Sixteen states record shrinking epidemics- Is rising slower than two weeks ago with number of daily tests decreasing

Experts worry that a plateau in daily diagnostic tests might miss infections and reflect an 'artificial slowdown'

Family members break down during the cremation of a Covid-19 victim at Nigambodh Ghat crematorium in New Delhi on Monday: Prem Singh

G.S. Mudur   |  TT  |  New Delhi   |  11.05.21: India’s second Covid-19 wave is rising slower than two weeks ago and 16 states on Monday recorded shrinking epidemics, but experts are worried that a plateau in daily diagnostic tests might miss infections and reflect an artificial slowdown.

The country’s number of daily tests had peaked to 1.95 million on April 30 but has since plateaued between 1.5 million to 1.92 million over the past week — with 1.4 million tests on Sunday.

A family member conducts the last rites before the cremation of a Covid-19 victim at Nigambodh Ghat on Monday: PTI

The seven-day average of daily new Covid-19 cases in the country — about 390,000 on Monday — has grown by 17,000 over the past week, compared with over 52,000 cases during the previous week.

Experts, however, are concerned that the numbers of daily tests have not kept pace with the surge and, in some states, declined at a time India has a high positivity rate — positive cases among those tested — of 24 per cent instead of an ideal less than 5 per cent.

“What this suggests is that for every 100,000 fewer tests on a day, we’re missing about 24,000 infections,” Rijo M. John, professor of health economics at the Rajagiri Institute of Social Sciences, Cochin, told The Telegraph.

Standard public health measures require health authorities to continue to ramp up testing to minimise the test positivity rate to at least below 5 per cent. But experts who are monitoring the testing rates have observed declines in some states.

“The number of cases we detect depends directly on the number of tests done,” said Giridhar Babu, a professor of epidemiology at the Indian Institute of Public Health, Bangalore. “We see the tests per million declining in some states. This can create an erroneous impression of falling cases.”

At the peak of the country’s first wave last year, John said, India’s daily new case counts had risen to about 97,000 at which point India was doing about 1.1 million tests daily. “Now, the number of cases has increased near four-fold, but we’re doing less than 2 million tests per day,” he said.

Oommen John, a physician and senior researcher at The George Institute for Global Health, New Delhi, said: “Under current circumstances, if we do not test more, there’ll be just more iceberg under the water.”

A family member breaks down during the cremation of a Covid-19 victim at Nigambodh Ghat on Monday: PTI

Experts believe the plateau in daily tests could be the outcome of multiple factors — overloaded labs unable to cope with increasing demand, shortages of materials required for tests, and redistribution of tests from high infection areas to low infection areas in the same state.

But, Professor Babu said, it is also possible that some areas are approaching the so-called peak counts and showing a real decline. “The second wave has been marked by a rapid ascent which makes a rapid descent likely,” he said.

A health worker takes rest outside the Covid care centre of the Rajiv Gandhi Government General Hospital in Chennai on Monday.: PTI

India’s 360,191 new Covid-19 cases recorded on Monday morning from the previous 24 hours has raised the country’s total number of active patients by about 8,500 to over 3.74 million. But Maharashtra, the hardest-hit among states, on Monday had about 12,300 fewer active patients than a day earlier.

Uttar Pradesh, the most populated state, had around 11,000 fewer patients, Bihar had about 2,000 fewer patients, and Delhi’s count shrunk by 1,000 patients. But the counts of patients increased in 20 states, including Andhra Pradesh, Bengal, Karnataka, Kerala, Madhya Pradesh, Punjab and others.