January May Decide The End Of Pandemic

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It is somewhat intriguing to see Goa still not attaining the WHO benchmark of TPR of five per cent to be maintained for 14 consecutive days

Nandkumar M Kamat

People were genuinely concerned about the new Coronavirus infecting the highly respected former ex chief minister Pratapsingh Rane and his wife Princess of Sondur, Vijayadevi Rane. The full state wished them a rapid and complete recovery. Health Minister Vishwajit Rane, who, no doubt, has successfully led Goa in 2020 from the front in our battle against Covid-19, was absolutely right last week  when he had expressed the apprehensions about large scale violations of the Standard Operating Procedures (SOP).

If Goa needs to be free of the pandemic then the people and the visitors to the state and the Goa Police who are empowered to take action against the violators need to take his warnings and advice seriously because elsewhere in countries like UK, France, Spain, Italy and Sweden wherever people defied the SOP the virus returned with a vengeance and killed hundreds. On the contrary in New Zealand people and the government worked like a team to free their nation from Covid-19 and they could celebrate Xmas and the new year in a normal manner.

The good news on Covid-19 front is that the anticipated spikes in the new Covid-19 cases related to Xmas celebrations were absent as per the reports of tests received till January 3. Generally, it takes from minimum two, average six and maximum 12 days for anyone catching Covid-19 to produce a positive RT PCR test. So, if any Xmas related effect is to be seen then we still need to wait for a few more days.

Another encouraging development from December is that the test positivity rate (TPR) remained in single digits, always below 10 per cent and on more than five separate days came close to the WHO benchmark of five per cent. The TPR ranging between 3.6 to 9.8 per cent for the full month of December clearly signalled that the extent of the local community transmission was on gradual decline.

However, the expected rapid decline in the number of active cases is yet to be seen. It is somewhat intriguing to see Goa still not attaining the WHO benchmark of TPR of five per cent to be maintained for 14 consecutive days. Once that benchmark is achieved the economy can be truly opened. But there appears to be divergent threat perceptions in the cabinet because the government is under considerable pressure to permit business activity in the tourism and transportation sector.

The Chief Minister must have known that considering the number of tourists who had already entered Goa and were lodged in hundreds of hotels any declaration of “night curfew” would not have been effective as it would have been impossible for an already overstretched and fatigued police to enforce it. The Health Minister was more concerned about the possibility of a super spreading event and the impact of thousands of tourists violating the SOP on the local population.

With more than 51 thousand Covid-19 cases in 2020 and after crossing four lakhs RT PCR based tests there is a general feeling that the worst may be over for Goa. However, with December reporting more than 100 Covid-19 positive tourists it has to be seen now whether the new year celebrations and the entry of nearly a million domestic tourists last week result in incremental Covid-19 positive cases in the coming days. Considering the incubation period of Covid-19, we could anticipate a higher TPR from January 4 to 15. It is difficult to predict how any infected symptomatic or asymptomatic Covid-19 positive tourist could initiate new local community transmission. Nothing has been learnt from the “Mangor hill, Vasco” super spreader event in June 2020.

The TPR from December had clearly pointed out that the nature of new infections in January may decide the end of the pandemic. For this purpose, the most basic requirement is to maintain a higher testing rate which was ranging from 1000-1900 per day in December. The decision of the Health Minister to purchase more RT PCR machines is important because then the number of tests could be increased. Although these machines are very expensive there is no substitute for the state to become totally self reliant in rapid diagnosis of viral infections. RT PCR machines would be permanent bioanalytical assets in the state if maintained properly. Goa is far ahead of other states which are depending on antibody-based tests which are not very reliable. The second requirement is to achieve the WHO benchmark TPR of five percent or less for consecutive 14 days- something which is eluding Goa. The third requirement is to prevent and contain the new variants of Covid-19 of UK, Nigerian, South African origin. If detected such patients would need special isolation and quarantine.

At present Goa does not have facilities for pinpoint detection of any new Covid-19 variant. The fourth requirement is to collect and send preserved swab samples of local Covid-19 patients from different centres for sequencing and molecular identification.

State government has consistently avoided this since June 2020. We still don’t know whether RT PCR tests have failed to detect any new local Covid-19. It is just a matter of time that the Government of India would have to get this done as a national project. The fifth requirement is computation, calculation and declaration of the effective reproduction number or ‘R value’ which tells us if we are close to the end of the pandemic. If the R value is close to or less than one then it is good news. The health department is sitting over a mountain of data to calculate ‘R’ value but strangely there is no enthusiasm to complete this task. It need not be scared because for the country as a whole ‘R value ‘had reached less than one in December. The sixth requirement is to be totally transparent on the proposed anti Covid-19 vaccination drive instead of creating false hope among the people.

The last requirement is to ensure strict compliance of SOP especially wearing of the masks in public. The proposal of the government to increase the fine for violation needs to be enforced. Goa has been blessed by an unusually warm winter and low humidity which has inhibited the spread of Covid-19. These conditions may continue in January. By end of this month the picture would be very clear and people would know if the end of the pandemic is close. However, if the prediction of the Health Minister comes true then we may again have a situation like October, 2020.