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By Shruti Menon
BBC Reality Check

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image captionA faster but less reliable method of testing has gained ground in many states

Indian Prime Minister Narendra Modi has called on the country’s worst-affected states to give top priority to testing and contact tracing to combat coronavirus.

Daily cases in India have been falling since mid-September, but there’s concern that varied testing strategies may be hindering the battle against the disease.

What type of testing is India doing?

India had been using the what’s known as a PCR test – regarded as the gold standard of testing – very widely.

But currently, only 60% of all tests use this method, and many Indian states – who are in charge of their own health policies – have switched to rapid antigen testing (RAT), a faster but less reliable method.

  • How does mass testing work?

RAT tests are known to miss up to 50% of cases due to false negatives (where infected people are not detected), although some experts believe they are still useful in areas which have become virus hotspots.

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“The ability to detect cases depends on a relative mix of the less sensitive RAT test and the gold standard PCR test,” says Prof Gautam Menon, an infectious disease expert from Ashoka University in Haryana.

India isn’t alone in using these tests, and some European countries grappling with further waves of infection have also resorted to rapid testing.

Is testing consistent across the country?

Maharashtra is the worst-affected state in India, with 17% of all cases.

In terms of total coronavirus cases, it’s followed by states with significantly smaller populations such as Karnataka, Andhra Pradesh, Tamil Nadu and Kerala.

But Uttar Pradesh and Bihar – two other states with large populations – appear to be doing much better.

They have lower proportions of confirmed cases at 2.9% and 1.6%.

What the testing data reveals is that in both Bihar and Uttar Pradesh (and some other states) less than 50% of total tests use the PCR method – so cases are being missed.

In Maharashtra, nearly 60% of tests have been PCR tests (although they are increasingly using rapid testing in the state capital, Mumbai.)

And Tamil Nadu state has relied totally on PCR testing, which means it is likely to have a far more accurate idea of the spread of the virus.

Patchy testing levels across states

There’s evidence that states may also not be testing enough in highly populated areas where infections tend to be higher.

As of 30 November, 13% of Uttar Pradesh’s cases were found in its capital, Lucknow, although fewer than 6% of total tests in the state have been carried out there.

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Kanpur district has the second-highest number of cases in the state, but just under 3% of total tests have been conducted there.

District-level data in Bihar reveals a similar trend. One of the most populous areas, Patna, accounts for 18% of all reported cases yet has conducted only 3% of the total tests in the state.

Other parts of the state have carried out relatively high numbers of tests, but have fewer cases.

“If you do fewer tests in areas where cases are high and vice-versa [more tests where cases are low], you end up reporting less cases while meeting a specific high-testing target,” says Dr Rijo John, a public health policy analyst in Kerala.

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He adds this can make the data on case numbers a bit meaningless.

Varying surveillance systems

India’s Covid-19 national guidelines say states should trace contacts of at least 80% of positive cases within 72 hours.

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image captionMany migrant workers left Delhi to return home during the national lockdown

But India’s parliamentary committee on health and family welfare has said that “poor contact tracing and less testing could have been a factor for the exponential growth of Covid”.

It’s difficult to get reliable information from every state about contact tracing.

Uttar Pradesh was recently lauded by the WHO for “early and systemic tracking of high-risk contacts”.

By contrast, data for Karnataka shows its numbers for primary and secondary contact tracing have fallen since September.

Telangana state has data for the proportion of tests carried out on the primary and secondary contacts of those who have contracted Covid-19.

This has come down a bit since September along with overall testing numbers.

In Kerala, the data shows 95% of all cases since 4 May have been traced back to the primary and secondary contacts of infected persons.

But none of these datasets reveals if 80% of contacts of someone who was positive were traced within the timeframe set out in the national guidelines.

And many states do not make this data public.

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Pelosi to move forward with impeachment if Pence doesn’t act to remove Trump

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“In protecting our Constitution and our Democracy, we will act with urgency, because this President represents an imminent threat to both,” Pelosi said in the letter to Democrats on Sunday night laying out next steps.

The House will try to pass a measure on Monday imploring Pence to invoke the 25th Amendment, through which he and the Cabinet declare Trump “incapable of executing the duties of his office, after which the Vice President would immediately exercise powers as acting president.” If Republicans object, as is virtually certain, Democrats will pass the bill via a roll call vote on Tuesday.

“We are calling on the Vice President to respond within 24 hours,” Pelosi wrote. “Next, we will proceed with bringing impeachment legislation to the Floor.”

But it’s not clear when exactly the Senate will take up the House’s measure. The Senate isn’t scheduled to return until Jan. 19, but will hold pro forma sessions on Tuesday and Friday. In theory, a senator could try to pass the House resolution by unanimous consent, but as of now it appears unlikely that it would pass.

