NEW DELHI: States that reimposed a lockdown to check the surge in Covid-19 cases and backed it up with aggressive testing managed to check the number of deaths, in some cases even brought it down, although in almost all the states there was a spike in fresh cases and active cases.
After India began the first phase of unlock on June 1, almost all states witnessed a surge in coronavirus cases. Alarmed, most reimposed a lockdown, largely localised, for a limited number of days and even periodic, such as Uttar Pradesh, where the relock is only on weekends.
This newspaper analysed if the relock had paid dividends, studying data of fresh daily cases, active cases and deaths during the relock period and the days preceding it.
The biggest finding from the relock is that states, cities and districts that augmented testing by over 20% were able to control casualty figures.
Of course, many other administrative steps were also at play, such as penalty for not wearing masks, ensuring door-to-door delivery of essential items, availability of well-maintained and well-stocked quarantine and medical facilities.
Maharashtra conducted 85% more tests during relock, Thiruvananthapuram 70%, Odisha 25% and Bihar 20%. The death rates either reduced substantially, as in the case of Bihar, or the growth rate was arrested, as in the case of Maharashtra.
In states where the testing rate was below 20% during relock, such as Assam 14%, Bengaluru 12% and Chennai 1.71%, the death rate seemed to go out of control, increasing by as much as seven times in Assam and 52% in Chennai.
As for active cases and fresh cases, except Thiruvananthapuram, there was a huge increase evrywhere, irrespective of the number of tests conducted. The findings on the death rate only seemed to support what public health experts and epidemiologists have argued, that lockdowns only work when they are localised and supplemented by a clear strategy of increased testing and isolation.
“The whole idea of a lockdown is to improve the health system’s capacity to respond. Increasing testing is an important component but each positive case needs to be acted upon with a strong public health response. So the states that have shown improvement in casualty figures would have not just increased testing but they must have also improved their public health response,” said Oomen John, a public health specialist at The George Institute for Global Health. In places where death rates came down significantly, the administration would have also identified people who were in close contact of those who tested positive, he said.
To get a sense of how the state performed during relock, data for 23 days between July 1 and July 23 and the preceding 23 days were analysed. From June 8 to 30, 4,17,098 tests were conducted, 31,215 active cases were detected and 4,795 deaths were recorded.
During relock from July 1 to 23, the tests increased to 7,71,831, the number of active cases doubled to 64,114 but most crucially, the death toll during this period went up only to 4,999, or an increase of only 4.25%. To better appreciate how the death rate was checked, data for 23 days before June 8, from May 16 to June 7, was also studied.
The death toll in Maharashtra during this period was 1,992. In the next 23 days, from June 8 to 30, the toll went up to 4,795, a rise of 140%. But the rate was sharply brought down to 4.25% after relock.
The Kerala capital was relocked from July 6 to July 28 and during this period it increased testing by 70%. The data analysed for 18 days from July 6 to July 23 and the previous 18 days from June 18 to July 5, showed that the active cases in the district reduced from 966 to 896. The new cases also came down marginally from 1,006 to 1,003. The district saw two deaths during the relock period.
The Nitish Kumar government ordered a relock from July 16 to 31. The data of the first eight days from July 16 to 23 showed that deaths have actually reduced by nearly 7%, from 59 to 55. During the relock, the state increased testing by 20%.
Odisha seems to be the exception to the general trend, where a 14-day lockdown has been enforced from July 18 onwards. Covid-19 data for six days from July 18 to July 23 was analysed and it was compared with the data during the preceding six-day period from July 12-July 17. While testing increased 23%, the death rate also went up by 50%. Active cases tripled while new cases went up by about 38%.
Assam was among the states where the testing percentage was low. The state capital, Guwahati, was relocked from June 28 to July 20 but it seemed to have little salutary effect, perhaps because testing increased by only 14.56%. The number of deaths during relock climbed seven-fold.
A similar trend was seen in Bengaluru. The Urban Bengaluru district was relocked from July 14 to 22. Testing increased by only 1.09% during this period while deaths climbed by 135%.
The Tamil Nadu capital was shut down again from June 27 to July 2. But it seemed to have little positive effect on deaths and daily new cases as testing increased by only 1.71% during this period.