Risks Of Under-Reporting


India should stop unreliable antigen testing for COVID-19

PRIME Minister Narendra Modi has asked the states and the Union Territories to work towards bringing down the coronavirus positivity rate to 5 per cent and the fatality rate to under 1 per cent. Chairing a review meeting on the status and preparedness of COVID-19 response, the Prime Minister suggested an increase in RT-PCR tests, even as he cautioned the states and the UTs against laxity in fighting the COVID-19 pandemic. “We need to speed up our efforts to reduce transmission of the virus. Testing, confirmation, contact tracing and data must be given top priority,” Modi told the Chief Ministers and officials of states and UTs even as he asked them to draw plans to ensure that people at the lowest level were also administered the vaccine, which is expected to arrive in the next few months.

On the face of it, there could be no disagreement with the Prime Minister’s view that the time had come for the authorities to focus on developing a good infrastructure for administering vaccines to everyone to contain the spread of virus and help save lives. However, there is still time when the vaccine would be accessible to common people. The current situation has to be dealt with humanly and effectively at first to reduce infections and mortality. The central government and the governments in states and UTs have to explain why India has been under-reporting the number of COVID-19 cases as some studies suggest. It is reported that the actual numbers of COVID-19 cases have been fudged in the country either by reducing the number of tests or by increasingly relying on rapid antigen tests which are known to give false reading. RT-PCR tests show a 2.5 to 3.5 times higher positivity rate than the antigen tests. Despite ample knowledge that antigen tests do not detect the coronavirus as well as PCR tests do, these tests are being widely used in almost all the states, including Goa. Is this a cover-up to show that the country has fought off the virus very well and contained its spread? The attempts by the Donald Trump administration in the United States to cut testing backfired as that country is witnessing a huge new surge.

Some reports suggest that as many as 34 lakh cases have been under-reported in India by deliberate increase in the use of the unreliable antigen tests. Though India began the fight against coronavirus by ensuring 100 percent testing of people by using RT-PCR test, the scale of testing using this method has come down drastically and at the moment stands at less than 60 percent. Bihar, Telangana, Gujarat, Delhi and Uttar Pradesh were the 5 worst performing states in the fight against coronavirus with less than 50 percent RT-PCR tests. On the other hand, Tamil Nadu and Rajasthan have been using 100 percent RT-PCR testing which has helped them in accurate reporting. While Tamil Nadu and Karnataka have been testing 1,400 and 1,300 people respectively out of 10,000 of their citizens using the standard RT-PCR testing mechanism, elsewhere in the country only around 550 people out of 10,000 citizens are being tested through RT-PCR testing mechanism, which experts say is much below par. 

The fight against the coronavirus cannot be won by relying on tests that are known to give false results. All states and UTs have to adopt a scientific approach in dealing with the virus and ensure that as many people, especially those with some symptoms, are tested for prevalence of the virus. Any attempt to bypass the scientific process in fighting the virus could have disastrous effects leading to a higher number of people being affected and more casualties and as such should be avoided. Now that the Prime Minister has called upon state and UT governments to bring down casualties to less than one percent, we hope they do not mislead the people of the country by doing more antigen tests. The experience in several parts of the world has shown that less reliable testing might help in the suppression of the actual data on infection rate and fatality, but it ultimately helps neither the people nor the government.