Updated: February 13, 2021 12:02:41 pm
THE FIRST red flags came six months ago. In August 2020 when Covid testing was suddenly ramped up as infections began to soar across the country. In Bihar, Katihar led the way with around 3,000 samples a day that month, opening up a wide gap with others that were testing “barely 700-1,000 per day”.
“After Katihar, a meeting of District Magistrates was called in Patna, where all DMs were asked to increase testing. Around that time, Antigen testing had begun and kits were being supplied in bulk to districts. A few other districts started following Katihar’s example, and there was pressure on other districts to increase testing,” a senior official, who attended the meeting, told The Indian Express.
“The DMs were asked to put in extra effort… But some of them pointed out that they did not have enough lab technicians to conduct the testing. All the 38 districts were then given 20-25 additional lab technicians and that was when testing really increased,” the official, who still tracks testing at the district level, said.
By the end of July, India had begun reporting more than 50,000 new cases every day, and over 70,000 a day by August-end. August was also the time when the numbers started swelling in Bihar. The state was routinely reporting more than 3,000 cases a day, hitting a peak of 4,071 on August 11.
A key subsequent turning point, the official said, was the Bihar Assembly elections in October-November. “The expected spike in cases did not happen, people stopped turning up for testing and manipulation of data started in a bigger way to make up the numbers,” the official said.
This, officials said, could also have paved the way for staff at Primary Health Centres where testing is done to inflate numbers by entering fake names and fudging contact details on a large scale — as revealed in the investigation by The Indian Express, which tracked 885 entries for tests in January from six PHCs in Jamui, Sheikhpura and Patna to find several cases where data was allegedly fudged, including mobile numbers, which is a key tool to trace those tested.
The investigation also found that in some cases, this was done to siphon off profits from unused testing kits with PHC staff allegedly colluding with suppliers to procure less number of kits but showing inflated data to meet daily targets.
On Thursday, the Bihar government ordered a probe into these findings. The probe is also expected to cover allegations of kits being tampered with to inflate Covid-negative numbers or destroyed by PHC staff who allegedly filled in fake data instead.
Asked to suggest a solution, the senior official said: “It would have been better if Covid testing had been linked to a valid ID document, Aadhaar, PAN card, driving licence or even bank account number.” The suggestion was echoed in the Rajya Sabha Friday by RJD MP Manoj Jha, who cited the findings of The Indian Express and sought a high-level probe by the Centre into the gaps in data.
Bihar had been testing less than 10,000 samples per day till the middle of July last year. But within a month, by mid-August, the numbers had crossed 1 lakh a day. In September and October, the state was routinely testing around 1.5 lakh samples per day before the number dipped below 1 lakh in January.
During its investigation, The Indian Express spoke to several PHC staffers in the three districts. Many of them said it is “easier” to manipulate Antigen test data. “At our PHC, we have to conduct 100 to 300 Antigen tests per day… We have liberty with Antigen tests as the samples do not need to be sent anywhere unlike for RT-PCR tests, which require specialised equipment and labs,” said a staffer in Sheikhpura.
“Between July and October, Covid test kits were in great demand. With some private labs being allowed to test since mid-July, it became easier to find buyers for unused government test kits in the open market,” a staffer at a PHC in Jamui said. The cost of an Antigen kit for one test in the open market is anywhere between Rs 100 and Rs 600, depending on the manufacturer.
Other senior state officials point out that the procurement of testing kits involves several layers of people and processes that make it difficult to keep track.
The Indian Express found that the journey of these kits — RT-PCR and Rapid Antigen — begins from warehouses in Patna, Purnea and other district headquarters of the Bihar Medical Services and Infrastructure Corporation Limited (BMSICL), a state government body.
“Our job is only to send Covid test kits to warehouses of the districts. From there onwards, it is the responsibility of the district health set-up to distribute it among PHCs,” Dr Vishwaprakash Pradhan, DGM (Drugs), BMSICL, told The Indian Express.
It is from this point that multiple layers come into play. A team led by the civil surgeon of a district, and assisted by the district programme manager, deputes district warehouse staffers to take the test kits to PHCs or ensure that PHCs arrange vehicles to get the kits.
According to procurement norms, the medical officer in-charge of a PHC has to send a requisition to the district warehouse for the number of kits required for a fortnight. “The supply can be staggered, depending on the convenience of a PHC and district warehouse,” said a district official.
While block health managers coordinate between a PHC and a warehouse for procurement, there are several others involved in the process, including keeping a tab on kits: from store keepers, lab technicians, accountants and medical officer in charge of a PHC to block health managers, block accounts managers and store keepers of district warehouses.
“District programme managers and civil surgeons are the overall nodal officers to monitor the entire process. But there are so many layers, it is not easy,” the official said.
The lack of oversight is evident in the testing records. Some of the mobile numbers used against entries were from other states, including UP and Jharkhand.
Dhanbad-based lawyer Shadab Ansari said he received 14 SMSes on his mobile number on December 18 last year, related to Covid tests conducted by the Bihar government. “I did not raise an alarm, but figured there was some data fudging going on…I don’t know how my mobile number entered the records. I have not visited Bihar in the last 10 years,” he said.
Each message included an ID as well as an OTP with a link to Bihar’s Covid management app, Sanjivan. The Indian Express downloaded the app and used the OTPs to track the linked records. They were for Antigen tests conducted on various residents of Champapur in Bihar’s Bhagalpur district — from a 40-year-old man to a three-year-old child.
Ansari said he didn’t know any of them. All the test results were negative.
(With Abhishek Angad in Ranchi)
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