COVID-19: Is India testing enough? Myth vs Truth
There is a lot of cry in the media, specially the western ones, on how India is not testing enough patients for COVID-19. They give a lot of reasons and figures for coming to this conclusion. On the face value and superficial analysis, it might appear true but are they using the correct metric? Only a biased Indian will trust the data and statistics and hype, especially given the negative hype, against India from the Western media houses. After all, as per these same media houses, India is the rape capital of the world, even though rapes per capita are 2000% higher in the West than in India. So, we set out to test the data at hand and check whether the media hype against the Indian govt is true or not.
The numbers used by the western and certain Indian media is completely misleading. They point out to the number of tests done per million people to come to the conclusion that India is not doing enough. But tests per million people is a spurious and misleading figure in this regard because not all people are going to have the disease. Only people who are in contact with the people affected by the people are going to have the disease. So it makes no medical sense to test anyone and everyone in the entire country for the virus. Why? Because that will be spuriously costly, the people who are in incubation period and window period might not show the disease and even if the test shows up negative it will still end up being meaningless because the person who was tested negative might still end up getting the disease at a later stage through contact from a convalescent carrier.
Tests per million is a stupid way to measure how good the country is handling the issue
India doesn’t even need to test all people. Nobody in the world can test everyone for that matter. It is prohibitively costly and has no treatment value. The only value for these tests is for epidemiological purpose- contact tracing, testing and quarantining. Because unlike tests for malaria, plague, cholera, Syphilis etc, there is no targeted treatment for this disease yet. Also, Imagine you getting CT/MRI scan of the chest for no reason for a simple fever. Obviously its good to know that you don’t have any underlying tumors. But why waste precious money and time when you don’t even have any symptom to warrant that. Same logic applies for Corona.
Even countries with supposedly very good testing rates for COVID-19 are not testing everyone. For example, South Korea has tested 9000 per million while USA is testing 5000 per million as of today. Does that mean South Korea and USA are doing a bad testing job because they are testing only 5-9 people out of 1000? Thus the entire argument that India is testing less compared to western countries based on tests per million indicator is a very bad way of comparing whether India is testing enough.
Why India has been largely unaffected so far from the epidemic
India has so far had only 4000+ cases of Corona virus so far. Compared to countries like UK with 47,000+ cases, USA with 330,000+ cases, China with 81,000+ cases, Italy with 128,000+ cases this looks like peanut. The western population and its media sees it as a proof that India is not testing enough. Of course, for the bigoted racist hacks, anything India achieves should be viewed with skepticism. It’s better for their fragile ego to believe that a former British colony made up of brown people who shit on the streets cannot be unaffected by the epidemic which is massacring them by the thousands rather than believe that their former slaves are doing better than them in handling a global crisis than their pathetic governments and population. But it is not the time for chest-beating.
India took proper steps at containing the disease at a very early stage. India started banning public gatherings in various states in a step wise manner way before most of the above mentioned countries. As soon as the corona virus break out was discovered in China, even before the WHO (who have become lapdogs for the Chinese CCP these days) started its travel advisory and closed down its borders with China. To get a perspective on how fore-sighted that decision was, note that countries like UK and USA didn’t close their borders with China even after WHO started issuing such travel advisory. India closed down its non-essential services like theatres, gyms, parks, even schools and colleges by the end of February. The leaders in UK(like British PM Boris Johnson) decided to face the epidemic by hugging the corona patients and spreading out the virus while encouraging his fellow countrymen to do the same. The UK government was trying to steepen the curve when the whole world was trying to flatten it. When Indian government was banning mass gatherings and religious events to fight the epidemic, Italian liberals and their mayors were celebrating “Hug a Chinese” movement to fight racism, than fight the epidemic.
India is not the only place where you can see this difference. Within US, New York City (America’s Wuhan) and San Francisco took different actions and consequently obtained different result.
