog member, during the government’s daily briefing.
India’s current doubling rate is 8.6 days, Paul added.
According to Paul, who also heads one of the high-level task forces coordinating the Covid-19 outbreak response, cases will decline and more gains will be reflected in the “first, maybe even second week of May”. “If we continued on the trajectory we were, there would have been 73,000 cases in the lockdown period. If we went on an exponential curve, cases would have been in lakhs by now”.
Experts, however, warned the numbers may not be an accurate representation of the outbreak. “Hospital-based testing is not required to be scaled up as it is need based, but public testing could be scaled up to get a better idea of the disease spread,” said Dr Chand Wattal, head of department of clinical microbiology at Sir Ganga Ram Hospital.
“However, one must also keep in mind that our positivity rate (number of positive cases per batch of tests) has been pretty much the same throughout, so if results are anything to go by we are not grossly under-testing either. We are dragging it (down), and it remains to be seen how far we manage like this,” he added.
According to the Indian Council of Medical Research data, the number of daily tests on Wednesday and Thursday were around 40,000 each. On March 25, this number was 20,864.
Testing per million people in India is less than 401 – a number that is among the world’s lowest — but it has constantly moved up. On March 31, it was just 27.
India’s testing strategy has been beset with problems of faulty kits – rapid testing kits that many states planned to deploy for community surveillance are now being revalidated after they showed huge variations — and tests using the conventional, and more reliable, swab technique routinely take 2-3 days to show results, complicating the next step of tracing, which makes containment of the disease tougher.
Test, trace, contain is largely seen by epidemiologists around the world as the bedrock of strategies countries can adopt to be able to look at lifting their lockdowns, a drastic measure that most countries were jolted into adopting in mid-March when infections began skyrocketing.
In terms of spread, infections were reported from 103 districts in 23 states when the lockdown began. According to latest health ministry data for which district information is available (17,250 of 24,404cases), infections are now in 426 districts.
India’s containment strategy hinges on dividing these districts into zones based on the number of cases reported in each. Hot spot ‘red’ zones are under the toughest curbs – with restricted access and most services, including essential ones, limited.
On April 15, the government announced that some relaxations, including for industries, will be allowed in low-risk areas starting April 20. But the response in these regions have remained tepid.
The lockdown has exacted unforeseen economic costs, with at least one in every four Indians in the working age now reporting they are unemployed. The Centre for Monitoring Indian Economy (CMIE) in the April 19 weekly unemployment estimates said the number stood at 26.2%, rising two percentage points from the previous week.
Unemployment rate in the week ending March 22 was 8.4%, according to CMIE, before it spiked to 23.8% within a week – confirming reports that hundreds of thousands, if not millions, of daily wage earners, factory workers and labourers lost their jobs due to the lockdown.
However, several western nations, such as the United States, show that the lives versus livelihoods debate is heavily tilted in the favour of continuing lockdowns. On Friday, the number of fatalities in the US crossed 50,000, the highest death toll for any country in the world.
Scientists are yet to determine more about the virus’s biology, particularly how fatal it is and what factors help or limit its spread. This, and the development of a vaccine that may yet be at least a year away, is crucial for officials to be able to decide reopening strategies.
Late on Thursday, Oxford University researchers gave the first shots of a potential vaccine to human subjects, even as reports came in of an antiviral drug — long seen as useful to treat Covid-19 patients — having failed in a randomised study.
