{"id":39542,"date":"2020-04-06T09:53:37","date_gmt":"2020-04-06T09:53:37","guid":{"rendered":"https:\/\/blogs.bmj.com\/bmjgh\/?p=39542"},"modified":"2020-04-08T07:41:25","modified_gmt":"2020-04-08T07:41:25","slug":"is-india-detecting-enough-cases-to-be-able-to-contain-covid-19-a-dive-into-sub-national-data","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmjgh\/2020\/04\/06\/is-india-detecting-enough-cases-to-be-able-to-contain-covid-19-a-dive-into-sub-national-data\/","title":{"rendered":"Is India detecting enough cases to be able to contain COVID-19? A dive into sub-national data"},"content":{"rendered":"

In a bid to control COVID-19, India is in the midst of a 21- day lockdown. It is increasingly becoming clear that COVID-19 cannot be solved in a 21-day race. The big question on everyone’s mind is how, when, and in what form COVID-19 will end?<\/p>\n

Successful containment comprises tracking the disease transmission within a community through active surveillance, extensive testing, isolation of COVID-19 cases, further contact tracing, and quarantine. The lockdown measures (mitigation) aimed to slow the rate at which further spread of the virus occurs and reduces the anticipated surge while expanding the testing and treatment capabilities. The Government of India has taken a significant step to build the capacity of more tests. So far, India has conducted 47 tests per million of the population, which is low compared to that of other countries. In contrast, the UK\u00a0 has tested 2,753, USA, 4572, South Korea, 8800,\u00a0 Australia, 11291, and UAE, 22,918 tests million. As of 1st<\/sup> \u00a0April, the UK has tested 348 per 100,000 of the population, Italy 895 per 100,000, South Korea 842 per 100,000, USA 348 per 100,000, and 27 per 100,000 for Japan. In terms of volume, France conducts \u00a010,000 tests per week, UK 16,000, US 26,000, Germany 42,000, Italy 52,000, and South Korea 80,000 tests. In comparison, it is essential to have a closer look at the sub-national data instead of cumulative national data to assess how well the COVID-19 containment measures are implemented.<\/p>\n

How are the states performing in containing?<\/strong><\/p>\n

Based on the available data in the public domain, we found the Indian states can be divided in four categories. Based on the testing rates and case fatality, we categorised (Table-1) the states which tested more than 38 tests per million (Median value of the tests conducted across all states of India) as good testing. Further, states with case fatality rate (CFR) higher than 2.3% (India\u2019s National Average Case fatality) was considered as state with high CFR.<\/p>\n

We used the population projections for India and States for 2020 from the 2011 Census and the current number of confirmed COVID-19 cases, deaths and tests to derive the cases per million, tests per million, and Case fatality proportion for the population. The number of tests conducted was sourced from the State’s Health Department Website as on 5th<\/sup> April, many states did not have the data updated on their websites, and the information was sought from Media Bulletin and press articles.<\/p>\n