Number of cases may be less as India’s testing rate too little to get the real COVID-19 picture

The Narendra Modi-led Centre seems to have taken Leo Tolstoy’s epic statement in War and Peace in its war against COVID-19 which has now infected around 733 people and resulted in 20 deaths: “The two most powerful warriors are patience and time.” However, while the World Health Organization (WHO) has said that the lockdown is only a part of the solution and the virus needs to be affected by identifying and treating the infected in the interim period, India’s abysmally low testing rate seems to be the biggest hurdle in this battle.

The Indian Council of Medical Research (ICMR) has said that India had performed 25,144 tests on 24,254 individuals as of 8pm on March 25. Among these, a total of 581 individuals had been confirmed positive. This means the rate of testing in India is nearly 18 tests per million of the population.

This is what has led experts to suggest that India’s relatively low number of coronavirus cases could be misleading and the actual figures of infected people might be much higher.

So, how low is India’s testing rate? Italy, which has recorded 80,589 cases, had performed 3,24,445 tests as on March 25, at a rate of 5,268 tests per million of the population. The UK has performed 97,019 tests till the same date at a rate of 1,469 tests per million people. The UK has 11,658 positive cases of coronavirus. South Korea, which is credited to have managed a sharp rise in cases had performed 3,57,896 tests at a rate of 6,931 tests per million people till March 25.

The United States, which has emerged as the new epicentre of those affected by the virus and the third most populated country in the world, has tested citizens at a rate of 1,280 per million of its population.

A recent report by data journalism portal IndiaSpend.com showed that within India, states and Union Territories, which have conducted more tests, have reported a higher number of coronavirus cases with Kerala leading at 137 tests per million.

WHO’s Director-General Tedros Adhanom Ghebreyesus has categorically stated that a lockdown is not enough. "Aggressive measures to find, isolate, test, treat and trace is not only the best and fastest way out of extreme social and economic restrictions, but they're also the best way to prevent them,” he said.

“This is not enough — it is not enough to test only patients in hospital with the most severe pneumonia,” Yogesh Jain, a public health specialist in Chhattisgarh and a member of a JSA working group tracking the country’s testing and treatment responses to the coronavirus, told The Telegraph newspaper.

“We need to quickly expand testing. Only then can we know the true burden of the infection in the country. We seem to be now trying to deny that the problem is big. But we still don’t know the true size of the infection,” Jain added, according to The Telegraph report.

In a country as densely populated as India, where the first instances of social transmission have already come to the fore, and where thousands of out-of-work wage labourers are walking hundreds of kilometres towards their homes, a low rate of testing is nothing but taking the riskiest gamble. If social spread reaches rural India and the hinterlands, India’s crumbling health infrastructure would find it virtually impossible to contend with the magnitude of the problem.