Follow the Kerala model

Aakar Patel

The government says we averted between 37,000 and 71,000 deaths by having the nationwide lockdown. It says that studies show that India could have had between 14 lakh and 29 lakh COVID-19 cases to date if the two lockdowns had not been ordered. The government, or at least a member of the Niti Aayog in his individual capacity, also apologised for giving the impression in a slide shown on April 24, that new cases would be zero by now.

The Niti Aayog member said on Friday that “no one has ever said that the number of cases would go down to zero at a particular date, there is a misunderstanding, which needs to be corrected. For the misunderstanding, I feel sorry and apologise,” he said in a response to a question that sought an explanation.”

Based on the material it releases at its COVID press conferences, the government is focused on two things at the moment. One, the recovery rate is rising, and second that without the lockdown strategy of the Prime Minister India would be in big trouble. It is not focused on new cases perhaps on the assumption, as that slide had shown quite clearly, that the lockdowns would end or slow the rise in the numbers of those infected.

The recovery rate refers to the number of those people who caught the infection, were tested, proved positive and then after a period of time proved negative again. As of Saturday morning, around 1.25 lakh people had tested positive and of them 52,000 had recovered – meaning a little less than half. Globally 53 lakh people were infected and 21 lakh had recovered. The percentage of those recovered will keep rising in natural fashion till it is around 95% and perhaps even higher.

Why? Because the fatality rate of COVID, meaning the number of people who die from it is currently 6%. And most of these have been very old people with existing diseases who died in Europe and the United States. The fatality rate in India so far is around 3% and so at some point our ‘recovery rate’ should reach 97% even if the government does not do anything at all.

Remember that there is no cure for COVID-19. If you catch the infection, you can only wait for it to pass through you safely. And even this does not mean you are now COVID-free because re-infections have been reported widely. So it is not clear why the government keeps speaking of recovery rate except perhaps to reassure people.

The problem is that the number that is likely to be in the news from now on and for some time to come is that of new cases. This number of those people who are infected daily was around 2,000 at the beginning of May. It was around 4,000 daily last week. Now it is over 6,000. It is not showing any signs of flattening except in Kerala. With the lockdown open, more people will be tested and this number will go up for the next few weeks.

That is how it has been in all the other countries except those where voluntary actions by individuals, such as social distancing and masks and hand-washing has made the growth flat or put the new numbers in decline. There are 11 nations which have more than 1 lakh infections. Of these, only Brazil, India and Peru are showing a continued path of escalating cases. So how bad can it get? The United States has been reporting between 20,000 and 35,000 new cases a day each day for the last 50 days. And the US has done 1.4 crore tests, checking 42,000 people out of every 10 lakh. India has tested only 2,000 out of 10 lakh.

Can we tell that our lack of testing has meant that there are many infected people who do not know that they are infected? Yes. One way is to look at death rates, now that we have sufficient data. Gujarat has 13,000 infections and 800 deaths, a fatality that is twice the national average. This means that almost certainly, there at least another 13,000 infected people in Gujarat who have not been tested and don’t know they are infected.

These people, all the people going back to work now, all the migrants who have walked home and are going home now, all of them will act to push the daily rate every higher. At some point, this will peak and then the daily rate will start to drop as it has in every other country including the US and Italy and the UK, the worst hit nations. This rate of new daily cases is the only important metric. Not the imaginary numbers of people saved in the past and not the recovery rate, which will automatically rise. How soon can we start reducing the number of daily infections? Only Kerala knows that. It was among the states with most cases at the beginning of March but today has dropped to number 17. Its success has been acknowledged and covered globally, but it has not been referred to even once by the Prime Minister. What they are doing in that state is a model for the rest of us. It is the only state where new cases are not on the rise and where the total number of those currently infected is often lower on some days because of recovery.

How many of us know what they are doing which Maharashtra and Gujarat and Delhi are not? If the answer to that is not many, it is because the Union government has refused to acknowledge it has a role model in curbing daily new cases, the only meaningful metric in assessing the COVID epidemic.

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