The total number of confirmed coronavirus cases have crossed 90 lakh in India, but the daily confirmed cases have been dipping steadily since mid-September’s high of 97,860. In fact, data showed that on November 16, the daily confirmed cases fell to 28,609, the lowest since July 13.

That the pandemic is being controlled is also being seen in the test positivity rate [(positive tests/total tests)*100 per cent]. This rate has been declining steadily since the second week of August. It was the highest — 9.01 per cent — on August 9, but fell to 8.01 per cent on October 14 and further down to 7.01 per cent on November 16. On Sunday, November 22, it stood at 6.89 per cent.

Positivity ratio

The test positivity rate signifies the percentage of people who have tested positive of the total who have been tested. According to the John Hopkins School of Public Health, the positivity rate or the per cent positive will be high “if the number of positive tests is too high, or if the number of total tests is too low. A higher per cent positive suggests higher transmission and that there are likely more people with coronavirus in the community who haven’t been tested yet.”

The WHO indicated in May that the positivity rate should move below 5 per cent before countries can begin lifting movement restrictions. While the number for India is not below the WHO threshold, the steady decline in the positivity rate in India is a good sign. Experts, however, warn that it is not time to let down the guard yet.

“In many parts of the country, the test positivity ratio has seen a considerable dip in the last few weeks. This clearly indicates that those parts have passed the peak for now, however, it does not indicate that worse is over. As we can see from Delhi, where the test positivity ratio was 5 around mid-September and has reached around 10 in last few days, the city is seeing its third wave and nothing stops other parts of the country from following similar patterns in coming months,” said Himanshu Sikka, Lead, Health, Nutrition & WASH, IPE Global. “Further, we maybe testing enough for now in those locations, but not universally across the country,” he added.

Testing inadequacy

Sikka also noted that several States like Uttar Pradesh and Bihar are testing much less than that required for their population size.

Among the States/Union Territories with high test positivity rates are Maharashtra at 17.5 per cent, Goa at 14.1 per cent, Chandigarh at 12.6 per cent, Nagaland at 9.8 per cent and Chhattisgarh at 9.7 per cent, as on November 21. On the other hand, the regions with low test positivity rates include Bihar at 1.7 per cent, Mizoram at 2.6 per cent, Gujarat at 2.7 per cent, Jharkhand at 2.8 per cent and Uttar Pradesh at 2.9 per cent.

Sikka said that the focus now needs to be on improving the quality of rapid tests and follow-ups. “Often people are not going for RT-PCR after testing negative on the rapid test, which can very well be a false negative. Protocols need to be strengthened to ensure that where some symptoms and strong history of contact with other positive cases exist, the patient goes through RT-PCR even when the rapid test has come negative. Also, moving forward, India needs to have more models of community-level mass screenings — which could be through waste-water screening etc,” he added.

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