Playing with fire: Telangana 'tests negative' in COVID-19 testing

What is wrong with Telangana’s strategy to contain the spread of coronavirus? The state has drawn all-round flak for its poor testing record and alleged under-reporting of COVID-19 cases.

As it has reported 1,700 positive cases and 45 deaths due to COVID-19, the Telangana Rashtra Samithi (TRS) government has come under criticism from opposition parties, medical experts and health activists for being complacent and casual about the crisis.

After the Centre openly expressed displeasure over the lack of “pro-active testing” in the state, it is now the turn of the Telangana High Court to pull up the TRS government over its poor track record. The Court has directed the government to allow authorised private labs to conduct coronavirus tests and private hospitals to treat such patients.

Lowest testing rate

With one of the lowest testing rates in the country, Telangana may well be sitting on a huge crisis. According to the latest data, it has conducted 652 tests per million population, compared to the national average of around 1,600.

As of May 14, the state had conducted just 22,842 tests, which was among the lowest in the country. It was even lower than the tests conducted by Chhattisgarh and Assam, both of which had less than 100 cases on May 14.

This roughly translates to an average of over 200 tests a day, making it the lowest among the southern states. Telangana had conducted only about 3,500 tests in the first two weeks of May even as its capital Hyderabad was labelled a virus hotspot by the Union Health Ministry.

Neighbouring Andhra Pradesh had, by then, conducted 2.1 lakh tests—almost ten times more than Telangana. Tamil Nadu had conducted more than 2.9 lakh tests.

“Testing-wise, a lot needs to be done here. The Greater Hyderabad Municipal Corporation has a lot of containment zones,” Dr Sanjeev Singh Yadav, secretary of the Telangana unit of the Indian Medical Association (IMA) said.

The Doctors for Sewa, an NGO of medical experts, had submitted a representation to the Inter-Ministerial Central Team last month, highlighting the low testing rate in the state.

Scientists and experts stress more and more testing as it usually results in finding more positive cases. Limited testing would lead to an explosion of cases at a later stage. Telangana is the only major state that does not reveal its testing numbers in the daily bulletin.

‘Do we get medals?’

“Do we get medals for testing more?” is the usual refrain of KT Rama Rao, the most visible minister in his father K Chandrasekhar Rao’s cabinet, whenever a question on testing is posed to him.

The Chief Minister himself has been quite evasive on the question during his media interactions. Health Minister Etela Rajender has asserted that the state was only following the guidelines of the Indian Council of Medical Research (ICMR) by testing people who show up with clear symptoms of coronavirus.

“Asymptomatic persons even in zones where COVID-19 positive cases have been reported are not being tested. We will not know whether the virus is spreading if there is no testing. The state is also not testing bodies, so we won’t know if they died of coronavirus,” said Dr G Veda Prakash, a member of Doctors for Sewa.

Recently, Union Health Secretary Preeti Sudan had written to Telangana Chief Secretary Somesh Kumar, saying that the state should not allow “the virus to chase us” when “we need to chase the virus”.

According to the Health Ministry, the number of tests carried out by the state made up only 1.5 per cent of the over 14 lakh RT-PCR (real-time polymerase chain reaction) tests carried out across the country.

The Centre has expressed concern that the percentage of people testing positive to the total tests is 5.26 per cent in Telangana as against 4.12 per cent in the country. More RT-PCR tests will help identify more positive cases and contain the spread of the pandemic.

The Union Health Secretary was also critical of the state not using private laboratories for RT-PCR testing.

Court directive

The Telangana High Court last week directed the government to conduct tests on bodies. The order came on two Public Interest Litigations (PILs) filed by activists against a circular issued by the Director of Medical Education not to conduct tests on bodies.

A bench, comprising Chief Justice Raghavendra Singh Chauhan and Justice B Vijaysen Reddy, asked the government to explain its logic behind poor testing.

The court noted that health experts had been asking governments to ramp up testing. At such a crucial juncture, it sought to know why Telangana decided to decrease the number of tests each day.

The court also pulled up the government for insisting that people should get tested only at the state-owned labs and go for treatment only at government hospitals.

Setting aside the government order authorising only state-run hospitals to conduct tests, the court ruled that citizens have the right to undergo tests and get treatment at private hospitals if they could afford.

Political heat

The Opposition Congress and BJP have stepped up their attack on the government over its handling of the pandemic.

“We have complained to the Centre how the TRS government had misled the Central team that had visited Telangana to take stock of the measures to contain COVID-19,” state BJP president and MP Bandi Sanjay said.

State Congress president N Uttam Kumar Reddy said while the World Health Organisation (WHO) had been advocating a three-pronged strategy of ‘Trace, Test and Treat’, the state government had adopted a strange policy of not conducting the tests even for suspects and secondary contacts.

The government has also not allowed even ICMR-approved private labs to conduct coronavirus tests, he pointed out.

“There are many instances where even patients with bilateral pneumonia are not being tested. ICMR guidelines clearly suggest that all ICU patients need to be tested for COVID-19. This is not being done in Telangana now,’’ a statement from Doctors for Sewa said.