India recorded 9,962 new cases of the coronavirus disease on Thursday. It may or may not cross 10,000 cases on Friday (Editor’s note: it did not; India saw 9,398 new cases on Friday). With the numbers continuing to rise – the country has added roughly 50% of its cases in the past fortnight – it is time to revisit some questions.
1. Is there community transmission?
The ministry of health has continued to insist there isn’t, but with a total of 236,037 cases as of Friday, it is time to accept that in hot spots such as Delhi, Mumbai and Chennai, there is community transmission. Studies in India have shown that around 28% of the people infected with the Sars-CoV-2 virus are asymptomatic. Globally, this proportion is around a third of the infected. Many others show mild symptoms and shrug it off. The positivity rate (positive tests to total number of tests) continues to rise or, at worst, stay the same in many states, especially those with a high caseload. We can continue to define community transmission restrictively, and insist that the pandemic has still not reached that stage in India, but it is perhaps time to accept the truth and move on. It is not going to change anything.
2. Do we have enough hospital beds?
This is a tricky question – simply because anecdotal evidence from two cities with a high caseload, Delhi and Mumbai, seems to suggest that we do not. Sure, on paper, there are enough hospital beds, but the honest way of framing this question would be whether everyone who is sick enough to be hospitalised (and who wants to be hospitalised) manages to get admitted to a hospital. The straight answer to that question would be: not always. Some do; others do, but after a long wait; and still others do not. India is not unique in this aspect. The health care systems of even the UK and the US were overwhelmed by Covid-19. And these were in better shape to begin with. May be states should declare more hospitals as dedicated Covid-19 facilities (as Delhi has done). And maybe they need to figure out a way of ensuring that high-risk patients (senior citizens and those with other ailments) get priority.
3. Is it easy to get tested?
The short answer to that would be: Ha!
The long one would be that between restrictive and limiting guidelines, long waits, and delayed results, it isn’t. India hasn’t changed its testing protocol since the middle of May. It is perhaps time that it did, making it easier to get tested. Unless there is a problem of capacity when it comes to laboratories and testing kits – which the health ministry and the Indian Council of Medical Research (ICMR) have repeatedly assured us is not the case.
India’s health care system (especially its public health care system) has for long been characterised by selfless health care workers labouring to do their best with inadequate infrastructure. Decades of low public investment in health care cannot be wished away by a few weeks of planning and emergency spending. Ergo, difficulties experienced in getting tested or finding a hospital bed are understandable. What isn’t understandable is the refrain from governments that there is no problem either with testing or with hospital admissions. Reports, including some carried by Hindustan Times, clearly point to a gap between what governments say is available in terms of testing and hospital capacity and what people say they have access to. It is time to address this gap now – by using technology to allot testing slots and hospital beds, and by aggressively expanding capacity. There is a very good reason to: the trajectory of the pandemic in India shows that it is yet to hit its peak here.