State officials say Bihar is now carrying out 1.5 lakh tests a day against 17,000 daily tests in the last week of July. Despite the nine-fold increase in testing, the number of people testing positive each day has fallen from 17 percent in late July to just 1.4 percent now.
On September 7, addressing his first virtual rally ahead of the Bihar assembly polls, scheduled for later this year, Chief Minister Nitish Kumar said his government was fighting the coronavirus pandemic at every level. Kumar, the Janata Dal (United) president, said his government had kept in place enough ICU beds and ventilators besides ramping up testing.
“As for Covid-19 preparations, we are conducting over 1.5 lakh tests per day. We are now conducting tests of 32,233 people per 10 lakh population,” Kumar said.
Stunning Covid-19 management indices
Frequently Asked Questions
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Vaccine development is a long, complex process. Unlike drugs that are given to people with a diseased, vaccines are given to healthy people and also vulnerable sections such as children, pregnant women and the elderly. So rigorous tests are compulsory. History says that the fastest time it took to develop a vaccine is five years, but it usually takes double or sometimes triple that time.
Going by the official figures, the indices tracking the coronavirus spread in the poll-bound state appear to be way better than those of other states and even the national average, in some aspects. The improvement has been reported in the past few weeks, as the polls, to be held before November 29 when the term of the assembly expires, draw close.
Sample this: On September 18, the recovery rate (number of patients getting treated and recovering) of Bihar was 91.4 percent, as per Union Health Ministry numbers.
As many as 1,50,040 patients of the 1,64,051 Covid-19 positive people had recovered. The state’s recovery rate is among the best in the country. Only Andaman and Nicobar has a better recovery rate of 93.7 percent. The national recovery rate on September 18 was 78.86 percent.
In the first week of August, the state’s recovery rate was hovering around 65 percent. Also, Bihar’s fatality rate of 0.57 percent (number of people who die among those infected) is lower than the national fatality rate of 1.6 percent.
Already grappling with the Covid-19 pandemic, Bihar faced another challenge due to the floods in July and August, a few weeks after migrants had started travelling to their homes. The pandemic was supposed to get worse. But Bihar didn’t do badly in arresting its spread, at least, going by the numbers. With 13,156 active cases, Bihar is at number 20 among states in terms of the number of active patients.
The Union Health Ministry’s assessment says that the overall test positivity rate of below 5 percent and a fatality rate of less than 1 percent show that a state has a grip over the pandemic.
“The continuous streak of very high levels of recoveries is the testimony of the effective clinical management and treatment protocols,” said a Health Ministry official.
Unusual: As testing rises, positivity rate falls
The state government cites ramped-up testing as one of the reasons for the improvement in the situation. “In the last week of July we faced criticism for not being able to control the situation. The government had marathon meetings and we reached the conclusion that testing has to be increased. For the last one week, Bihar has done more than 1.5 lakh tests per day. We have increased the number of labs, too,” said Dr Ragini Mishra, state surveillance officer.
From the last week of July (17,000 tests per day) the state has increased testing. Over the last one week, Bihar has been carrying out an average of 1.1 lakh tests per day. But these are mostly antigen tests, which are more likely to have false negatives. While Uttar Pradesh has done 75 lakh, the highest in the country so far, Bihar is next with 53 lakh tests.
More testing would normally mean more cases. But not, it seems, in Bihar. The state’s daily positivity rate, which is the number of people who test positive among those tested, is 1.4 percent. This was 10 percent in the first week of August and 17 percent in late July. The national daily test positivity rate is 8.6 percent.
Sources within the Bihar government said the state started pulling up its socks after July, keeping the polls in mind. Facing criticism over its poor management of the pandemic, the Bihar government removed health secretary Uday Singh Kumawat on July 30. Kumawat was replaced by Pratyay Amrit, a 1991-batch IAS officer known to be close to CM Kumar. Amrit was Bihar’s third health secretary in less than two months. The government also transferred seven IAS officers around the same time.
“Not just the labs, testing kits were placed in the remotest areas for early detection of infections,” said a Bihar government official.
Doubts over numbers
Some experts, however, have hinted at the manipulation of Covid numbers by the state.
“Reports from the ground have not just brought to light the shortages of health infrastructure and overworked health workers but also exposed the gross underreporting of Covid-19-related cases,” wrote Richa Chintan of People’s Health Movement, in a recent article on the newsclick website.
Others, however, credit ramped-up testing of the wider population for the improvement in numbers.
“I think this indicates that with the increase in the number of tests being done, it is not just those who are symptomatic or have been exposed to infection who are being tested but a wider population, which is why the test positivity rate has fallen,” said Dr Anant Bhan, a specialist in global health and policy.
“Also, it is likely the medical care available has been ramped up recently and also more individuals with milder or asymptomatic infections are being identified and managed, influencing the recovery rate,” he said.
The state’s health indices and its underperformance in terms of expenditure on health and related infrastructure are an open secret.
Among the states, Bihar has the poorest doctor-people ratio, says the National Health Profile, 2019, released by the Indian Council of Medical Research (ICMR). With 2,792 allopathic doctors, the state has one doctor for every 43,788 people. The WHO recommends at least one doctor for 1,000 people.
Public documents reveal that 3.94 percent of the state’s total expenditure was on health in 2018-19, which was the second-lowest after Haryana. The state allocated 4.6 percent of its expenditure towards health in 2019-20, less than the average allocation of 5.2 percent in the previous fiscal year.
Also, Bihar’s per-capita expenditure on health is lowest at Rs 495. The state has an acute shortage of government hospital beds, with just 0.11 beds available per 1,000 people, the National Health Profile 2019 indicated.
(Ritesh Presswala contributed to the article)Follow our full coverage on COVID-19 here.