The test positivity rate (TPR) has been spiralling above 22 per cent in Ahmedabad city since March last year, data accessed and analysed by The Indian Express has found. This is despite the Indian Council of Medical Research’s (ICMR) direction to maintain TPR – percentage of tested people turning out to be positive for Covid-19 infection – below five per cent by “testing, tracking and treating” as it was the only proven strategy to control the transmission of the disease.
The monthly TPR in the city, analysis of testing data maintained by AMC shows, had never dipped below five per cent between March 2020 and January this year. And the rate was the highest in June and July last year — above 22 and 21 per cent respectively.
Daily TPR for April this year, when the city witnessed a sharp surge in infection cases, showed a peak, touching almost 16 per cent on April 26. While the TPR has been recorded above five per cent since April 9, the number has been increasing by about two percentage points per day since April 16 when it was reported at 9.9 per cent and reached nearly 16 per cent just 10 days later.
Of the total 20,445 Covid-19 tests – both RT-PCR and RAT – conducted across Ahmedabad city, 1,296 people had turned positive on April 9. This jumped to 2,631 positive cases on April 15 when 23,177 RT-PCRs and RATs were conducted in the city.
On Tuesday, Ahmedabad city had 48,072 active cases. It had added 5,619 fresh cases till late Monday. “The positivity rate for Ahmedabad city is much higher than what is being shown in the government data. The daily hospitalisation rate is merely one of the reflections to this,” Dr Mukesh Maheshwari, co-ordinator Indian Medical Association (IMA) Gujarat branch said. Dr Maheshwari was also the vice-president of Ahmedabad Association of Pathology and Microbiology for two years before it was dissolved into Gujarat Association of Pathologists and Microbiologists.
A letter to Gujarat Chief Secretary Anil Mukim, dated March 20, 2021, by the Secretary Department of Health and Family Welfare, GoI, Rajesh Bhushan, following a visit of high-level multi-disciplinary central government team to Ahmedabad Municipal Corporation and Vadodara Municipal Corporation areas had recommended the state to ensure an increase in testing (as per ICMR guidance) and to couple with a low confirmation percentage of less than 5 per cent by imposing severe restrictions.
In a separate communication, dated March 19, Bhushan had informed Gujarat Chief Secretary Anil Mukim: “The state needs to ensure that an increase in testing (as per ICMR guidance) should be coupled with a low confirmation percentage of less than five per cent. Further, maintaining the ratio of RT-PCR vis-a-vis (rapid) antigen test to 70:30 is the key. Hence, the proportion of RT-PCR tests need to be significantly increased.”
The central government team, after assessing the ground situation in the cities of Ahmedabad and Vadodara, had also briefed Gujarat Principal Secretary (Health) Jayanti Ravi and Health Commissioner Jai Prakash Shivahare on their observations.
In a letter to Jayanti Ravi, dated March 30, Bhushan had reiterated “the state should aim at achieving test positivity rate below five per cent in each district duly focusing on increasing number of tests”. He specifically referred to the four districts of Ahmedabad, Surat, Vadodara and Rajkot as “among 46 districts of concern” where the state’s case load was as high as 77 per cent. Ninety-seven per cent deaths, the letter said, was also being reported from these four districts. The communication also stressed on maintaining at least 70 per cent RT-PCR tests.
An ICMR directive for 70:30 ratio of RT-PCRs and RATs also has not been maintained in Ahmedabad city, despite repeated communications from the Union health ministry. As per the state government’s own data, on April 10 the city conducted a total of 25,452 tests, of which only 8,797 (or 34.5 per cent) were RT-PCR and the remaining 16,655 were RAT. Just a day ago, the city had recorded 9,103 RT-PCR tests.
Only on two days April 16 and 12, the city maintained an RT-PCR test ratio of 59 per cent. Despite repeated warnings, the RT-PCR ratio maintained by AMC remained around 52 per cent on April 23.
TPR in state above 9%
The daily TPR in Gujarat has been on the rise. While on April 22 the TPR stood at around seven per cent, on April 25, when the state reported 14,296 new cases and tested 1.68 lakh samples, the overall daily TPR stood at 8.5 per cent. On April 26, when the state reported 14,340 cases and tested 1.59 lakh samples, the TPR stood at over nine per cent. The state’s share of RT-PCR tests has remained less than 40 per cent of the total 1.60 lakh-odd tests it conducts each day.
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