Tuesday saw Indian conduct nearly nine lakh (900,000) COVID-19 tests, reports indicate – but how reliable is India’s testing infrastructure?
The Union Ministry of Health and Family Welfare claims that India conducted 899,000 COVID-19 tests on August 18th. However, Our World in Data puts the number of tests lower, at 818,212. Sushma Dey reported for The Times News Network that the rise in testing coincided with the daily positivity rate for COVID-19 – the disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) or, simply, coronavirus – touching 6.1 percent. The lower positivity rate, despite higher testing,” Dey reports, “is seen as a reassuring development as the daily count of cases has risen in the past couple of months.”
Conducting COVID-19 tests is seen as a vital component of global efforts to tackle the COVID-19 pandemic. In mid-March, the World Health Organization (WHO) espoused a mantra of “test, test, test.” Director-General Dr Tedros Adhanom Ghebreyesus described “testing, isolation and contact tracing” as “the backbone of the response. The most effective way to prevent infections and save lives is breaking the chains of transmission. And to do that, you must test and isolate.”
India has taken steps to strengthen its testing infrastructure. As of August 9th, Statista reports that India is home to 1,406 testing centres for COVID-19. Of these, 941 are publicly-run. The private sector runs the remaining 465.
Prime Minister Narendra Modi aspires to conduct one million tests a day. However, as Shruti Menon reports for BBC News, this “should be put in the context of India’s population of 1.3 billion.” It also points out that India’s testing capacity per 100,000 people as of August 11th is less than that of South Africa and the United Kingdom, countries with significantly smaller populations. In addition, the BBC News report highlights concerns over the reliability of the tests used in India
“The one that’s been most commonly used globally is a PCR (polymerase chain reaction) test, which isolates genetic material from a swab sample…These are regarded as the gold standard of testing, but they’re the most expensive in India and take up to eight hours to process the samples. To produce a result may take up to a day, depending on the time taken to transport samples to labs. In order to increase its testing capacity, the Indian authorities have been switching over to a cheaper and quicker method called a rapid antigen test, more globally known as diagnostic or rapid tests…but these tests are less reliable, with an accuracy rate in some cases as low as fifty percent.”
Similarly, Bloomberg’s Ragini Saxena reports that “India’s bid to control its surging virus infections by increasing the use of fast but less sensitive tests could actually be making things worse.” It cites a press briefing by Indian Council of Medical Research (ICMR) Director-General Bharam Bhargava, who said rapid antigen tests account for 25 to thirty percent of COVID-19 tests.
This, the report outlines, “casts further doubt on the ability of Prime Minister Narendra Modi’s government to stem the epidemic, which is now surging unchecked through the nation’s hinterland. It may also mean the falling case numbers seen in its big cities could be due to false negatives, raising questions over whether infection is truly being curbed. Worse, the use of rapid tests could be letting some infected people return freely to the community, spreading the pathogen to even more people.”
It is not enough to say COVID-19 tests are crucial. Reliable COVID-19 tests are crucial. The number of COVID-19 tests carried out is important, but it is equally important that this be reflective of the reality of the country’s testing infrastructure. Without effective testing, we cannot contact trace – and therefore, the pandemic may only worsen.