India accomplished its 100 millionth check for Covid someday on Friday, in keeping with the HT dashboard. By the Indian Council of Medical Research’s depend, the quantity was marginally decrease, 92.25 million exams (ICMR has a counting protocol that isn’t adopted by all states), which implies that the 100-million mark might be crossed in every week, perhaps sooner.
Still, I’m going to stay with the 100-million-on-Friday mark as a result of the check numbers on the HT dashboard are those we use for measuring the positivity price.
Only the US (round 122 million) and China (160 million) have achieved extra exams than India. Even by way of exams per million, at 100 million exams, India has performed round 77,000 exams per million of the inhabitants. That interprets into 7.7% of the inhabitants — enough in keeping with most consultants if the trace-isolate-treat protocol that follows the exams is stringent sufficient. Unfortunately, it hardly ever is, not simply in India, however in most components of the world.
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The 100 million quantity additionally contains retests. And it contains not simply molecular exams such because the reverse transcription polymerase chain response (RT-PCR) exams but additionally fast antigen exams (RATs). I’ve written extensively in regards to the indiscriminate use of the latter, in contexts through which it doesn’t make sense for them for use, and in enormous numbers (particularly in Bihar and Uttar Pradesh the place they account for a lot of the exams performed; even Delhi makes use of far too many fast exams for its personal good — and for the great of its individuals). Still, 100 million is 100 million, and for a rustic that began with the capability of some laboratories and some thousand exams in late February and March, the quantity marks an incredible achievement.
India, as Dispatch 176 on October 7 identified first, has seen off the primary wave and is within the lull between that and the sure-to-come second wave. Given this, and the testing milestone, how are Indian states doing?
The desk accompanying this piece lists 11 states that collectively account for 79% of India’s circumstances, 82% of its exams and 70% of its exams as of Thursday night. Sure, 10 is a greater quantity however I picked 11 as a result of Bihar is the 11th on the record by way of variety of circumstances and its numbers are attention-grabbing.
Of the 11, Bihar and Uttar Pradesh have the bottom positivity charges — the variety of individuals testing optimistic to exams performed, 2.3% and three.6%, respectively. The common of those 11 states is 8.3%, a quantity skewed upward by Maharashtra’s excessive case quantity and positivity price. The nationwide common is 7.4% (in keeping with the HT dashboard).
Interestingly, if the case fatality price is a proxy of the standard of a state’s well being system — it must be — then Bihar, Kerala, Odisha and Telangana are extra comparable than most individuals would count on. Kerala has the bottom case fatality price of 0.34%; Odisha’s is 0.43%; Bihar’s is 0.48%; and Telangana’s 0.57%. The solely different state among the many 11 with a case fatality price decrease than 1% is Telangana. The case fatality price of those 11 states is 1.56%, marginally larger than India’s 1.52%. Uttar Pradesh’s case fatality price, at 1.46%, is definitely decrease than the nationwide quantity.
It’s troublesome to clarify Uttar Pradesh and Bihar’s low positivity price (and we received’t attempt to). There may be a doable rationalization for the low case fatality charges in Kerala as a result of the state does have a superb public well being system. And there may be a doable rationalization for the low case fatality charges in Bihar as a result of the infections began displaying up within the state nicely after they did in lots of others, and each nationally and internationally, well being care methods have turn into higher at saving lives because the pandemic has progressed. Does that designate charges as little as 0.34% and 0.48%? Uttar Pradesh’s numbers are at the very least internally constant — it has few circumstances, however the proportion of deaths is sort of the identical because the nationwide quantity.
Just just like the thriller surrounding Africa’s numbers — I wrote about this in Dispatch 154 on September 10 — that surrounding Uttar Pradesh and Bihar’s extraordinarily low positivity price and Bihar’s low case fatality price want finding out, for it may maintain solutions on managing the pandemic.