The R-factor in COVID management

The decline in new COVID-19 positive cases is vital for reducing the pressure on the health system and emphasis by the Central government on a key indicator is going to put the states in the northeast region on toes. The Central government has alerted all states that an increase in R-factor or Reproduction number of COVID-19 spread in some of the states is a matter of concern and it must not rise above 1.0. The R-factor is an indicator of the ability of the COVID-19 virus to spread. Union Home Secretary Ajay Bhalla's advisory to all chief secretaries stating that R-factor above 1.0 is an indicator of the spread of the virus asking them to regulate crowded places indicates the precarious COVID-19 situation in the country. It also explains the slow pace of decline in positivity in north-eastern states and why the process of relaxing restrictions needs to be calibrated. News Agencies Press Trust of India and ANI have reported that research carried out by Chennai-based Institute of Mathematical Sciences revealed that R-factor for the country increased from 0.78 in June to 0.88 in the first week of July. The rise in the R-factor despite a decline in overall new positive cases has amplified worries of the Central government of a spike in infection if strict containments measures are not followed across the country. Sitabhra Sinha, who led the institute's research team has been quoted as saying that "for the northeastern states, the R for Manipur is 1.07, Meghalaya 0.92, Tripura 1.15, Mizoram 0.86, Arunachal Pradesh 1.14, Sikkim 0.88, Assam 0.86." Sinha was also quoted that "with a small difference of 0.1 in R, we will have twice the number of active cases in about two weeks." This should put all states in the region on maximum alert against laxity. The MHA advisory is a caution to the states in the region that decisions relating to easing COVID-19 restrictions must consider the R-factor and not just daily or weekly positivity rates. Even though R-factor for Assam, Mizoram, Sikkim and Meghalaya is hovering at less than 1.0, the rise in the national R-factor after the states started unlocking is an important lesson that it may rise above 1.0 and a fresh rise in infection if complacency sets in. R-factor of Manipur, Arunachal Pradesh and Tripura being higher than 1.0 these states recalibrating their containment strategies will be critical to check the spread of the virus. The MHA advisory follows a review meeting on the COVID-19 situation in the region taken by Prime Minister Narendra Modi with Chief Ministers of all North-eastern states. The Prime Minister emphasized increasing vaccination, reducing vaccine wastage, adopting micro-containment zone and adhering to all COVID related protocols. The Central government has rightly cautioned the states that the second wave is not yet over and COVID appropriate behaviour should follow along with testing, tracking, treating and vaccination. The MHA advisory has urged the states to make authorities concerned shall be made responsible for ensuring COVID appropriate behaviour in all crowded places such as marketplaces, malls, market complexes, weekly markets, restaurants, public transport, railway platforms and all other public places. Marriage functions in several places in Assam become a spreader of COVID-19 infections, such enforcement and strict measures have become necessary to prevent a section of irresponsible people from spreading infection when the government and rest of the society have joined hands to prevent a third wave of the pandemic. Authorities in some of the districts under total containment having been compelled to deploy police and paramilitary forces to keep people indoors speaks volumes about a section of the society still not realising the gravity of the situation. The Ministry of Health and Family Welfare has also cautioned that continued gross violation of COVID appropriate behaviour can nullify the gains so far and the third wave may be caused because of the complacency. A prolonged second wave in the state has adversely affected the state economy, education, and various development activities. Extension of inter-district transport and movement of people has become necessary to contain the spread of the virus, but it has caused immense financial hardships to transport owners and their employees. The clamour for financial support to transporters, tour operators, stakeholders in the hospitality sector, various small businesses, farm families, entrepreneurs will increase if the COVID situation shows no improvement and high R-factor prevent the states from easing the restrictions. All eyes will be on the ensuing Assam budget of the new state government if the state government will announce any such proposals for providing relief for COVID-impacted sectors. The Central government communique indicates that Assam and other states in the region will have to factor in the R-factor in containment strategy and weigh it against other COVID Dashboard indicators such as new cases, positivity rates, vaccination, and active caseloads for deciding the right containment strategy and measures.