The above mentioned stupidity is not the first US screw up either. Even during 1918 Spanish Flu Pandemic, City of Philadelphia (≡ today’s NY) and St. Louis (≡ today’s SF) behaved differently. Consequently, obtained different results
The results of these actions by various govts across the world are apparent today. Italy’s health system broke down. The same liberals who spread the infection far and wide with their “Hug a Chinese “ campaign were dying in the streets without proper medical facilities as the cases started overwhelming the system. The UK now has started implementing the same systems Indian government had implemented way back, only after it is too late. USA was still debating whether to save old people and slowdown the economy or to kill a few old people to keep the profits up. Of course, being the last major country to establish the quarantine and lockdown procedures, finally after deciding that human lives even of that of old people is more important than money, USA now leads the world in Corona cases and is poised to overtake Italy in the number of deaths from the pandemic.
The numbers in India are still less than 5000 despite the ruckus creating individuals who dis-obeyed the government advisory on travel and gathering.For example- Tablighi Jamaat are the ones who have been disproportionately affected by the virus and have been responsible for half the spread of the virus in India. As one can see, more than anything else, the reason India has been spared the horrors of this virus is because of how well the Indian central and state governments have handled it so far. Their response has been one of the best if not THE best in the entire world
Test positivity rate vs Tests per Million
Most westerners find it hard to believe that such a poor country run by their former slaves could muster up such a good response to this epidemic. This has been the reason why there has been a slew of nonsensical articles on the western countries on how India is handling the disease. They first started by ridiculing our Prime minister’s suggestion to pay homage to our healthcare workers with claps. When the same was repeated across the globe from the superior white European countries like UK, USA etc, surprisingly there was no such ridicule. After all, if the whites do it, it is scientific and boosts morale to fight the virus as a community, while if the brown polytheistic Hindus do it, it is superstition and blind bhakti to Modi.
This is also where their obsession with tests per million come in. We already saw that tests per million is a useless metric to analyze the number of tests done. We will give further reasons why that is a waste of time. Firstly, the resources are not infinite. If possible, we can theoretically test everyone and we should test everyone in the country. But that is a nonsensical and impractical statement of no value similar to saying that there should be no poor people in the country. Nobody can argue against that statement- that there should be no poor people in the country. Similarly, nobody will argue against the statement that testing more people is better and testing capacity should be increased. Such statements are so broad and vague that it can be made for anything and it will as meaningless in those scenerios as it is here. For example, there should be more hospitals for treating all the diseased, there should be more doctors, there should be more honey, there should be more houses for everyone etc are all equally vacuous assertions with no meaning and it has no end.
Unfortunately, in the real world, we have limited resources and we need to spend them wisely.It applies to even the richest country in the world, the USA. Even there, the testing is limited to suspected individuals and not every tom dick and harry. Contrary to the popular belief, the testing in case of COVID-19 has no prognostic value in the disease progression. The survival of the patients, even the ones worst affected by it is not dependent on the diagnosis of the disease. Even drugs like chloroquine and hydroxyl chloroquine are only given as a experimental drug and hasn’t actually been proven to work in Randomized Control Trials. So the most important reason for testing for the virus is for epidemiological purposes. That is, it is for contact tracing, isolation and quarantine. That is, the testing is done for studying the spread, prevalence and incidence of the virus and to plan a strategy to contain the spread of the virus.
So when this is the case, rather than look for tests per million, which is a meaningless test in India because India nearly doesn’t have as many cases or contacts to justify spending 4,500 rupees worth test for each and every citizen of the country. That is why even the supposedly best testing country in the world South Korea is not testing more than 9/1000 patients. What the government has done – testing the contacts and the ones with symptoms suggestive of the disease is the most prudent way to use the limited resources. When the prevalence rate in India is expected to be lower because India was not twiddling its thumb and started taking actions to control the spread of the disease way back from January, it is stupid to even suggest that India should be testing as much as a country like USA. It is not needed and it won’t even help us. Another example to show why Tests per million is pointless is to point out that India has not tested any case for Ebola virus of late. So the test per million here is even lower compared to the African under-developed countries. Does that mean we should now start testing everyone for ebola? Obviously not and that is the point. You don’t test people based on the whims and wishes of the media houses. You test people based on the needs and requirements.
