There are countries where extensive contact tracing has helped break the transmission chain of the virus. Some focus only on the period after a patient becomes infected, others also do ‘retrospective tracing’ of a patient’s movements before she contracts the disease, to identify the places and people behind the infection. India’s performance has been subpar. So, after underlining that in some states contact tracing has not been undertaken with the required rigour, the Centre has reportedly asked all states to ensure contacts of at least 80% of new cases are traced and quarantined within 72 hours of testing positive. But is this too big an ask?
According to an ICMR study, between January and April, using both technology and a large battalion of government field staff, it was Karnataka near the top, testing 47 primary contacts per case compared to the national average of 6, Maharashtra’s 2.3, Delhi’s 2.1. But when the state let the ball drop and pulled back from testing, the infection spread worsened. This month has seen a massive spike and Bengaluru has become the state’s biggest epicentre. And the reality is that once case numbers surge, thorough contact tracing becomes a fairy tale. If Delhi was doing such a poor job of contact tracing when its confirmed cases had just crossed 3,500, it’s not practical to expect that it will do a better job at a lakh and counting.
Of course many parts of the country are at a stage where not only is the kind of contact tracing prescribed by the Centre doable, it will also help them avoid the fate of a Delhi, Mumbai, Bengaluru, Hyderabad. For example, India’s most populous state Uttar Pradesh should definitely take note. Between June 1 and July 4 an average of only 7 contacts was listed for patients in Lucknow and 10 in Agra. In doing much better the goal is to avoid community transmission, where the source of infection can no longer be known. This is indeed the lived experience of some of our biggest cities now, even if officials are loath to admit it.
In emerging hotspots like Bengaluru and Hyderabad, increased testing is the best hope. Mumbaikars can now be tested without a prescription in authorised labs. Sooner rather than later this service must be made available everywhere.
This piece appeared as an editorial opinion in the print edition of The Times of India.