COVID 19 Cases Are Just Tip of the Iceberg

With 258 reported infections and four deaths so far, is India taking this advice seriously? Is the world's second-most populous country testing enough?


“Have always suspected that the numbers we see are just the tip of the iceberg. The real numbers are much higher”: Dr Arvind Kumar, Sir Ganga Ram Hospital, on Coronavirus Outbreak in India.

So far India has recorded 258 case of the novel coronavirus with 4 fatalities. These numbers when compared to European countries or America gives Indian some relief. The ICMR statement refusing probability of community transmission has also been good news for India.

“We have a simple message to all countries – test, test, test,” World Health Organization (WHO) head Tedros Adhanom Ghebreyesus told reporters in Geneva earlier this week.

The coronavirus outbreak, which has killed more than 10,000 people and infected nearly 250,000 in at least 159 countries.

“All countries should be able to test all suspected cases, they cannot fight this pandemic blindfolded,” he said.

With 258 reported infections and four deaths so far, is India taking this advice seriously? Is the world’s second-most populous country testing enough?

The jury is out on this one. India had tested some 14,175 people in 72 state-run labs as of Thursday evening – one of the lowest testing rates in the world. The reason: the country has limited testing. So, only people who have been in touch with an infected person or those who have travelled to high-risk countries, or health workers managing patients with severe respiratory disease and developing Covid-19 symptoms are eligible for testing.

So, why India with a population of over a billion people, and high risk of spread, is not testing enough samples?

Well the official assumption Is that that there is no case of community transmission in India. ICMR conducted a study with more than 826 samples collected from patients suffering from acute respiratory disease from 50 Government hospitals across India between 1 and 15 March tested negative for the coronavirus. It also noted that there is no significant spike in respiratory distress cases.

“It is reassuring that at the moment there is no evidence of community outbreak,” says Balram Bhargava, director of the Indian Council of Medical Research (ICMR). He believes Mr. Ghebreyesus’s advice is “premature” for India, and it would only “create more fear, more paranoia and more hype”. But experts are not so sure.

Let’s hope that community transmission doesn’t happens in India because if it does, the main cause will be lower testing rate. The reason why India in not scaling its testing facilities are unclear. Was it lack of resources? Carelessness or to keep number of COVID 19 positive cases low? In India’s case it might be all

All those countries who saw spike in cases of COVID 19 did the same mistake of not testing enough samples. Iran and Turkey present a contrasting situation, despite sharing border with Iran turkey has seen only 2 deaths because of its proactive testing measures. US only recorded Exponential rise in coronavirus because it didn’t take the testing seriously.

Many of them believeIndia is testing below scale because it fears that its under-resourced and uneven public health system could be swamped by patients. Expert added that India could be buying time to stock up on testing kits and add isolation and hospital beds. A health expert said instead of testing India should work to stop community transmission”.

Contrary to that, a senior virologist said random, on demand testing will only create the panic among the masses and further strain the feeble public health infrastructure. Instead we need focused testing through a sentinel screening process.

Like every country India is in battle with deadly coronavirus in its own way with limited resources. Despite poor health infrastructure in past India has been successful in defeating polio, small pox, successfully controlling spread of HIV/Aids and other deadly diseases. With rigorous surveillance, sharp identification of vulnerable people, targeted intervention and early engagement with private sector India can win the fight against coronavirus.

India is scaling its fight against coronavirus. By the end of this week it will have 122 testing labs which will be able to test 8000 samples a day, claimed authorities. The private sector will also come up with 50 labs withing 10 days and will significantly improve testing capacity. (Testing at state-run labs is free, and it is unclear whether the private labs will charge.)

Two rapid testing labs, capable of doing 1,400 tests a day, are expected to be operational by the end of the week. India has also placed orders for a million test kits, and will be possibly asking the WHO for a million more.

India has eight doctors per 10,000 people compared to 41 in Italy and 71 in Korea. It has one state-run hospital for more than 55,000 people. (Private hospitals are out of reach for most people.

The possibility of virus making a return is also hard to reject, Virologists say. “Given the way it is progressing in India, it seems it is about two weeks behind Spain and three weeks behind Italy. But that’s the number of known cases. And without sufficient testing and shutting down large gatherings, the numbers could be a lot worse,” Shruti Rajagopalan, economist and a Senior Research Fellow at the Mercatus Center at George Mason University, told BBC. Long neglect to public health infrastructure is going to take a toll if the virus spreads to small Towns and villages.

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COVID 19 Cases Are Just Tip of the Iceberg
With 258 reported infections and four deaths so far, is India taking this advice seriously? Is the world's second-most populous country testing enough?
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