On Monday, multiple House Democrats plan to introduce impeachment resolutions that would become the basis of any impeachment article considered by the House later this week.

Rep. David Cicilline (D-R.I.), who will introduce an article of impeachment against Trump on Monday, said on Sunday that roughly 200 Democrats have co-sponsored the measure.

Currently, 211 voting members (plus three nonvoting members) support Cicilline’s legislation, and they are hoping to reach 217 voting members by Monday morning, enough for the House to impeach Trump, one Democratic source familiar with the matter told POLITICO.

A small number of Democrats have opted not to co-sign the bill, but privately say they will vote to support the resolution on the floor, the source added.

The impeachment effort in the House is likely to be bipartisan, with Democrats expecting at least one GOP lawmaker — Rep. Adam Kinzinger of Illinois — to sign on. A handful of other House Republicans are seriously weighing it, according to several sources, though those lawmakers are waiting to see how Democrats proceed, and some are concerned about dividing the country even further.

Among the GOP members whom Democrats are keeping an eye on are Reps. John Katko of New York, Brian Fitzpatrick of Pennsylvania, Fred Upton of Michigan, Liz Cheney of Wyoming and Jaime Herrera Beutler of Washington.

Across the Capitol, at least two Republicans — Sens. Pat Toomey of Pennsylvania and Lisa Murkowski of Alaska — have called on Trump to resign. On Saturday, Toomey told Fox News, “I do think the president committed impeachable offenses,” but told CNN the next day that he does not believe there is enough time to impeach.

Sen. Ben Sasse (R-Neb.) has also said he would consider articles of impeachment.

Another option has emerged among some Republican and moderate Democratic circles — censuring Trump — though it remains highly unlikely to advance.

A censure resolution would gain far more support in the GOP than impeachment. Some Republicans have privately been pushing for that route and are trying to get Biden on board, according to GOP sources. That group of Republicans is also warning that impeachment could destroy Biden’s reputation with Republicans.

But censure is considered a nonstarter in an incensed House Democratic Caucus, where members see it as a slap on the wrist that gives Republicans an easy out.

The Democrats’ enormous step toward impeachment on Sunday comes after Pelosi and other top Democrats held a private call on Saturday night in which they discussed the potential ramifications that a lengthy impeachment trial could have on Biden’s presidency.

Democratic leaders discussed several options to limit the political effects on Biden’s first 100 days, with one option — floated by House Majority Whip Jim Clyburn (D-S.C.) — for the House to delay the start of an impeachment trial in the Senate by holding on to the article of impeachment.

Senate Majority Leader Mitch McConnell (R-Ky.) has sent out a memo to senators explaining that the Senate could not take up impeachment until Jan. 19 at the earliest, absent unanimous consent.

A final decision has not been made, and House Democrats will discuss the matter on a 2 p.m. caucus call on Monday.

Lawmakers are already privately expressing concerns about returning to the Capitol for multiple days this week, worried about both a potential coronavirus outbreak and whether the building is secure, given how easily an armed pro-Trump mob invaded on Wednesday.

The Capitol physician urged House lawmakers and staff to get tested in a memo Sunday, saying they might have been exposed to someone who had the virus while huddling for safety in a large committee room for hours on Wednesday. During the hourslong lockdown, several Republican members refused to wear masks despite being offered them by Democrats worried about the spread of the deadly virus.

Melanie Zanona, Olivia Beavers and Marianne LeVine contributed to this report.

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Matt Hancock Scraps “Unnecessary Training Modules” Blamed For Slowing Vaccine Rollout

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Matt Hancock has agreed to remove some of the training modules required for volunteers to sign up to deliver the Covid-19 vaccine (PA)


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Matt Hancock said people will no longer need to undertake training including an anti-terrorism course to give the coronavirus jab after MPs said “bureaucratic rubbish” was delaying mass vaccination.

It comes as MPs called for the government to produce targets for the number of people given immunity before lockdown can be lifted.

The health secretary said a series of “unnecessary training modules” are being scrapped to speed up the process of getting people qualified to deliver the jab.

Speaking in the Commons, Sir Edward Leigh said he was shown by his fellow the Tory MP, a qualified GP, the “ridiculous form” he had filled out to start delivering the vaccine.

“When he’s inoculating an old lady, he’s not going to ask her if she’s come into contact with Jihadis or whatever, so the Secretary has got to cut through all this bureaucratic rubbish,” he said.

In response Mr Hancock said: “I am a man after Sir Edward’s heart and I can tell the House that we have removed a series of the unnecessary training modules that had been put in place, including fire safety, terrorism and others.