Further, when one looks at the ratio of the total number of tests done in India to the total cases tested positive to that of the other, one has to come to a conclusion that India is actually testing way higher for the prevalent disease rate compared to that of the western “advanced” countries. For example, as of April 4th 2020, India had tested 70000 samples of which 4000 had tested positive, giving us a test positivity rate of 4.5%. On the same day, USA had tested 1.2 million people of which it had tested positive among 250,000 people meaning the test positivity rate in USA is about 16%, the similar rate for UK is about 18%. The rate for Italy is something similar. What this means is that, atleast so far, the testing rate in India has beenway higher than its disease load will suggest. That is more people are being tested negative in India than that in USA. Even though the government is having stringent testing protocols in India, India is reporting way lower positivity test rate than the “advanced” countries.
Lets say for argument’s sake that the Indian government is not testing enough as per the advice of the western “enlightened” media. Then as per that argument, government is only testing the close contacts of the disease and those who are symptomatic and that Indian govt is only testing people who are at very high risk of having the disease, you expect that the total number of positive results from the tests to be very high. If on the contrary, if the government criteria is relaxed for testing and more people are being tested for the disease even with relatively lower indication for testing for the disease, then you will get a lower number of test results. So when Indian test positivity rate is 4.5% and that of the USA is 16% and UK is 18%, it means that Indian government is on average testing 4 times the number of people than countries like USA and UK for the same case load.
Some western media houses and their brown sepoys claim that India is vastly under-reporting the cases in the country. That is a stance borne out of ignorance and prejudice- after all how can a country of former slaves of the white man have a disease load lower than the advanced superior white race countries? However this is patently nonsense. Contrary to popular belief, Indian government is actually maintaining strict vigilance of all cases with fever and other symptoms related to corona viruses. All clinics and hospitals across the country are being asked to report the fever cases getting treated by them and it is being enforced strictly. So it is not like the fever cases are getting sweeped under the rug by the government. It is not. Contrast this to how a superior western European country like France or UK is dealing with patients having fever and mild symtoms- asking them to stay at home and never come to a hospital.
This is not to say that Indian government should not increase testing capacity- it should. The same way arguing for best way to combat poverty is not the same as suggesting nothing should be done against poverty. The question is not whether the government should increase the testing capacity or not. It should, given that we expect an increase in the number of cases and testing more people is better. But the real question is whether the government has done enough testing compared to advanced economies? The answer to that is, contrary to the popular belief- yes. The government’s strategy to test the contacts and their contacts and symptomatic cases is very good and effective. In fact, Indian government’s handling of the health crisis has been perfect so far, except perhaps their handling of the Tablighi Jamaat fiasco, which the government should have nipped in the bud. So rather than listen to the racist western media and their brown sepoys, it is better to trust our government and our society.
Contrast the behavior of our citizenshttps://www.thehindu.com/news/cities/chennai/these-ngos-are-working-around-coronavirus-lockdown-restrictions-to-feed-the-needy/article31192583.ece, who are banding together to help our poor in this crisis compared to what superior westerners have devolved into in such a situation https://www.thesun.co.uk/news/11207109/thugs-smash-sainsburys-loot-alcohol/. You can see the same behavior during Natural Disasters – we will look for ways to help others or at least, don’t create additional Law and Order breakdown. Our Government never once imposed Emergency to control Law and Order during Natural Disasters. In West, when Disaster hits, they experience loot and arson which their Government controls by imposing Martial Laws. During the Chennai floods in 2016, people of Chennai pooled together to help each other survive while for any flood in the superior, white civilized world like USA or UK is arson and loot
So this is the time for us to show the world on why we have been the most successful continuous civilization in the world, despite our problems and not the time to give any credence to the jealous white racist media buffoons and their brown sepoys here.
.The author of this article is an MBBS doctor from Madras medical college. Image credit: https://www.euractiv.com/section/all/news/new-rapid-test-kit-to-detect-covid-19-soon-available-in-eu/