If you are following daily updates of Prof Shamika Ravi (Twitter: @ShamikaRavi)
of Brookings Institute, you must be knowing that after a successful run for several
weeks, India's curve flattening effort suffered bit of a set back over last one
week as the cycle of doubling
confirmed cases came down from 14 day to 11 day.
Such small hiccups are expected in a long and tedious fight put up by a democracy
of 137 crore that has three times the population density of China and 15 times
of the US. That we restricted infection count to 53000 and death toll near 1800
tell the success vis-à-vis Europe, America and even large parts of Asia. Singapore
is already facing a second and deadlier wave.
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| Window snip from www.covid19india.org on May 7 |
Having said that there is scope to question the Indian story so far. The
biggest question is if we have enough testing, which is key to identification
and isolation. The India set the alarm bell ringing in January and it went into
lockdown in end March. The intermittent period was used in laying out the
testing protocol and facilities. The process continued post lockdown period.
The Indian strategy was to step up the testing coverage as the disease
spreads. This is a well laid out strategy which was followed by countries like
Taiwan. On the opposite spectrum stands Vietnam who went on mass testing even
before the disease had spread. For one COVID case Vietnam conducted 967 tests. The
second highest, Taiwan did 150 tests for every confirmed case. As is well known
only six persons died in COVID in Taiwan that took restrictive actions like
closure of flights by January. Vietnam didn’t see any death so far. But it is
to be seen if they can withstand the second wave, because they have gone whole
hogged a bit too early.
The testing and identification data is actually not comparable as countries
like Senegal went for low cost rapid tests which have low specificity when
compared to the most effective RT-PCR test. Rapid tests offer ‘false-negative’
results and are used by India to understand degree of social transmission in select
clusters
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| Source: https://ourworldindata.org/what-can-data-on-testing-tell-us-about-the-pandemic |
The question is: if Indian is keeping up with the strategy? The answer is
yes. We are now testing over one lakh samples a day, up by 50 times since
March. The capacity is under further enhancement. But already it has pushed our
testing averages by five-times in last one month. As on May 7, we are testing
at the rate of 0.93 people/1000. The average was 0.71 a few days ago. In the
coming weeks it will move up the ladder sharply, as we now have developed critical
testing capacity. You can see details here.
Stepping up testing average is not enough. It must beat the spread of the
disease so as to contain. Are we successful on this front? The answer is visible
in tests per confirmed case data also available in Ourworldindata. As on date India is conducting 26 tests to
find one COVID case. The ratio was way lower two weeks ago. It means India is successful
in containing the spread of infection. The India ratio is among the best in the
world. Let’s not blame it on lockdown. Because the entire world was under lockdown.
After 75000 deaths, USA is still getting one COVID case in every 6 tests. Scary
NO?
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| Source: https://ourworldindata.org/what-can-data-on-testing-tell-us-about-the-pandemic |
So how did, India’s neighbours did compared to India? Pakistan (21 crore)
and Bangladesh (16 crore) have 12-16% of India’s population (137 crore). But,
when it comes to infections: Pakistan has almost half of India’s numbers and
Bangladesh has a little less than 25%. This is indeed alarming. However, when
it comes to mortality (death/total infection), both are way lower than India’s
3.4%. Bangladesh is 1.6% and Pakistan 2.4%. This is intriguing. Ideally, our
death rates should be identical. There
can be three factors to it. First, could be better healthcare infrastructure,
which is doubtful at least in the case of Bangladesh. Second, heard immunity. The
third one is “Bengal-factor” where numbers are inconsequential. If you do not
know what I mean read it
Leaving behind death rate. The spread of infection is really alarming in
these two neighbouring countries, particularly in Bangladesh which is lagging
both in terms of tests/population and tests/covid case ratio. It might mean,
there are too many unidentified COVID cases in Bangladesh and one doesn’t know
what’s happening to them. Bengal-factor once again. Pakistan is marginally
better off than Bangladesh. Their test/population is slightly better than
India. But tests/COVID case (10) is less than half of India (26) and a shade better
than Bangladesh (9).
It is not that Bangladesh hasn’t done anything. Except Pakistan, all countries
in the neighbourhood followed Indian strategy, which is expected. In fact,
Bangladesh’s performances are way better than richer SE Asian countries like
Indonesia as is evident in both test/population ratio and case/test frequency. Bangladesh’s
ratio’s improved over the last two weeks, indicating they are on the job.
However, the gap between India and Bangladesh got wider in case/test ratio,
indicating higher prevalence of the disease. This is either due to mismanagement
of the lockdown or due to high population density (1115 people/sq km) compared
to India’s 464/sq km and Pakistan’s 287/sq-km.
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