Battling Covid. Data is key in Covid battle

The lack of “swachh statistics” is what is making it difficult for India to combat Covid-19 effectively. The second wave has proved to be devastating mainly because of lacunae in the database created by the Centre and States/UTs since March 2020, when the country was caught in the first wave. Data is vital for deciding on the necessary medical infrastructure required to battle the pandemic.

The Principal Scientific Advisor to the government has already issued a warning about the possibility of a third wave.

There has been under-reporting of Covid-19 infections, fatality rate and total number of deaths This is because of a weak data collection system.

Some of the glaring lapses are: (a) some of the Covid-19 positive cases and deaths under home quarantine or of those waiting outside hospitals are not being considered; (b) no information is collected and maintained of a patient from the stage of testing positive till the outcome of infection; and (c) there are cases which are negative in RT-PCR test but diagnosed as positive in CT-scan or chest X-ray. These cases are not included in official statistics.

Also, there are no estimates in the public domain on how much under-reporting is there due to the above factors. However, some researchers in the US and the EU have said that under-reporting of infections may be to the extent of 90 per cent, which means only one case out of 10 is reported.

Taking into account the huge rural population (about 70 per cent), where testing facilities are inadequate and people do not want to go for testing for fear of being hospitalised, these estimates may not be far-fetched.

An analysis of recent data shows that the second wave has gained traction much faster in rural than urban areas, thanks to the poor healthcare infrastructure there.

Also, the WHO recently asserted that the Covid-19 death toll globally is likely to be “significant under-count”; rather than the official figure of 3.4 million, it may be 6-8 million. Such under-counting would be true especially in India’s rural areas, where health officers ascribe deaths due to Covid-19 to co-morbidities. This is partly due to inadequate testing facilities or to showcase their efficient handling of the pandemic.

These outcomes should make India’s administrators and planners seriously look at the correctness our database.

The data on genome sequencing — that is, the trajectory of virus spread and its variants — is insufficient. Can we fight a war without proper surveillance and intelligence? Thus, a system which incorporates spread pattern of the virus needs to be designed.

India knew that B.1.1.7 is highly contagious and its so-called ‘variants of concern’ created huge spike in cases in the UK, Israel and the EU. Genomic sequencing is critical and the UK does it for 5-10 per cent of all infected cases, and the US for about 2 per cent. India does it in for insignificantly small fraction and, according to experts, the country has to increase it tenfold.

Vaccine requirement

Till today, there is no reliable statistics in the public domain on our requirement, procurement and management of vaccine doses. The Centre recently said that it would make available 200 crore vaccine doses during the five months August-December, by enhancing domestic production and though imports.

The country’s current production is just eight crore doses and the negotiations with foreign governments indicate that they may not be able to provide he desired quantity in time. How far India can ramp its production is also not clear. All this data must be available urgently for correct assessment.

Further, 200 crore doses only meets the requirement (two doses per person) of our adult population (18 years plus) of about 100 crores. What about 30-35 crore children below 18 years? In their case, a suitable vaccine is yet to be approved.

The Centre, without leaving it to the States, should come out with a clear-cut policy on how it plans to vaccinate at least 75-85 per cent of its population uniformly across age groups. According to the WHO, this level of vaccination is required to achieve herd immunity. The government should get this done by at least by the middle of next year and adequate finance must be provided for this.

Swachh statistics is the need of the hour and the Supreme Court appointed National Task force should be fully involved in monitoring Covid-19 statistics on a daily basis.

The writer is a former ISS and UN Consultant

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