COVID-19 testing in India in comparison to the rest of the world. If Indian testing strategy was replicated in the other top 15 COVID-19 affected countries in the world, the status would be startlingly different
How to cite this article: Parikh PM, Bapna A, Krishna MV, Mehta P, Aggarwal S, Gulia A. COVID-19 testing in India in comparison to the rest of the world. If Indian testing strategy was replicated in the other top 15 COVID-19 affected countries in the world, the status would be startlingly different. Indian J Med Sci 2020;72(2):107-9.
In terms of the absolute number of COVID-19 positive cases, India is among the top four countries in the world. There is a lot of unwarranted criticism about the alleged inadequacy of COVID-19 testing in India. The facts available from international and publicly available online non-government source covering the entire world show otherwise. While India is fourth in terms of an absolute number of cases, its rank is 132nd in terms of cases per million population and 107th for deaths per million population. These are indications that India is doing much better in the battle against COVID-19 than it is getting credit for. The correct benchmark for the adequacy of testing is the percentage of COVID-19 positive results as compared to the total number of tests performed. India ranks 5th (out of 215) in this respect – being better than some western countries such as the USA, Spain, and France. Thus, the Indian strategy for COVID-19 testing is better and more appropriate than the majority of other countries with the large absolute number of positive cases.
Adequacy of testing
Ratio to population
COVID-19 is an unprecedented global pandemic that has infected more than 8 million cases worldwide (as on June 15, 2020) and unfortunately led to the loss of 435,666 lives. The caseload in India has been steadily increasing over the past 3 months, and presently, India is counted among the top four countries in the world (behind USA, Brazil, and Russia) in terms of absolute numbers. There is an ongoing debate about how governments and health authorities are responding to the COVID-19 pandemic. Specifically, there is a lot of criticism regarding the adequacy of testing and whether all the cases are being detected.
To evaluate these claims, we decided to analyze the publicly available data obtained at a single point in time (June 15, 2020) from an international, online, and publicly available non- government resource that have provided real-time facts from across the globe – covering 215 nations.
Table 1 compares the number of cases in the top four countries – USA, Brazil, Russia, and India. Not to compare apples with oranges, we have added columns to show the number of cases per million of each country’s population as well as the number of deaths per million of population (along with the world rank for these parameters). While India may be ranked #4 in terms of absolute number of cases, its rank is 132nd in terms of cases per million population (out of a total of 215 countries). These are very encouraging figures and indicate that India has less cases as a percentage of its population as compared to the rest of the world. In terms of deaths per million of the total population, India ranks 107th. Despite rather dire predictions about the volume of cases, these figures probably indicate that India has been able to contain the COVID-19 pandemic to some extent.
|Country||Absolute number of COVID-19 positive cases||Cases per million of population|
|Total cases||World rank (out of 215)||No||World rank (out of 215)|
The other area of significant concern has been the adequacy of testing. The top 15 countries are compared in Table 2 (adapted from Parikh PM 3M India.in). To get the right perspective, we have shown the absolute number of COVID tests performed as well as the ratio of COVID-19 positive tests to the total number of tests actually performed (as a percentage). The generally accepted implication is that the lower the percentages, the higher is the adequacy of testing. Table 2 shows that Russia is the best with only 3.54% of tests being positive. India’s rank among the top 15 countries is 5th, with 5.77% positive tests which appear to be significantly better than some European countries such as Spain (rank 6th), France (Rank 9th), and the USA (rank 8th).
|Country||Absolute number of COVID-19 positive cases||Absolute number of tests||Adequacy of testing – Percentage of positive tests (ratio of positive tests to total number of tests; lower percentage is better) (%)||Rank of adequate testing (least number of positive cases per tests performed)||Number of COVID-19 tests that would have been required if testinggave the level of positivity as India|
|Total cases||World rank (out of 215)||No||Rank||Total tests required||Change in testing required to match India’s level (percentage) (%)|
Rather intriguingly, if we use the level of COVID-19 testing in India as a benchmark and then compare other countries, a rather different pattern emerges regarding the adequacy of testing. There is a wide variation with several countries being seen to have inadequate testing relative to the number of cases – including France, the USA, and some South American countries. We agree that this is a single measure only and that further granular analysis is need once the pandemic resolves.[5,6] Till hard additional data become available to the contrary, we hope that this will put to rest all complaints about India not testing enough people. Indian strategy for COVID-19 testing is better and more appropriate than the majority of other countries with a large absolute number of COVID-19 positive cases.
Declaration of patient consent
Patient’s consent not required as there are no patients in this study.
Financial support and sponsorship
Conflicts of interest
The authors Purvish M. Parikh and Ashish Gulia are on the editorial board. They do not have any competing interests.
- Available from: https://www.worldometers.info/coronavirus [Last accessed on 2020 Jun 15]
- Available from: https://www.m3india.in/contents/editor_pick/136721/covid-19-pandemic-contrast-between-saarc [Last accessed on 2020 Jun 15]COVID-19 Pandemic: Contrast Between SAARC Countries and Western World. 2020.
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