Coronavirus confusion: How much testing is enough?

India is testing fewer samples for the size of its population. But it is testing more for every positive coronavirus case compared to other countries.

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Gyan Prakash/Bharat Chauhan
New Delhi A consistent complaint against India in the fight against novel coronavirus has been that its testing is too low. India is aiming to increase the daily testing of samples for coronavirus to 1 lakh from the current (at last count) around 30,000 tests in 24 hours. So, the testing numbers are set to improve now. But for that the labs have to work double shifts.

Dr RR Gangakhedkar of the ICMR on Thursday said India can test a total of 42,418 samples for coronavirus in a nine-hour regular shift at its labs.

The good news is, India has got its delayed shipment of 5 lakh kits from China. The kits were supposed to arrive in India some 10 days earlier. Another 6.5 lakh testing kits would be arriving soon. India needs more, much more, however.

The delayed arrival of import orders – a part of which was reportedly diverted to the US midway and another part delayed over unsatisfactory quality of testing kits – too held India back from testing as it might have wished.

With over 130 crore people, how many should India test?

The rhetorical answer is a comparison with other countries. India has tested 3.02 lakh samples for coronavirus till Thursday. The US – worst affected by novel coronavirus pandemic – has tested more than 32.5 lakh samples with a population of less than 33 crore.

The single-line prescription from the World Health Organisation (WHO) to fight novel coronavirus pandemic has been: test, test, test. The US could report more cases because it tested more samples, many health experts say. In India, Mumbai alone accounts for about 15 per cent of total number of positive coronavirus cases in India. And, it has tested the most for any city or even more than other states. Delhi is another example of the test more-find more model.

The global norm for testing has been to see tests per million of population. Germany, Italy, South Korea and the US are among those testing the maximum. China is excluded as it has been parsimonious with its coronavirus testing data.

Germany has tested more than 15,700 people per million, Italy over 14,000, South Korea over 10,500 and the US almost 10,000 per million of population. On this scale, India stands at 211 tests per million of population.

But then data is as useful as you interpret it. The ICMR, which is handling the testing, has a different rationale to justify how India is testing how many at present.

The ICMR’s interpretation of the testing data is that India is testing far more than other countries for every positive case of novel coronavirus infection. That is, India has tested 24 samples for one positive Covid-19 case.

On this scale, Japan stands next with 11.7 tests for one positive coronavirus case, Italy tests 6.7 samples, and the US 5.3. And, Germany has conducted almost 13 tests for one positive coronavirus case (17 lakh tests, 1.33 lakh positive).

Ideally, every individual should be tested for novel coronavirus to have the full measure of Covid-19 pandemic. But for a country like India, the cost could be a big deterrent.

Somesh Upadhyay, OSD to Odisha health department, posted a tweet estimated the cost for India if it goes for 130-plus testing. He estimated the cost at Rs 6,300 billion which is equivalent to 3.3 per cent of GDP or 64 per cent of total Direct Tax collection.

Some countries such as South Korea offered coronavirus tests to everyone. India, on the other hand, has restricted the coronavirus test to only those with influenza-like illness. At some places, — in Mumbai and Delhi — random testing has begun or is about to begin over next few days.

It may seem a departure from the WHO’s prescription of “test, test, test” in what has been India’s contain Covid-19 strategy. The WHO’s formula translates into something like this: test, trace and treat. But the guiding principle in India’s fight against coronavirus seems to be “trace, test and treat”.

There is another indicator that can be used to look at the spread of Covid-19 in a country: positive cases of novel coronavirus infection per unit population. According a New York Times report, the US has 204 coronavirus cases per 1 lakh population, Spain 396, Italy 280, Germany 161 and India less than one. But then Mainland China had just six.

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