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Significance of Testing for Identification of COVID-19
The official and media discourse in India often focuses on the cumulative or daily detection of infected cases irrespective of the number of people tested and thus confuses the issue of disease progression. Based on the analysis of the number of infected cases identified and the number of people tested in eight states in India, it is emphasised that identification and quarantine of those who are infected slows down the spread of the disease. Mobilising resources towards the primary healthcare system for expanding contact tracing and investing in additional facilities to quarantine and treat infected patients is suggested.
As of 27 April 2020, over 3 million people worldwide have been infected with the novel coronavirus, out of which more than 0.2 million people have died, while. India has identified a total of 29,451 positive cases with 939 deaths. India, on 24 March 2020, implemented a complete nationwide lockdown that has now been extended up to 17 May 2020. The global experience has shown that lockdowns may have helped gain time for preparing to handle the rush of cases needing institutional care, setting up systems for case tracking, and, above all, in mobilising resources. But, by themselves, lockdowns are not effective. In India, however, the official as well as media discourse at this time is mostly centred around the lockdown and the rate of growth in the number of infected cases in the country in addition to whether it is accelerating or slowing down and, in turn, its implications for possible lifting or relaxing or extending the ongoing lockdown. Even this debate first requires a careful examination of the trends before any inference can be drawn.
The trend of infected cases in any region must be seen in the context of the number of people tested, and this should be compared on a daily basis (Reddy 2020). In India, daily detection of infected cases closely corresponds to the number of people tested daily (Figure 1), exactly like in other countries during the relatively early phase of the disease spread. Only when there is a decline in the number of infected persons detected daily without a similar decline in daily testing, as witnessed in South Korea or New Zealand around 6 March 2020 and 6 April 2020 respectively (Figure 1), can we state that the spread of the disease is slowing down.1 India has not yet reached that stage. It indicates that in the coming days, more infected people will be identified as testing increases, or else, inadequate testing will result in underestimating the number of infected persons. Given the inter- and intra-state variations, it is important to assess the number of tests conducted and the corresponding cases reported in order to comment on the trend of disease progression.
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