Rates of testing low in India: Lancet

India’s sudden enforcement of the lockdown appeared to be “hastily prepared” and“disadvantaged” already vulnerable populations, the Lancet has said.

However, the good news is “the lockdown is already having the desired effect of flattening the epidemic curve,” it added.

According to the Lancet better planning could have helped avert the crisis. “There has been a mass exodus of migrant workers and concerns are rising about starvation among people who work in the informal economy. Implementing public health measures is difficult in places with overcrowded living conditions and inadequate hygiene and sanitation. Non-Covid-19 health services have been disrupted,” it said.

It said that some reports suggest that the government’s efforts to provide financial support and a measure of food security to ease these pressures will be insufficient to meet demand.

The pandemic has also been used to fan anti-Muslim sentiment and violence, after a gathering connected to the group Tablighi Jamaat was identified as being responsible for many cases, the Lancet has said.

The experts have recommended that testing needs to be expanded exponentially as well as strategically as a tool to provide epidemiological evidence. “India’s response has also been constrained by a shortage of health workers,” it said.

In India’s favour is its young population (65% aged <35 years) and, to date, a less severe pandemic than was feared.

However, it has cautioned that ongoing pandemic could be the much needed wake-up call to the necessity of long-term changes to India’s health system.

It said that the immediate challenge for India is to keep infections at manageable levels and ensure the ability to test, trace contacts, isolate patients, and disseminate timely information.

The experts said that states deserve much of the credit for India’s Covid-19 response and has advised that the central government should loosen its control and give more autonomy to the states over their funding and decision making.

It said that India should pay greater attention to the health sector and recognise the importance of having strong public sector capacity, especially in primary care and at the district level.

Citing that India’s public health-care system as underfunded (at just 1·28% of GDP), leaving primary care weak. In an editorial published in the British medical journal on Friday, it said India’s population of 1·3 billion across diverse states, health inequalities, widening economic and social disparities, and distinct cultural values present “unique challenges”.

The experts lauded the efforts of several states like Kerala which has been able to contain the infection, Odisha for its exposure to precious natural disasters, Maharastra which has used drones to monitor physical distancing during lockdown for physical distancing, have all resulted in containing the infection, “The premise relies on there not being community transmission, it said.

The report states that India’s rates of testing have been low (0·28 per 1000 people as of April 20), capacity issues, absence of political will, and operational feasibility have been to blame. However, efforts to reverse the situation are underway as hundreds of thousands of testing kits have become available, and more testing companies and laboratories have been approved, it further said.

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