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‘Increased testing or well-behaving virus?’: What’s behind J-K’s declining Covid-19 numbers
Bhupinder Kumar, in-charge Covid mitigation,said that testing rates in Jammu and Kashmir have been one of the highest in the country which helped in curbing the spread of infection.
Jammu and Kashmir has apparently witnessed a substantial drop in its average daily number of Covid-19 cases reported in October.
While the authorities are upbeat, some doctors are not enthused attributing the decrease to the increasing use of RAT tests instead of much reliable RT-PCR. Others say that the virus was “behaving well”.
As against an average of 1,245 daily cases of Covid-19 in September, October has recorded slightly more than half of that which is around 699 average cases daily till date.
In terms of fatalities also, the average daily deaths in October have been around 11 as against 16 in September. In September, 478 patients lost their lives while this month, till October 19, the number stood at 207.
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“There is a definite reduction in the number of cases this month. Death rate is a good indicator. The number of fatalities has also gone down. Visibly, the trend is downwards,” said Bhupinder Kumar, mission director, National Health Mission (NHM) and in-charge Covid mitigation.
Kumar said that the testing rates in Jammu and Kashmir have been one of the highest in the country which allowed them to stop the spread from those which would have remained undetected. “We test around 25,000 persons every day on an average,” he said. “Besides, patients’ management at home, as well as in hospitals, was streamlined”.
Most of these tests have been done using the RAT (Rapid antigen tests).
“Three-fourth of the testing has been done using the RAT while 25 percent is through RT-PCR (Reverse transcription-polymerase chain reaction),” he said.
The total number of tests conducted in the Union territory till October 19 crossed 20.23 lakh of which 88,369 tested positive and 1,388 patients had died. The overall recoveries have reached 78,667 which account for a recovery rate of 89.0 percent, the highest so far.
However, the use of the RAT has been criticised by one of the factions of the Doctors Association of Kashmir (DAK). It has said that the rapid antigen tests were hiding the region’s Covid-19 numbers.
“One in two persons infected with the novel coronavirus receive false-negative results by rapid antigen test,” said DAK president and influenza expert Dr Nisar ul Hassan.
He said, while rapid tests provide results in minutes, they are far less accurate than the gold standard RT-PCR.
The specificity rate - or the ability to find those not having the virus - of RT-PCR is high as against the RAT which is 50 percent. On the other hand, the sensitivity rate, the ability to find those having the disease, of the RAT is high as against RT PCR which is 67 percent.
However, the RAT provides results within 15 minutes while RT PCR takes at-least 24 hours.
“Not only do these rapid tests hinder the diagnosis in individual patients, but also obscure the true extent of the outbreak. We may feel the cases are falling and we have begun to flatten the curve, but the reduction in the positive cases can simply be due to unreliable testing,” Hassan said.
Kumar, however, disagreed with this analysis and said that the RAT positivity was also decreasing this month as against August and September.
“I would not deny that the sensitivity of the two tests is different, however, the RAT gives a scale of advantage owing to its readily available results. Besides, if we analyze the data, the positivity rate of the RAT tests was 10 percent in August and September which has come down to a large extent in October,” he said.
He said that the overall positivity rate stood at 4.7 percent in July, 5.3 percent in August and 5.7 percent in September. “It has come down to 3.5 percent in October (till October 16). The reality is that the span of infection has reduced,” he said.
Positivity rate is the number of people testing positive out of the total number of those tested.
Dr Muhammad Salim Khan, head of community medicine at Government Medical College, Srinagar, stated that the decrease in cases has not been substantial as the RAT testing has increased and sampling has gone down because of harvesting.
However, he stated there has been an incremental decrease in the number of sick people coming to hospitals irrespective of the testing.
“Invariably, the sick patients will land in hospitals with or without symptoms, or whatever the type of testing. Severe patients would not stop coming to hospitals whatever be the positivity rate. We have witnessed that there has been an incremental decrease in the severe patients landing in hospitals,” he said.
Qazi Haroon, state immunization officer on special duty for Covid-19 mitigation in Kashmir, said that the virus was “behaving well” now.
“Now the deaths are mostly those of co-morbid elderly. Earlier, even young patients would become its victims. The positivity rate and the fatalities are decreasing for the past three weeks. The virus is behaving well,” he said.
