The illusion of COVID control in Northeast

The projection made by the State Bank of India (SBI) that the third wave of COVID-19 may hit India in the second fortnight of August is going to keep north-eastern states on toes. A review of the prevailing situation by the Central government reveals that six states in the region still account for more than 46 of the 73 districts in the country with a current case positivity rate above 10 per cent. It is a worrying situation and calls for better management by the states in the region to prevent the third wave from triggering a full-blown health crisis. The Central government has pressed the alarm bell for the region and called for stricter containment measures to bring down the cases. Union Health Secretary writing to chief secretaries of these six states urging them to take immediate action to bring down the cases speaks volumes about the precarious situation. The Central government has rushed a team of health experts to Arunachal Pradesh as the state reported a weekly positivity rate of 16.2 per cent during the week ending on July 4 and a rise of 12 per cent in weekly new cases. Of the total 25 districts in the border state, 19 districts reported more than a 10 per cent positivity rate, which if not brought down, could prove to be disastrous. In Assam, the daily positivity rate remaining below 3 per cent has not lessened worries of the Central government as it observed that 29 of the state's 34 districts reported more than 100 new cases during the week from June 28-July 4. Data discrepancies resulting in a mismatch between the state and Central government data on COVID-19 cannot be ignored but the states in the region have been compelled to continue total or partial lockdown and other restrictive measures indicate that the region is far from breaking the transmission. The SBI Special Report titled "COVID-19: The race to finishing line!" cautions that global data showed that on an average third wave peak cases are around 1.7 times the peak cases of the second wave. Assam and other states in the region have added to healthcare infrastructure by increasing hospital beds, intensive care units, augmenting oxygen supply. The SBI's projection and the Central government's worries caution the north-eastern states against any sense of complacency over added health infrastructure leading to overlooking the potential rise in positive cases stretching the health system to the limit. Infections remaining high in the region when the rest of India is unlocking after a substantial decline in new cases has resulted in north-eastern states missing the momentum of revived economic activities in the country before it gets disrupted by a potential third wave of the pandemic. The onset of floods in Assam is going to put the COVID-stressed health system under more stress making the management of the double-disaster situations a challenging task. The Central government has emphasized the five-pronged strategy of "test-track-treat-vaccinate and adherence to the COVID-appropriate behaviour" apart from strict containment measures. While the states in the region have gradually scaled up testing, tracking and treatment, greater responsibility of vaccination lies with the Central government. The states have demonstrated the capacity to vaccinate more numbers of people with Assam leading the states by vaccinating more than 3 lakh beneficiaries on a single day. Failure on the part of the Central government to ensure steady supplies has reduced the vaccination momentum and the Health and Family Welfare Ministry will have to shoulder the responsibility to help the states implement the five-pronged strategy in earnest. The fifth strategy of "strict adherence to COVID-appropriate behaviour" remains the most important preventive strategy but the states have failed to enforce it miserably that allowed the virus to spread and cause a spike in new cases. The fresh rise in cases in Guwahati is a fallout of the irresponsible behaviour of a large number of people dropping facemasks, crowding in public places even when seven districts have been put under complete lockdown and inter-district passenger transport and movement of people continue to be suspended, curfew continues to be in force. There is standing order on the imposition of penalty for dropping facemasks and its enforcement becomes necessary if COVID-inappropriate behaviour poses serious public health risks through the spread of infection. The State government has to set the example by ensuring official visits of ministers for inspection or review of projects low key and preventing crowd of people to gather and grow in size during such visits. A comprehensive review of the current containment measures will help the states in the region to find out the critical gaps that have allowed the virus to sneak in and spread. The COVID-19 dashboards of these states providing improved data sets for more clarity on risk are critical to articulating the required response. This can be possible only if the north-eastern states can overcome the illusion of control.