Sharp fall in COVID-19 positivity rate in near future unlikely
With the state election approaching, throwing to the winds appropriate behaviour will be the norm. And people, including those in the administration, are carrying out in the sly sporting activities, which is in clear violation of rules and liable to penalty.
There was a belief that with the slow lowering of the Positivity Rate (PR) in August, by the end of September it will go below five and normality restored, including opening of educational institutions. In fact almost all activities have slowly been opened up; not based on the data available but on perception; including the Ima Keithel on a regulated manner but educational institutions and sporting activities is still yet to be allowed to open properly; with educational institutions still physically not yet opened and recourse to virtual mode of learning still resorted, while for sporting activities no SOP is notified.
People including those in the administration are taking advantage by carrying out in the sly sporting activities, which were reported in the media; a clear violation of guidelines and liable to penalty. In some districts, even schools were reportedly opened and physical classes conducted, while many are taking tuition classes at home. This is highly undesirable and need immediate correction as it indicates utter lack of governance. Rule of law must be enforced though the government must be amenable to the voice of the people. The over-confidence that the government alone knows what is best for the people will ultimately destroy the system.
On September 1, 2021, the PR stood at 8.1 while on 30th it stood at 6.8 though there are a few days when it went down and on 22nd it stood even below 5 at 4.8. If district wise data for September 30 is taken, six districts have PR of less than five which are Jiribam, Kakching, Noney, Senapati, Tamenglong and Thoubal, but Pherzawl has a high PR of 23.5. By October 4, the number of districts with PR less than five increases and the districts are Chandel, Churachandpur, Imphal West, Jiribam, Kakching, Kamjong, Noney Senapati, Tamenglong, Tengnoupal, and Thoubal. Only five districts had PR above 5 which are Ukhrul at 13.4, Pherzawl at 12.5, Bishnupur at 9.2, Imphal East at 7.7 and Kangpokpi at 5.6. As regard mortality, during the month of September the total deaths are 73, of which 12 were vaccinated with single dose while 9 with both doses.
Mortality continues to be a problem with 6 deaths on 4th October. The data shows that breakthrough infection is not uncommon leading to deaths. The reason why the PR is still in a plateau is perhaps due to less testing with continued reliance on RAT; more opening up of activities, less vaccination, violation of appropriate behaviour, etc. In the visuals of any political meetings one sees many, including intending candidates and wannabe politicians without masks, giving a twist to the Government protocol on COVID appropriate behaviour. Similarly in Government functions, guidelines are observed more in breach.
On the vaccination front, September saw less vaccination as during the month only 35,345 received the first dose while 1,35,829 received the second dose. By September 03, the number of fully vaccinated was 4,79,276 which constitute only 24.73% of the target while those who have received the first dose inclusive of those who had got both the doses are 12,23,626 which constitute 63.19%. Despite Government’s efforts the turnout continues to be poor in the hills, except for a few districts with some showing abysmal low figures.
There is hardly any improvement in the Effective Reproduction Number (R), and in fact deteriorates from the week ending September 25 where 5 districts have R of 1, that is Jiribam, Noney, Pherzawl, Tengnoupal and Pherzawl. The R value for the state for the week ending October 2 continues to stand at 1.02 and only 4 districts have a value of 1 that is Jiribam, Kakching, Noney, and Thoubal while Ukhrul has the high of 1.11. There is a very slow and unsteady improvement during September. Government may perhaps look into the need to relax the restriction district wise rather than apply state wide restriction. Districts which has a R of less than 1 and a PR of less than 5 can be permitted to open schools and colleges with certain restrictions like wearing of masks, all eligible are vaccinated both doses, classes in phases, classes in the open, etc. Those districts which have R of 1 and above and with PR above 5 may be kept under more restrictions. If such an arrangement is made, those districts under stricter restrictions will be forced to try harder to improve.
Regarding opening of schools there are two diverse opinions. One which continues to emphasise on public exams contends that classes X and XII should be opened first followed by Classes IX and XII with lower classes following later. On the other hand, many including UNICEF indicates that non-cognitive learning is to be imparted at the young age and therefore lower classes must be opened first with the usual restrictions of teachers and staff fully vaccinated, basic appropriate behaviour is enforced, classes in smaller number and more classes in the open. This is supported by the data regarding the number of kids who have had severe infections and deaths.
Despite about 18 per cent of the positive cases are children during the second wave in the state, the number of severe cases among children is low and in total only 5 have reportedly succumbed to COVID-19. This author had communicated with friends residing in various countries and most of the developed countries starts the lower classes first and in fact many countries do not close the lower classes during the second wave, and if closed was for a limited period.
As regards, colleges and universities, where all involved are eligible for vaccination can be opened subject to that only those who are fully vaccinated are allowed to attend classes, subject to other protocols being strictly followed. This will put pressure on the unvaccinated to get it as soon as possible. At the entrance gate, anyone entering the campus must be checked about their vaccination status and only those who were fully vaccinated allowed entry, rest refused entry.
For the teachers and staff, those who cannot be vaccinated due to health conditions like organ transplants, etc may be allowed to involve in virtual classes from home and those who are eligible for vaccination but have not done so may be marked absent and the period deducted from the EL account. If there is no leave account, deduction from salary may be considered. This is not only for educational institutions but for all government institutions. One cannot be allowed to continue as lotus eaters for perpetuity.
The chances of either R or PR coming down sharply in the near future can be ruled out and may slightly increase, as with the election approaching; throwing to the winds the appropriate behaviour will be the norm. Drinking and eating together in groups which is still limited will open up.
Screening the variants is important as there are a few variants which may create problems like the mu variant of interest and others which are variants under monitoring like C.1.2 and R.1. Quite a few variants are under monitoring like B.1.427; B.1.429; B.1.466.2; B.1.1.318; B.1.1.519; C.36.3; B.1.214.2; B.1.1.523; B.1.619; B.1.620; B.1.617.1; B.1.526 and B.1.525. A few VOI like zeta, P.2; Theta and P.3 are no longer in the VUM category after close monitoring. The above list was just to give an example of the complexity of the mutations and the variants that are under monitoring to assess their virulence and ability to escape immune response mechanism.
Manipur also need to follow strict clamp down when a new variant is noticed in the location where such variants were detected as done in many countries such as New Zealand, Singapore, Taiwan, South Korean, China, etc. No state wide restriction is called for. One major worry is that despite claim that RT-PCR is the gold standard for testing, new variants may be able to escape detection and for all practical purposes despite claim its sensitivity is only about 80%.
With no sero-survey carried out in the state, it is not clear how much of the population has the antibody specific to SARS-CoV-2. The latest national survey indicate that about two third of the population has the antibody, indicating that the spread of infection is much higher than what is reported after detection through the various tests. This on the other hand also indicate the size of the population which are better protected from severe infection and if this information is available for the state and if possible district wise; calibrated response could be worked out including the opening of the PHSMs.
Government need to think about the opening of the educational institutions and sporting activities as without these, children and youth will become more asocial as psycho-social skills are not being learnt and may indulge in more risky behaviour as their energy is not being utilised properly and may be misdirected. A more holistic approach is called for rather than a mechanical and compartmental response.
(The views expressed are personal)