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Covid test positivity rates, rising deaths indicate that India isn’t seeing the full picture

In episode 490 of #CutTheClutter, Shekhar Gupta delves into the Covid testing data of various states to see how the pandemic is playing out in these regions.

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New Delhi: With a high test positivity rate of 37.82 per cent and no effort to ramp up testing, Delhi is handling the coronavirus crisis like a pigeon closing its eyes to an approaching cat, ThePrint’s Editor-in-Chief Shekhar Gupta said in episode 490 of Cut The Clutter.

India has now ramped up its Covid testing to about 1.42 lakh a day. While this figure is much higher than what was being done when the lockdown started, the country as a whole needs to continue to increase its testing as the test positivity rate (TPR) is now rising.

Test positivity rate is the percentage of tests that are turning out to be positive for SARS-CoV-2. If the rate is too high, it indicates that only the sickest are being tested and a large section of the population could be missing out.

“Last week (31 May to 6 June), the TPR had gone up to 7.5 per cent. Yesterday, it went up to 8.2 per cent — which means one out of 12 tested is turning out positive,” Gupta said.

When the test positivity rate rises, it means that the percentage of people you test that turnout positive is rising, and one must ramp up to test a larger number of people.

India can ramp its testing up to nearly half a million per day, as that many test kits are being produced, Gupta added.

“It is generally believed, and that’s what ICMR also tells me, that once your test positivity rate goes beyond 10 per cent, you have to increase your testing,” he said.

While the national average TPR is below 10 per cent, in a large country like India, a national level picture can hide many sins, Gupta said.

A look at the areas from where the bulk of India’s cases and fatalities are coming from can paint a more accurate picture.

On Saturday, Delhi had a test positivity rate of 37.82 per cent. When this rate went beyond 10 per cent, the national capital should have upped its testing, but Delhi chose not to do that.

“Delhi today has this unfortunate dubious distinction of having the highest test positivity rate by far in the whole country and almost five times as much as the national average,” Gupta said.

Several states reduce testing 

As of 7 June, Telangana has a TPR of 23.66 per cent, while for Maharashtra it is 23.12 per cent. In Mumbai alone, TPR is over 40 per cent.

Gujarat has a TPR of 13.47, but if the data from Ahmedabad were to be looked at, the TPR would be very high, Gupta said.

Tamil Nadu and Haryana have TPR of 11.25 per cent and 10.23 per cent respectively, which means that there is a need to ramp up testing here as well.

Delhi and Maharashtra have low rates of testing because they have kept their testing numbers steady, instead of ramping it up.

On the other hand, West Bengal has reduced the testing from about 11,919 tests to 10,909. The TPR in the state is 26 per cent.

Telangana, which was testing very little to begin with, has reduced its testing by 45 per cent — from 1,030 to 579. Bihar has reduced testing by 42 per cent.

“These are states which should be testing more, but they are testing less, because they somehow think by doing this, they can reduce their overall positive number. So once again, it’s like a pigeon closing its eye at the cat that’s coming in,” said Gupta.

From 31 May to 6 June, Delhi’s total tests conducted was about 35,210, with total positive cases of 11,623. This means 33 per cent of those tested are turning out to be positive.

“But in the last 24 hours, the TPR has risen to 37.82 per cent,” he said.

Maharashtra has conducted 88,316 tests of which 19,231 have turned out positive, bringing the TPR to 21.8 per cent.

Telangana, Gujarat, Tamil Nadu, and Haryana recored a TPR above the national average of 8.5 per cent in the last week.

Tests per million in different states

Telangana is among the worst-faring states when it comes to tests per million. The state has conducted just 4,714 tests, which amount to 121 tests per million. With 21,260 tests, Bihar has conducted about 174 tests per million.

Uttar Pradesh has conducted 232 per million, which is about twice that of Telangana.

“So even Yogi’s government is doing enormously better than KCR government of Telangana,” Gupta said.

Kerala, too, is currently testing very little — about 391 per million — despite being hailed as a model.

Madhya Pradesh, Chattisgarh, Odisha, Gujarat are all trailing behind the national average with 469, 504, 519, and 587 tests per million.

Overall, India is testing 685 per million. States like Karnataka, and Andhra Pradesh on the other hand are testing a lot more.

“They are actually showing very good results on the ground in terms of their cases, and fatalities,” Gupta said.