“I’ll write to him with the full panoply of the training that is not required and we have been able to remove, and we made this change as of this morning and I am glad to say it is enforced.

“I am a fan of busting bureaucracy and in this case I agree with him that it is not necessary to undertake anti-terrorism training in order to inject vaccines.”

Dr Fox had earlier challenged Boris Johnson to drop the “bureaucracy” and “political correctness” of the forms vaccine volunteers must fill out.

He told MPs: “As a qualified but non-practising doctor, I volunteered to help with the scheme and would urge others to do the same. 

“But, can I ask the Prime Minister why I’ve been required to complete courses on conflict resolution, equality, diversity and human rights, moving and handling loads and preventing radicalisation in order to give a simple Covid jab?”

Mr Johnson said he had been “assured by the Health Secretary that all such obstacles, all such pointless pettifoggery has been removed”.

The government has been attempting to recruit thousands of volunteers to help with a mass vaccination programme, and with the recent approval of the more easily deliverable Oxford/AstraZeneca version has today revealed the location of seven mass vaccination centres set to open next week.

The Prime Minister’s official spokesman told journalists at a briefing they would be at Robertson House in Stevenage, the ExCel Centre in London, the Centre for Life in Newcastle, the Etihad Tennis Centre in Manchester, Epsom Downs Racecourse in Surrey, Ashton Gate Stadium in Bristol and Millennium Point in Birmingham, and it is expected they will be run with a combination of NHS staff and volunteers.

But so far the government has not said how many people need to be inoculated before it has an impact on the coronavirus restrictions.

Mr Hancock was asked by a number of MPs if the measures could be eased once the top few tiers in the vaccine priority list had been clear.

Former Conservative chief whip Mark Harper said once the top four groups, which includes care home residents and staff, frontline NHS workers, the clinically extremely vulnerable and everyone over 70 “we’ve taken care therefore of 80% of the risk of death”.

Adding: “What possible reason is there at that point for not rapidly relaxing the restrictions that are in place on the rest of our country?”

The health secretary replied: “We have to see the impact of that vaccination on the reduction in the number of deaths, which I very much hope that we will see at that point, and so that is why we will take this – an evidence-led move down through the tiers, when we’ve broken the link, I hope, between cases and hospitalisations and deaths.”

The ex-Tory minister and another doctor, Andrew Murrison, said: “The logic of anticipating what is going to happen in two or three or four weeks’ time from the number of cases we are getting at the moment is that we can do the same in reverse.

“That is to say, when we have a sufficient number of people vaccinated up we can anticipate in two or three or four weeks’ time how many deaths have been avoided. 

“That means, since it cuts both ways he will be able to make a decision on when we should end these restrictions.”

Mr Hancock replied: “The logic of the case that Dr Murrison makes is the right logic and we want to see that happen in empirical evidence on the ground.

“This hope for the weeks ahead doesn’t take away, though, from the serious and immediate threat posed now.”

The Cabinet minister said the challenge for the government is to increase the amount of doses available, claiming “the current rate-limiting factor on the vaccine rollout is the supply of approved, tested, safe vaccine”.

He added: ”We are working with both AstraZeneca and Pfizer to increase that supply as fast as possible and they’re doing a brilliant job.”

But Labour’s shadow health secretary Jonathan Ashworth called for the government to ramp up its vaccination programme to six million doses a week.

He told the Commons: “The Prime Minister has promised almost 14 million will be offered the vaccine by mid-Feb. That depends on around two million doses a week on average.

“Both [Mr Hancock] and the Prime Minister have reassured us in recent days that it’s doable based on orders.

“But in the past ministers have told us that they had agreements for 30 million AstraZeneca doses by September 2020 and 10 million of Pfizer doses by the end of 2020.

“So, I think people just want to understand the figures and want clarity. Can ministers tell us how many of the ordered doses have been manufactured?”

Mr Ashworth added: “Two million a week would be fantastic but it should be the limit of our ambitions, we should be aiming to scale up to three, then five, then six million jabs a week over the coming months.”

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How South African police are tackling pangolin smugglers

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Quiet, solitary and nocturnal, the pangolin has few natural enemies, but researchers believe it is the most trafficked mammal in the world. The tough scales covering its body are sought after for use in Chinese medicine, in the erroneous belief that they have healing properties.

The animal has also been of interest to researchers during the coronavirus pandemic. Related viruses have been found in trafficked pangolins, though there is continued uncertainty around early theories that pangolins were involved in the transmission of the virus from animals to humans.

After South African police seized a pangolin from suspected smugglers, BBC Africa correspondent Andrew Harding witnessed how vets tried to save the animal’s life.

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