Covid-19 Overview: Why Last Week's Data Is Of Concern And Where The Spikes And Plateaus Are Coming From

This week saw a slight rise in the number of Wuhan virus cases being reported across the nation. While the increase was less than daily numbers from the week before, this sustained rise across three consecutive days merits detailed investigation.

As we can see from the chart above, the consistent decline of daily cases (red curve) has eased off into a plateau, with a brief rise at the end. Similarly, the test positivity ratio (TPR; green curve) has started rising again after bottoming out.

Daily death data has been exhibiting fluctuations through June and July (black curve). This is primarily a function of some states revising their fatality tallies upwards. Still, a distinct downward trend is visible.

Testing levels (purple curve) are holding steady, which is a good sign, but the rate of decline of the cumulative positivity (CP; orange curve) is not as high as it should have been by this time, if June trends had been maintained.

All in all, a working inference is that while the second wave has abated from most of the country, it is still festering strongly enough in certain pockets, to potentially trigger a nasty third wave if we let down our guard. This threat is being exacerbated by reckless tourists crowding into cramped holiday spots, and an air of complacency on the street.

Therefore, the focus of this piece will be on where the dangers lie, why things are the way they are, and what state governments should do. The Prime Minister has already identified Maharashtra and Kerala as key provinces of grave concern, but these are not the only ones; there are other problem areas on the list as well.

As explained earlier by Swarajya, the most important monitoring parameter on date is the cumulative positivity of a state, rather than TPR, since CP is the best indicator of how exactly a state is fighting to eradicate the Wuhan virus. The standard thumb rule is that a state may be deemed to be in the clear if its CP is brought down to below the four-five per cent band.

However, as chart 2 above shows, a number of states are yet to hit that safety mark, even though their TPR has come down to below 1-2 per cent. This is both a cause for concern, and a warning to those states, that they had better girdle their administrative efforts if they are not to trigger a third wave nationally.

The cumulative positivity in Kerala, Maharashtra and West Bengal continue to hover near the 15 per cent mark. Karnataka and Andhra Pradesh, though lower, are still in the double digit band. The CP in Tamil Nadu and Odisha may have finally dipped into single digits, but at the rate at which declines are taking place, it is doubtful of they would hit the 4-5 per cent band before mid-August. That is a month too many.

The gravest concern continues to be Kerala, where the Pinarayi Vijayan government has demonstrated a persistent inability to bring case counts and positivities down.

Today, Kerala accounts for a full third of all cases reported in the country. Worse, daily cases (red curve) and the TPR (green curve) are rising to dangerous levels, rather than declining. It is frankly shocking that the TPR has remained consistently above 10 per cent for over a month now. Consequently, the CP is in an abominably high plateau, and does not look set to decline to the requisite mark for months. And this precarious state of affairs is being dangerously prolonged, simply because testing, tracing and isolation are just not being conducted competently, at necessary levels. Perhaps it is not long before the state’s borders are sealed, and the Centre takes over.

The third highest risk is posed by West Bengal. It may not seem so at first glance, since cases are down to about a thousand a day, and the TPR is at just 2 per cent. However, the biggest concern is a persistent decline in testing levels. It appears that the West Bengal government has chosen TPR as the principal monitoring parameter, rather than CP, and started to slacken off testing levels the moment TPR fell to around 5 per cent.

The state’s leadership may argue in return that this is needless fussing, since the CP too, is declining consistently. In that case, they would do well to look at the chart below, and note two points: declining testing levels are causing both case counts and the TPR to plateau, while holding the CP at a dangerously-high level for simply too long. The focus should be on denying reproductive space to the virus, so that it doesn’t mutate too much; so the sooner the West Bengal government realises that, and ramps up testing to at least 1.25 to 1.5 lakh tests a day for starters, the less of a threat they will be to residents in their jurisdiction, and the rest of the country.

Apart from these are the Northeastern states, where rising cases have pushed up the national tally. Here, terrain, logistics and remoteness are a real constraint in tackling the epidemic. The case counts may be small compared to large states, but they are gigantic when compared to the populations of the seven sisters. The TPR in Manipur is 16 per cent; in Sikkim it is 18 per cent; Mizoram reported over three hundred cases in the past 24 hours. And yet, the remedy is the same as for large states – aggressive testing, tracing, isolation and treatment. Size doesn’t matter.

Thus, the bottom line is that, the only way we can prevent a third wave, or at least stave it off, is by maintaining testing at peak levels, while the vaccination drive grinds on. Monitoring and inoculation have to move in tandem. So yes, there were severe bottlenecks in vaccine supply, which are now being gradually removed, but until the vaccine manufacturers come into their own, by August-September, the onus lies on the state governments, to maintain monitoring at peak levels, so that a nation-wide resurgence is inhibited.

All data from Covid19india.org.