While the central government and health experts have been pushing for aggressive testing, Mumbai, which accounts for 20 per cent of India’s Covid-19 case load, kept its testing numbers almost stagnant in May.
The city tested between 4,000 and 4,200 daily, even as the number of positive cases detected rose steadily. Mumbai has the capacity to carry out about 10,000 tests every day.
The city’s stagnant testing numbers were in sharp contrast to the daily testing figures for Maharashtra as a whole, which saw a 100 per cent jump over the same period — from 7,237 tests on May 1 to 14,504 tests on May 31.
This suggests that as Maharashtra increased its testing capacity, all of the new testing happened outside Mumbai. This is surprising, given that the problem is not as acute in other districts of the state.
Mumbai and Pune together account for 70 per cent of Maharashtra’s case load. But as of now, less than 50 per cent of the state’s tests are being carried out in these two cities.
Pune has been testing 1,200 to 1,500 samples every day. As a result, Mumbai’s share in the state’s testing declined from 55 per cent at the beginning of May to less than 30 per cent at the end.
“Earlier, in March, around 70-75 per cent of tests in Maharashtra were happening in Mumbai. From May onward, we have noticed a consistent decline. That is worrying,” a state health official said.
Experts underline that since most novel coronavirus infected people do not show symptoms, aggressive testing is the only way to identify and isolate them, so they do not transmit the virus to others.
Mumbai’s approach is more surprising because the positivity rate in the city has been increasing steadily. At the beginning of May, Mumbai reported around 750 positive cases every day; by the end of the month, this number had doubled to about 1,500. That gives the city a positivity rate of more than 35 per cent, the highest in the country.
India has an overall positivity rate of 5 per cent, and most other states are around the same number, although there are fluctuations in the daily rate. Cumulatively, Mumbai’s positivity rate is 20 per cent, data until June 1 show – much more than most other cities or states.
Dr Soumitra Ghosh of the Centre for Health, Policy, Planning and Management at the Tata Institute of Social Sciences (TISS), said Mumbai was taking a “conservative approach” – “The positivity rate is increasing, which means the incidence of the virus in the population is increasing. We will not be able to contain the virus if this approach continues.”
Maharashtra’s medical education secretary Sanjay Mukherjee told The Indian Express that the high positivity rate showed Mumbai was targeting its tests better.
But Dr T Sundararaman, former dean of TISS’s School of Health Systems Studies, said this also showed that Mumbai was not testing adequately outside the target group.
“This (the increasing positivity rate) shows that the virus is spreading fast in the community, and if we don’t test more we will miss out on several more positive cases,” he said.
Mumbai has adopted a targeted approach from the beginning, testing only the primary contacts of infected people, others who are showing symptoms, and frontline workers such as healthcare staff who are at the greatest risk of getting infected.
As per protocol, all high-risk contacts have to be tested, either after five days of quarantine when they develop symptoms, or at end of their quarantine period. The protocol mandates testing of all symptomatic cases, where fever, bodyache, cough, and breathlessness are reported.
The death audit committee in Mumbai has advised the government to test vulnerable sections, including senior citizens, pregnant women, high-risk contacts, and people with kidney or heart ailments, at the earliest.
According to Municipal Commissioner Iqbal Chahal, Mumbai is testing 13,400 per million population. Even though Mumbai (with 39,686 cases on May 31) has double the case load of Chennai (14,802), it is testing less than Chennai. Chennai is testing 15,500 per million population.
Asked why the number of tests have remained constant around 4,000, BMC’s Additional Municipal Commissioner Suresh Kakani said: “Earlier our contribution was more in state because other districts were not testing as many people. Now other districts have started testing too.”
Across India, 41.03 lakh people had been tested till June 1, according to Indian Council of Medical Research (ICMR) data. On Thursday night, the ICMR portal showed India’s total testing number as 42,42,718, with 1,39,485 samples having been tested over the previous 24 hours.
Maharashtra has 78 laboratories for Covid-19 testing, the most among Indian states. Until now, it has conducted 4.83 lakh tests, of which 2.02 lakh have been in Mumbai.
When contacted, BMC spokesperson Dr Daksha Shah said: “We did maximum testing from the very beginning and we are maintaining that. We now have more than 16 labs since March.”
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