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India’s Covid curve is still rising PDF Print E-mail
Monday, 07 September 2020 00:00
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Ishaan page one ... two stories

Despite very low levels of testing, new infection levels remain high, so no curve-flattening in sight for some time

 

If India overtook Brazil over the weekend to become the world’s second-ranked country in terms of total Covid-19 infections so far – India became the top-ranked in terms of new infections on August 8 – the main reason for this is poor levels/protocol for testing so far; this has allowed those with infections to remain undetected and go around spreading the disease.

Worse, in case of those that were diagnosed as Covid-infected, India’s health authorities declared that they had been cured without even testing them; once again, this allowed the infection to spread. While WHO guidelines say recovery takes place in 14 days, the average for India is 11 days and it is as low as eight days in Bihar.

As a result of this, positivity levels – fresh infections as a share of fresh tests – rose from 6.5% on June 1 (5-day rolling average) to 10.7 on August 1, before falling a bit to 7.6% on September 5; at their peak, positivity levels in India were 17% on March 23. In the US, while the peak positivity was 22.3% on April 7, this fell to 4.9% on June 1, rose to 7.6% on August 1 and then fell to 5.6% on September 5. In the case of Italy, once the worst in the world, positivity rates had shot up to 13% on April 24 but are now down to 2.1%.

While the number of tests that India has done has shot up, from 40 lakh on June 1 to 4.9 crore on September 5, this is very low compared to other countries, especially when seen relative to the levels of population. On June 1, the US had done 1.9 crore tests and this rose to 9 crore on September 5.

In per capita terms, the comparison is far worse. On June 1, India had done a mere 2.9 tests per thousand persons as compared to 57 for the US; on September 5, India had one 35.4 tests per thousand persons versus 272.7 for the US. The UK had done 223 tests per thousand on September 5 and Germany 147.8.

While data is not available for all countries, India’s testing data becomes even less impressive when you consider that an increasing share of India’s tests are Rapid Antigen Tests (RAT) which have a much lower ability to detect Covid-19 infections as compared to the conventional RT-PCR tests. In a submission to the Delhi High Court on July 27, the Delhi government had said that between June 18-July 21, 19.3% of those tested using RT-PCR were found to be Covid-positive versus just 6.3% in the case of the RAT tests. Interestingly, the sero survey done in August had estimated that 29% of Delhi’s population had at one time or the other been infected with Covid-19.

So, the states/cities that have a high share of RAT tests, like Delhi and Bihar, could well be understating their infection levels as compared to a Tamil Nadu that has virtually no RAT tests. Interestingly, in this context, one of the reasons for Delhi’s infection levels rising over the past few weeks is the fact that the share of RT-PCR tests is rising again.

ends of first story

 

Infections growing most in states that tested too little

 

The story of low testing levels leading to higher infection levels over time becomes even more evident when you look at individual states or cities, and even countries.

On June 1, the US conducted 57 tests per thousand people as compared to India’s 2.9. Between June 1 and September 5, while the number of tests in the US rose 4.8 times, the number of infections rose by a smaller 3.5 times. In other words, a high level of initial testing results in a lower rise in infections later.

In the case of India, since the initial levels of testing were low, infection-levels spread faster once the levels of testing were raised. As the number of tests rose by 12.3 times – from 2.9 per thousand on June 1 to 35.4 on September 5 – infections rose 21.1 times.

The same picture gets repeated across the country. In the case of Delhi and Mumbai, where initial levels of testing were 4-5 times the all-India average, the spread of the infection wasn’t as high as in other parts of the country. In Delhi, the number of tests rose 8.2 times between June 1 and September 5 while the number of infections rose 9.5 times. In the case of Mumbai which was doing 40% more tests than Delhi on June 1, while the number of tests rose four times, the number of infections also rose by around the same number.

A totally different picture emerges, however, in the case of states that, to begin with, tested much less than Delhi. Take Kerala, where testing levels – in per capita terms – were around a fifth those of Delhi on June 1. In Kerala, the number of tests rose around 23.6 times by September 5 while the number of infections rose 66.8 times.

For Tamil Nadu, where testing levels were around half those in Delhi, infections rose 20.5 times even though the number of tests rose just 10.6 times. And in Odisha, a 13-times rise in testing led to a 58-times rise in infections.

In Karnataka, where initial tests were around 40% those in Delhi, an 11.2-fold rise in the number of tests resulted in infections rising 120.8 times. West Bengal’s testing levels were around a sixth those of Delhi on June 1 and so when, between June 1 and September 5, West Bengal’s tests rose 10.4 times, its infection levels rose 32.3 times.

In the case of Andhra Pradesh, its testing levels were around 60% those of Delhi on June 1. While the number of tests rose 10.8 times by September 5, the number of infections rose 132.5 times.

 

Last Updated ( Monday, 07 September 2020 04:47 )
 

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