COVID-19: National data masks the variation at the state-level

The national-level coronavirus data masks unique state-specific epidemic trends that would require the Centre’s broad COVID-19 management strategies to be finely tailored to the needs of specific states, experts have advised.

Across states, the test positive rate shows varying trends. In some states it has fallen to low levels (Andhra Pradesh, Kerala, Odisha); in some it is high but falling (Punjab, Madhya Pradesh, West Bengal) and in some other it is high and stable or rising.

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The last category includes Delhi, Gujarat, Maharashtra, and Tamil Nadu.

One of the consequences of such variations could be different peak levels in different states, argued a team of researchers from the University of Massachusetts and University of Michigan, USA.

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If the states attain disease peaks at different points of time, then devising a national strategy on the basis of India's pandemic peak doesn't have much significance.

"Focusing on national trends is misleading and not of much use for policy making because the spread, severity and impact of the pandemic varies a lot across states," Deepankar Basu, lead author of the paper from the University of Massachusetts told DH.

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According to the observed data, Punjab may have already seen its first peak whereas Kerala may witness a second peak as there are few recent cases after the initial strong control.

"It is more or less clear now that states will see peak infections at different times. Hence, resources (testing capacity, additional quarantining facilities, or additional ICU beds) should be mobilised and shifted across states to match the severity," he added.

In their study, the researchers noted several possibilities that could arise from varying transmission dynamics in the states.

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One possibility is that the states which saw the early wave of the pandemic (Delhi, Maharashtra, Gujarat, Tamil Nadu) will see early peaks.

A second option that could not be ruled out is a case in which the states where case counts are the maximum now will see late peaks, because the severity of the outbreak in these states will make it that much more difficult to contain the spread.

Because of the migration, it is also possible that Bihar, Odisha, Uttar Pradesh, and West Bengal where the migrants are traveling to, will see later peaks.

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"Given the spatial and temporal pattern of the spread of the pandemic, it is extremely important to prioritise the policies," they said in the paper, which is not peer reviewed yet but has been put out in the public domain for others to examine the findings.

Resource mobilisation, the researchers argued, could happen in such a way to address a group of states falling in a particular category. While problems of one set of states were addressed, a second group can be put on high alert.

However, it was difficult to precisely say which states would see early and which one would see late peaks due to the limitations in computer modelling studies, they acknowledged.