As the country surpassed the grim milestone of 9 million total infections on Thursday, official daily figures appear to show a marked slowdown in the spread of the disease. Prepared to surpass the US As the nation with the highest number of cases, India has for weeks reported fewer than 50,000 new cases per day, while infections are skyrocketing across the United States.
Rather than show that India is gaining control over Covid-19, the slowdown momentum may largely reflect patchy testing levels and a heavy reliance on questionable kits.
The country’s daily tests of 1.4 billion people have recovered since the early days of the pandemic, currently at around 1 million, but it is still much lower than most countries with high infections. Just as significant, nearly half come from less reliable rapid antigen tests, which can report false negatives up to 50% of the time.
The upshot is that India’s Covid-19 cases are likely much higher than the national numbers. Health experts fear new waves of infection as the country gathers for a wedding and festival season amid a foggy winter in the densely populated north.
Rapid antigen tests “are not very reliable, they are not sensitive and patients do not receive any treatment,” said Harjit Singh Bhatti, chairman of the forum of progressive doctors and scientists who has been working on the front lines at a Delhi suburban hospital since He started the epidemic. “The next few months will be very dangerous.”
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Most other countries with large outbreaks, such as the US and the UK, use RT-PCR tests that take longer to generate more reliable results by detecting the genetic material of the virus. Experts say rapid antigen tests can help countries with sudden outbreaks quickly detect where the worst-hit areas are. But for an accurate understanding of spread, these must be followed by RT-PCR tests.
False negatives
“Rapid antigen tests can have very high false negative rates – it’s supposed to be followed up with RT-PCR, which is hardly done” in India, said T Sundararaman, global coordinator of the New-based People’s Health Movement. Delhi.
As of last week, 49% of India’s daily tests were rapid antigen, an increase of about 25% to 30% in mid-August, according to the most recent federal data. However, some of the most populous states in the country do not regularly publish detailed test data. That makes it difficult to identify the worst affected areas or evaluate your testing strategy.
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“The number of cases you can identify depends on the effectiveness of your tests,” said Rijo M John, an adjunct professor at the Rajagiri School of Social Sciences in Kochi. “We have reasonably good data on tests and cases in city centers and more urban districts, but a similar type of data is lacking in rural areas.”
Bihar, an eastern state with a population of over 100 million, may turn out to be the most vivid example of how low overall evidence and even the lowest high-quality evidence could be obstructing a clear picture of the Indian pandemic. Up to 88% of all tests in the state are the rapid antigen variety. It also held elections this month, India’s first major vote since Covid-19 hit. Hundreds of thousands of people crowded the campaign rallies, and few wore masks.
So far, any possible increase has been muted in official data. On Thursday, Bihar added just 604 new infections during the previous day, despite its huge population. Uttar Pradesh, the most populous state in India with more than 220 million people, more than double that of Bihar, reported more than 2,500 new cases.
By comparison, New Delhi, with an estimated 16.8 million people, added more than 6,900 new infections. Post test numbers every day, including information on the type of tests used. Still, his regimen, heavily skewed in favor of rapid antigen testing, has come under fire for the past two weeks as new cases skyrocketed amid colder temperatures, high pollution and little social distancing.
With hospitals in Delhi filling up again, some health experts believe the situation will only get worse with unreliable tests.
“We hold on to the straws,” Sundararaman said.
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