Covid-19 in India — Need to scale up testing
Data used as available till April 4, 2020
South Korea managed to cut down Covid-19 cases daily for the last 4 weeks (3,867 active cases on April 3 vs 7362 active cases on Mar 11) and keep low 1.7% fatality rate (percentage of diagnosed patients deceased — ie 174 deaths out of 10,072 cases) compared to global 5.4% [1,2].
Italy (and comparably, Spain) have seen a high fatality rate (12.2% — ie 14,681 deaths out of 119,827 cases). Covid-19 infected patients may also be asymptomatic — ie not carrying any medical symptoms of being ill. Yet, these asymptomatic patients may continue to spread the virus. Various articles [3.4] have compared the very different fatality rates of coronavirus for Italy with those in South Korea, and the reasons therein.
They have attributed this mostly due to inadequate & mostly mid or late stage symptomatic testing in Italy, leading to a disproportionately older infected population (average 62 yrs in Italy vs 45 in South Korea) and doubly higher fatality rate for the same age group. South Korea (and Germany) set an example of aggressive testing, even of asymptomatic cases.
India is slightly earlier in the journey than Italy or South Korea — we have an opportunity to learn from their experiences. India’s younger population (average 29 yrs in India, compared to 45 & 42 yrs in Italy & South Korea respectively) is an advantage. However, our current testing levels are low — with 51 tests per million population. A recent Maharashtra state government report found 87% of infected people as asymptomatic .
Our testing until recently was purely on symptomatic suspect cases — which means that there’s a possibility of significant asymptomatic carriers already around. Aggressive early exhaustive testing is much needed — given India’s population density, we need to atleast target Korea’s or Germany’s testing levels. Ramping up testing late still leads to a spiralling number of cases as in the US and Italy. Even targeting ~4000 tests per million India comes to additional 5 million people tested, or almost 170,000 days per day over a 30 day period — upto from the current ~10,000 tests being done daily.
Whether we go Korean way or Italy way depends on our ability to test quickly. We don’t have a choice.
(Continues to Covid-19 in India — What constrains our testing?)
- The updates on COVID-19 in Korea as of 3 April, KCDC (https://www.cdc.go.kr/board/board.es?mid=a30402000000&bid=0030&act=view&list_no=366731)
- COVID-19 Coronavirus Pandemic (https://www.worldometers.info/coronavirus/)
- Italy’s coronavirus death toll is more than double China’s — this might be why, CNBC (https://www.cnbc.com/2020/03/27/why-coronavirus-deaths-are-higher-in-italy-spain-than-in-china.html)
- Why are deaths from coronavirus so high in Italy?, Live Science (https://www.livescience.com/why-italy-coronavirus-deaths-so-high.html)
- REPORT OF COVID-19 CASES — Medical Education and Drugs Department — 31st Mar 2020 (https://arogya.maharashtra.gov.in/pdf/upload9.pdf)
- Germany conducting more than 50,000 coronavirus tests a day, Financial times (https://www.ft.com/content/6a8d66a4-5862-4937-8d53-b2d10794e795)
- America’s COVID-19 testing has stalled, and that’s a big problem (https://arstechnica.com/tech-policy/2020/04/americas-covid-19-testing-has-stalled-and-thats-a-big-problem/)
- SARS-CoV-2 (COVID-19) Testing: Status Update 03 April 2020 (https://icmr.nic.in/sites/default/files/whats_new/ICMR_testing_update_03April_9PM_IST.pdf)