Covid-19: Need regular sero-surveys, especially in big metros

A virus that kills 0.08% of the population is clearly not as deadly as one that kills 2.8% of those that it infects.

Though many are alarmed at the results of the ICMR serological survey—to see if people had developed antibodies to fight Covid-19—that said 0.73% (a little under one crore persons) of the population had been infected, the exercise is an important one as it helps fill critical gaps in the anti-Covid battle, including the critical issue of ‘community spread’. It also helps remove some of the fears over how deadly the virus is. While the ‘case fatality rate’—the number of deaths as a share of the those reported as infected—as revealed by the daily data the government puts out, is around 2.8% right now, the ICMR press statement talks of the ‘infection fatality rate’ being a much lower 0.08%.

This is got by dividing the current 8,103 Covid-19 deaths by one crore infected persons. A virus that kills 0.08% of the population is clearly not as deadly as one that kills 2.8% of those that it infects.

For the exercise to be even more useful, ICMR needs to conduct it regularly—say, once a month—and needs to give more data than it put out on Thursday. While Thursday’s press note talks of the survey being conducted in 83 districts, it also mentions that the data presented applies to just 65 districts; the press note put out on May 12 to announce the survey had talked of 69 districts, and these did not include Delhi and Mumbai that together account for 30% of India’s reported infections.

The 69 districts ICMR mentioned accounted for 13% of India’s infections on May 28 and this rose to 14.5% by June 10. It appears the detailed study—this is not yet complete—of the containment zones of hotspot cities includes Delhi and Mumbai (a total of 12 districts are being surveyed), but what is not clear is whether, once the results are out, this will change the overall 0.73% number for the country.

Also, when the survey is carried out regularly, this will give a clearer picture of whether the spread is increasing so that the authorities can better plan the infrastructure response.

While a much lower infection fatality rate is reason to celebrate, this hardly means India is out of the woods as it is clear that big cities like Delhi and Mumbai are unable to cope with the pressure on the health infrastructure. Indeed, a presentation by the Cabinet Secretary to state chief secretaries and health secretaries is quite scathing, The Indian Express reported. According to the Cabinet Secretary, Delhi would have run out of ventilators by June 12 and Maharashtra will do so by July 27; sadly, the presentation does not have more granular details at the level of, say, a Mumbai, Chennai or Kolkata.

Also, the presentation is based on the projected cases till June 30, not for July or August; in the case of Delhi, the June 30 projection is for 91,419 infections but the deputy chief minister has been talking of this going up to 550,000 cases by the end of July.

In which case, the Cabinet Secretary also needs to monitor the progress of the infrastructure-creation as well as the state’s capacity to deliver; FE has long been advocating asking the army to create several field hospitals at the earliest. And, the ICMR guideline on testing remains restrictive and clearly needs to be scrapped if testing is to rise to required levels.

To cite one example of the obvious gaps, while the number of Covid-19 cases have risen 9.9 times and the deaths 17 times in Delhi between April 30 and June 12, the number of beds have risen only 3.1 times and the tests 4.7 times. If local governments such as in Delhi need more money, this has to be provided immediately since it is clear the current equation is unacceptable.