Brief Statistical Inferences of Covid -19 in J&K with special reference to District Bandipora

Brief Statistical Inferences of Covid -19 in J&K with special reference to District Bandipora

This study reviews the data on 27 th of August, 2020 and with simple graphical presentation of statistics may help in understanding the spread of pandemic across districts in J&K. The proportionate to population analysis reveals actual spread, recovery and Deaths. An insight into Covid Data of Bandipora through positive rate and testing per case may act as self assessment of interventions made or additional steps required to be taken for proper Covid mitigation management. Presence of Cumulative Positive cases and Active Positive cases proportionate to District Population per 1000 souls has been worked out. The virus concentration is traced high since March till 27 th of August in Districts of Srinagar, Shopian, Bandipora, Pulwama, Kulgam, Ganderbal, Baramulla, Budgam, Kupwara and Ramban and Kupwara among 20 Districts of J&K.
However, Covid mitigation efforts have given different pattern to Active positive cases. Active positive or the present high concentration places in J&K are Bandipora, Ganderbal, Srinagar, Pulwama followed by Kupwara and Budgam. District Jammu , Reasi and Samba are next high concentration active Districts. Ramban , Kishtawar and Doda have least Active Positive case concentration.
Districts where either good immunity, best health care or better Covid management (needs separate study on three parameters) have significantly contributed to recovery of infected cases are Shopian, Srinagar, Kulgam, Bandipora, Pulwama, Ramban, Ganderbal, Budgam and Baramulla.
Covid Deaths, which are still haunting J&K, could also be impacted by immunity, health care and Covid Management parameters to be studied separately. The Districts with high per thousand proportionate to population deaths are Srinagar, Shopian, Baramulla, Pulwama, kulgam, Budgam, Ganderbal, Bandipora, Kupwara and Jammu. Here is the intervention required from the Government and Health Department should focus on the mentioned Districts to avoid high covid Deaths. The health infrastructure including ventilators, availability of Doctor per population and per health institution needs a review. Moreover Covid Management efforts are to be reoriented to save precious lives.

Deep Dive into District Bandipora
District Bandipora is one of the northern Districts of J&K. There is One District Hospital, 3 Sub District Hospitals, 6 PHC,21 NTPHCs, 69 Sub Centers and ten 24*7 health institutions in the District catering to around 4 lakh population. Health indicators reveal the information on vitals as IMR = 21/1000, MMR =47/10000, Institutional deliveries = 96.9 % , (992), life expectancy = 69%. No of Doctors/population = 1/2340, Average Population per PHC= 65340, Per SC= 5604. The total Strength of Doctors including NHM = 168 Doctors in position= 139 Vacant posts of Doctors= 29. Paramedical in Position= 321, Vacant posts of Paramedics= 53

The positive rate: A crucial parameter for understanding the pandemic
The share of tests returning a positive result is known as the positive rate. The positive rate is a good parameter for how adequately countries are testing because it indicates the level of testing relative to the size of the outbreak. To be able to properly monitor and control the spread of the virus, countries with more widespread outbreaks need to do more testing. We see enormous differences across countries: Some countries, like Australia, South Korea and Uruguay have a positive rate of less than 1% – it takes hundreds, or even thousands of tests to find one case in these countries. Others, such as Mexico and Bolivia, have positive rates of 20%–50% or even more. In these countries a case is found for every few tests conducted.
According to criteria published by WHO in May, a positive rate of less than 5% is one indicator that the epidemic is under control in a country or the reference area.
Because limited testing makes it likely that many cases will be missed, the positive rate can also help our understanding of the spread of the virus . In countries with a high positive rate, the number of confirmed cases is likely to represent only a small fraction of the true number of infections. And where the positive rate is rising in a country, this can suggest the virus is actually spreading faster than the growth seen in confirmed cases. Other Districts should calculate positive rate with the help of daily testing data.
The daily testing data since 23rd of March till 27th of August has been analysed and positive rate is computed for around 151 dates. The trend is plotted for drawing some important references. Bandipora emerged as hotspot of Covid-19 with travelers mostly carrying the virus to the District. The positive rate spikes (more than WHO recommended 5%) is seen in graph from 23rd March till 26th of April, one month span. It is evident that proper contact tracing mechanism, robust covid management efforts, fumigation in affected zones and above all lockdown brought down the District to below WHO recommended value of 5%. The District behaved well till 10 th of July, 2020. It is however important to note that after lockdowns were lifted there has been an upsurge in cases since 10th of July. The Covid management teams now need to gear up afresh as District has again rising positive rate trends. An opportunity is there to revert to April –May successful mitigation techniques. August trends have to be lowered down below WHO 5% average, if not, the District may again become high concentration zone.

The Scale of testing compared to the scale of the Outbreak
The Districts that do very few tests per confirmed case are unlikely to be testing widely enough to find all cases. The WHO has suggested around 10 – 30 tests per confirmed case as a general benchmark of adequate testing. It is evident that one reason how District Bandipora managed its spread successfully between May till mid July is aggressive wide testing. The lowering of sampling is evident post July, and has gone down below 10-30 cases recommended level by WHO. Here again reverting to May –July mechanism is required.
It would be interesting to study positive rate trends and scale of testing in comparison with other J&K Districts, once data is obtained and may be accordingly analysed.

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