Tamil Nadu has a large number of cases, but very low fatalities. The state has a good primary health system, and higher testing rates helps catch those cases much earlier.

Case fatality rates

Case fatality rates refer to the percentage of people who died among those who tested positive.

This figure will go up if you are testing less.

“The more you test, the more positive cases you have, the less will be the percentage of people who died, and your case fatality rate will go down,” Gupta explained.

Another way to hide data is to not register Covid-19 fatalities.

Gupta said that some states unfortunately are underreporting Covid-19 deaths. However, there is a limit to which the death toll can be tweaked.

Beyond a point, hiding the death toll will become difficult because of the bodies piling up at crematoriums and burial grounds.

“When the government and ICMR are nudging you to increase your cremation capacity, both with wood and electricity, you know that you are in deep trouble,” Gupta said.

That is why testing becomes important, to discover cases early and thereby reduce fatalities by providing timely treatment.

If states like Maharashtra and Delhi try to hide their true infection numbers by testing less, their case fatality rates will be much higher.

“As you would expect, Delhi has a high case fatality rate of 40.67 per million — that is if you believe Delhi’s official figures,” Gupta said.

“Gujarat has a case fatality rate of 19.08 per million, it will be even higher for Ahmedabad, which has been handled very poorly,” Gupta added.

Ahmedabad has a case fatality rate of above 40 per million. About two weeks back, Mumbai had a case fatality rate of about 78 per million. In Kolkata, this figure is about 23-24 per million, while Chennai has a case fatality rate of about 15-16 per million.

India’s overall figures are just five per million, which means, Delhi is already more than eight times the national fatality rate, and Mumbai is probably 10 times India’s case fatality rate per million, Gupta said.

Karnataka model 

Karnataka as a state has a case fatality rate of 0.8 per million. It is among the lowest in the country, definitely lowest among the large states.

“In fact people talk about Kerala model, Bhilwara model — but the state that gets very poor credit, but should get a lot more credit for all this is Karnataka,” Gupta said.

He added that other states ought to learn from Karnataka since they have tested a lot.

Gupta said that even if states try to take pride in the fact that they have low number of coronavirus cases, their TPR and case fatality rates paints a different picture.

“So you know, just because you hide your figures and just because you close your eyes to the oncoming cat, you can do no better than the silly pigeon,” Gupta said.

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  1. Bihar Test Positivity Rate was claimed as 22.83% on 06th June 2020 which is not matching with the official figures released by health department of Bihar. I have attached screenshots of the same. There are 3570 test results were released & 194 found positive as on 06 June. So it is 5.43 %. Another fact presented that Bihar reduced it’s testing by 42%. Firstly there is no time period mentioned with this data. I also not able to find any such test reduction in any time period. On an average Bihar was doing 2000+ tests in May 3rd week which is increased by 2500+ tests in May last & then it is in around 3500. So can u plz explain the data behind these stat presentated?

  2. Where can i check delhi testing rate and number of daily tests? Searched everywhere but couldn’t find it

  3. Where is MP.
    The big state is not in your article indicates that you shitty paid media is only work for money like a pig.

  4. I am surprised by some of the data that you shared. For example, “On the other hand, West Bengal has reduced the testing from about 11,919 tests to 10,909. The TPR in the state is 26 per cent.” Presumably, those testing counts are daily ones. WB has not tested more than 10000 in a day even once till date. The highest was 9786 yesterday. Since the number of confirmed cases were 449 yesterday, TPR was 4.59% only. So it is surprising how those figures turned up.

    The next interesting note is on Case Fatality Rate and it has been mentioned “Delhi has a high case fatality rate of 40.67 per million”. WHO, for example, has defined CFR as “The reported case fatality rate (CFR) is a measure of the severity of a disease and is defined as the proportion of reported cases of a specified disease or condition which are fatal within a specified time.” Ref: It is measured in percentage and if it has to be measured in per millions, no one would even be worried.

    When a publication with such wide readership discusses such important matters, it is only expected that the journalists involved should be responsible enough to provide correct information.

  5. Pandemic will play out. Population density in India will see to it. It is also clear there is no antiviral which works on Covid 19 despite claims made by various entities. But politics of oneupmanship will continue. That will ensure we won’t get reliable data.

  6. Guptaji, the closet epidemiologist. And why not, when you are the chief hack you can wear many hats.

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