Why COVID-19 Cases, Positivity Rate in Northeast States Are Still High

47 districts in India, a majority of which are from the northeastern states have a positivity rate above 10 percent. Image used for representational purposes. 

(Photo: PTI)

India’s overall COVID-19 positivity rate has been on a decline for a month, but a high positivity rate in some of the northeastern states is indicating that the second wave may not have ebbed uniformly across the country.

In the first weeks of July, the Health Ministry had highlighted the concern of rising cases in the region, prompting the MHA to hold meetings with the state chief ministers to review the situation.

As of 22 July, the weekly national average of positivity rate was recorded at 2.09 percent. The daily positivity rate has remained less than three percent for 30 consecutive days, government data shows.

But 47 districts in India, a majority of which are from the northeastern states – Manipur, Tripura, Meghalaya, Mizoram, Arunachal, Nagaland, Sikkim, and Assam – are reporting a positivity rate of more than 10 percent, as of 15 July.

Rajasthan, Kerala, Maharashtra, and Puducherry are a few of the other states that have become a cause of concern.

(Photo: Shruti Mathur/The Quint)

In the northeast, other than Assam, which has an overall positivity rate of 2.09, the weekly average of some of the other states was above 5 percent.

According to covid19India.org, which curates state and central bulletins for COVID-19 data, Meghalaya had a weekly average of 10.02 percent between 16 and 22 July, Nagaland's was 7.3 percent, while Arunachal Pradesh was at 7.6 percent.

But Manipur, Mizoram, and Sikkim are three states that are showing a big spike in infections with 16.07 percent, 12.02 percent, and 18.6 percent positivity rate in the past one week.

With 1,327 fresh positive cases in Manipur and 807 new positive cases in Mizoram, both the states recorded the highest single-day rise in COVID-19 cases between 20-21 July.

Government data available on the MoHFW website also shows that the active case ratio is comparatively higher in all the northeastern states and Kerala.

The high positivity rate in these states has turned out to be a worrisome factor, mainly because the population in the northeastern states are much lower compared to the bigger Indian states. Altogether the NE states make up for 3.7 percent of India's population.

In a previous interview with The Quint, Dr Gautam Menon, professor of physics and biology at the Ashoka University, said the coronavirus curve in the northeast shows that the second wave hasn't completed its course.

"If you look at the curve, it looks like the epidemic in much of the northeastern states never really came down after the second wave. They came down a little bit and then they began to show an up trend, so maybe this is just the fact that the second wave hasn’t completed its course...And we need to step up vaccination in those regions where we suspect that there is still a background of large susceptible population yet to be infected."

Dr Gautam Menon, professor of physics and biology at the Ashoka University

What's Causing the Spike?

In the peak of the second wave between April and May, while the rest of the country was logging in extremely high numbers of infections and cases, the smaller northeastern states such as Arunachal Pradesh, Sikkim, Nagaland, and Mizoram were reporting less than a few hundred cases.

Assam was the only state that was reporting between 5,000 and 6,000 cases per day.

But even as the cases started dipping towards June, one of the possible reasons behind the high positivity rate, could be due to a reduced testing. Low tests would indicate low numbers of infections without successfully cutting down the chain of infections.

Moreover, the Centre has also written to the northeastern states cautioning them about the increased R factor that could be slowing down the decline in infections.

The R factor is needed to assess the rate of the spread of the infections. Hence, if the value of the R factor is above one, it means that one infected person can spread the infection to more than one person.

"In general, the rule is that if your R is greater than one, the number of cases on a day-to-day basis keeps increasing, if less than one, they are decreasing. If they are increasing, they signal an incipient leading to potential pandemic / epidemic locally. If they are decreasing, it tells you that the epidemic has run its cause on its way down," Dr Menon says.

As per government data from 15 July, the R-values in Manipur is 1.07, in Arunachal Pradesh it is 1.14, while for Tripura it is 1.15. Kerala is another state with a concerning high R value of 1.10.

Meghalaya, Mizoram, Sikkim, and Assam have slightly lower R values at 0.92, 0.86, 0.88, and 0.86 respectively.

"Many things can interfere with it, for example, a new variant can come along which is more transmissible and moves more easily between people. That can drive your R up. I wouldn’t say this is the only important number. Test positivity is significant."

Dr Gautam Menon, professor of physics and biology at the Ashoka University

The presence of the Delta variant in a lot of the new cases from these states could also be another reason for the spike.

Assam Doctor Infected With Two COVID Variants Simultaneously

In one particular case from Assam, Dr BJ Borkakoti – a fully vaccinated doctor – was found to be infected with both the Alpha and the Delta variants of COVID-19 simultaneously, reports said.

The spike in daily cases has now made many districts of the northeastern states to go under a lockdown once again.

Five districts in Assam – Jorhat, Golaghat, Sonitpur, Biswanath, and Lakhimpur – are currently under curfew.

According to the state government, over 358 micro-containment zones from these districts are contributing to 90 percent of the state's cases.

97 out of 98 COVID Samples in Sikkim Test Positive for Delta Variant

97 out of 98 samples of COVID-19 test from Sikkim, which was sent to a genome testing to a lab in West Bengal, reportedly tested positive for the Delta variant of coronavirus.

"We can now conclude that the positivity rate hasn’t gone down because of the spread of Delta Variant in Sikkim. The COVID fatality rate is at 0.59, which is not so worrisome."

MK Sharma, Sikkim Health Minister

Amid the rising cases, the Sikkim government has imposed strict restrictions and decided to ban all socio-religious gatherings in the state for 30 days.

Manipur had also announced a 10-day lockdown from 16 July onwards, while the neighbouring state of Mizoram has announced a total lockdown in the Aizawl Municipal Corporation area till 24 July.

The Tripura government had imposed a weekend curfew and extended the existing day curfew in Agartala Municipal Corporation and 11 other towns or Urban Local Bodies (ULBs) till 23 July. The state government hasn't indicated any further extension of the curfew yet.

What is the Govt Doing About the Spike in NE?

The alarming rise in infections had prompted PM Modi to hold a COVID-19 review meeting with the chief ministers of the northeastern states earlier on 13 July, where he urged them to ramp up vaccination rates.

He also asked the CMs to set up temporary hospitals and form micro containment zones with aggressive testing to control the growing infection.

Arunachal Pradesh CM Pema Khandu has announced plans to inoculate 100 percent of the state's population against coronavirus. Certain parts of the state, such as the Itanagar Capital Complex (ICC), has vaccinated way above 100 percent of its population, the state government said.

Meghalaya, which has an estimated population of 34.4 lakh people, has vaccinated one lakh people with both the doses so far. While Assam has vaccinated only 7.04 percent of its eligible population with both the doses.

Union Home Minister Amit Shah will also be holding a second meeting with all the chief ministers, chief secretaries and DGPs of northeastern states on Saturday, 24 July, in Shillong.

During his visit, he is expected to take stock of the COVID-19 situation in the region and also inaugurate a cryogenic oxygen plant.

During the two-day visit on 24-25 July, the home minister will also inaugurate a cryogenic oxygen plant, visit the headquarters of the Assam Rifles in Shillong and attend an event in Guwahati.

Overall, India logged in 41,383 new coronavirus cases as of 22 July, while total fatalities from COVID-19 rose by 507. Currently, the country's cumulative caseload stands at 3.12 crore, while the total fatalities are at 4.18 lakh.