Test Results: A confusing scenario

IFP Editorial: The Manipur health department should have a dedicated cell composed of experts to undertake data analysis and scientifically study the different trends and trajectories of the pandemic in the state.


Ever since the aggressive mass testing was started in certain parts of the state, the daily figure of Covid-19 positives had been rather erratic leading to a confusing scenario. Previously, when daily testing was based on contact tracing, one could at least feel the vibe and understand the increase or decrease in daily figures although they could not get a scientific explanation out of it. But now, as the number of daily tests has increased from a previous range of 1,500-2,500 to 5,000-9,000. One can only be content with the daily percentage of infections, but not understand the nature of the spread.

In the last one week, the daily figures were up and down ranging from 600 below to 800 plus. It was 824 on Sunday and 598 on Monday, and it increased to 748 on Tuesday out of 8,928 total tests. The mass testing had been carried out in mostly infection prone areas, including Imphal West and Imphal East. Thoubal and Churachandpur have become a cause of concern, while cases have come down in Imphal West and East. One understands that, percentage-wise, the number of daily figures have come down from the figures before mass testing began. But then, there is little relief among the general public as the percentage wise decrease is not explained.

The state health authorities and epidemiologists seem to be more concerned with the infection rate as against the number of tests conducted daily. What is more important is the calculation of the R factor using different mathematical models, which would be more useful in pinpointing the nature of spread and in framing an adequate response. The reproduction number is a measure of how contagious a disease is: It tells us the average number of people who will contract a contagious disease from one person having that disease. If the R value is more than 1, each existing infection causes more than one new infection. As we said before, the state health department should have a dedicated cell composed of experts to undertake data analysis and scientifically study the different trends and trajectories of the pandemic in the state, since its first coming through the second wave and in preparation of the third wave. Aggressive testing is also a part of articulating a targeted response to the pandemic.

Meanwhile, we also have to understand that the general public are still wary of the Rapid Antigen tests which are being used in the present aggressive mass testing. The shortfalls of diagnostic testing is the possibility of false negatives (failing to detect a condition when it’s present) and false positives (detecting a condition when it’s absent). It’s easy to see why false negatives can be a problem – we lose the benefits of early intervention. But false positives can also cause harm, including unnecessary treatment. This is why positive screening tests are often followed up with a second, different test to confirm a diagnosis. The advantage of using rapid antigen test is that it reduces the burden of relying on just RT-PCR tests to identify Covid-19 patients. Antigen testing is useful because even if it’s less sensitive, it is rapid and the results that are positive will be positive. So, patients who test positive can get into isolation faster. Besides the mass testing drive, we are glad that the state is seriously considering mass vaccination among the population which seems to be the only solution to check the pandemic. The lockdowns and Covid-19 appropriate behaviour of washing hands frequently or maintaining physical distance or masking oneself are just temporary measures to delay the infection. Who knows, what strain would come in the third wave?

 
First Published:June 9, 2021, 1:19 a.m.

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