Till Sunday, July 5, India tested 9.79 million people (9,790,387 to be precise – excluding repeat tests) for the coronavirus disease (Covid-19). That translates into 7,531 tests per million (taking India’s population as 1.3 billion). India’s Covid-19 dashboard on Sunday night read: 697,284 cases, 19,700 deaths, and 424,596 recoveries. That translates into a positivity rate of 7.12% overall, a case fatality rate of 2.82%, and a recovery rate of almost 61%.
But the number of daily cases has been on the rise (as has the number of deaths). On Sunday, 24,422 cases and 421 deaths were recorded. The average number of cases registered last week was 21,180; the average number of deaths, 460. The positivity rate on July 5 was 13.52%; the average positivity rate for the past week was 9.43% (which is a better measure; testing in India seems to fall off on Sundays). Still, given that the positivity rates of the past week have been higher than those overall, there’s clearly some increase, although this is not necessarily a bad thing – as this writer has previously pointed out, positivity rates increase with testing up to a point, then plateau, and finally start decreasing with more testing (as is happening in Delhi). Sure, the system can be gamed (and some Indian states are definitely guilty of this) by going slow on tests, although no one gains in the long term from this.
Delhi and Tamil Nadu have been aggressive in testing, and the results are evident – Delhi has actually seen the number of daily cases begin to fall from their June peaks, although they are still high (on Sunday, for instance, 2,244 new cases were recorded in Delhi) and experts are beginning to speak of the city entering a long plateau in terms of cases; Tamil Nadu has seen the number of cases increase (4,150 new cases on Sunday alone), but has managed to keep its positivity rate in the 7-12% band, and lower than previous peaks, indicating adequate testing. The big difference between Tamil Nadu and Delhi is that the latter is carrying out antigen tests, which are administered indiscriminately in so-called containment zones (which means anyone in a containment zone can get tested, not just those who meet the Indian Council of Medical Research’s stringent criteria for testing). Last week, the central government asked states to roll out antigen testing, pretty much on the same basis that Delhi has. This is a good move, and may finally mean India starts testing adequately.
Which brings us to the original question: How does one define adequate testing?
Russia has so far tested close to 16% of its population, according to worldometers.info. The US has tested 11%, and the UK 15%. India has tested 0.8% of its population. Even Brazil has tested 1.5%. And China, with a population higher than India’s, has tested 6% of its population.
India’s policymakers and politicians have been happy to cite per capita statistics to show how India has managed the pandemic well, but point to the country’s size and population when its low testing number is highlighted. If China (the world’s most populous nation) and the US (the world’s third most populous nation) can test 6% and 11% of their population, India can surely do better than 0.8%?
So, what should India’s target be, when it comes to tests?
India should aim for 50 million tests (which would mean testing a little less than 4% of the population).
India has increased its testing capacity manifold – but the most tests it has carried out in a single day in the past few weeks is a quarter of a million. Is there a way to increase this to a million? For that would mean hitting the 50 million tests target by August 15.
This is the kind of challenge and deadline I’d like to see ICMR set for itself.