India, which had 100% PCR tests at the beginning of the Covid pandemic is now down to less than 60%. Furthermore, there is a huge rise in Antigen testing, which has increased from a negligible number to now approximately 5.5 crores. This constitutes more than 40% of total tests. This doesn’t stop here as there is a continuous rise in Antigen testing.
The actual number of Covid cases can be compromised in two different ways:
- Firstly, the obvious way. Which is to reduce the number of tests conducted, which US President Donald Trump suggested repeatedly.
- Secondly, a less obvious way. This is by increasing the number of Antigen tests and reducing the number of PCR tests.
It is a known fact that Antigen tests do not detect the Covid virus as well as PCR tests. Moreover, a few states have published separate data on PCR vs Antigen test results. According to this data, PCR tests have a 2.5-3.5 times higher positivity rate than Antigen tests. For instance, in Delhi, the Antigen test’s positivity rate is 4% while the PCR test’s positivity rate is 14%.
The tabulated data below is from the ICMR site via NDTV. These tables indicate the very best and the very worst of the Indian states.
1. Signs of Poor Testing
This table shows the percentage of PCR tests that were performed in the respective states. The states are ranked from the lowest or worst to the highest or best in terms of PCR testing.
States like Bihar, Telangana, Gujarat, and Delhi are the worst hit with less than 40% PCR testing. Tamil Nadu and Rajasthan, however, have an excellent score of 100% PCR tests.
2. Under-Reporting of Covid Cases
Another concern for the country is the massive increase in the under-reporting of Covid cases. States, where a high level of Antigen testing is happening, are presumably going to have a high rate of missing positive cases.
As per the table, we can see that Bihar, Telangana, and Gujarat have an appalling rate of under-reported cases. Bihar which leads the list with 132% of under-reported cases saw a massive rise during the Bihar elections.
3. Massive Number of Covid Cases Not Reported
These percentages indicate that India has not reported a massive number of Covid cases. When we break down these percentages into numbers, almost 3.4 million cases are unreported.
The official number of Covid cases in a state on the two factors:
- The population of the state
- How badly Covid has spread across the state
The actual numbers are tempered by the extent of Antigen testing in the state.
According to the data, Maharashtra and Delhi are the worst hit in terms of the highest actual numbers of missing Covid cases. Together they are missing over 10 lakh Covid cases.
Tamil Nadu and Rajasthan once again show the most responsible, accurate, and true data. Along with Punjab, these three states have reported the most accurate number of Covid cases in the states.
4. States Ranked by Genuine Testing Levels
States can truly be ranked on how accurately it is testing their population can be determined by the PCR tests being conducted.
Tamil Nadu once again stands on top with the highest number of PCR tests. It is also the only state to conduct over 1 crore PCR tests. It also has nearly 1,400 tests per 10,000 of its citizens.
Following Tamil Nadu is Karnataka in the second place with 1,310 tests per 10,000 of its population.
Bihar, Telangana, and Gujarat once again are at the bottom of the list with alarmingly low rates of PCR testing.
Overall, the PCR tests conducted in India is not enough. About 550 of every 10,000 citizens are going through PCR testing.
5. States Underestimating their True Positivity Rate
The official data on India’s positivity rate is also deceiving. The true positivity rate is much bigger. The PCR tests reveal the whole truth.
On a whole, India’s true positivity rate is 139% of the official declared rate.
For example, the official positivity rate for the country as a whole is 6.9%. While the true positivity rate is 9.6%. So, 9.6% is 139% of 6.9%.
Bihar, Telangana, Gujarat, and Delhi are the worst hit in terms of states underestimating their true positivity rate.
While Rajasthan and Tamil have shown excellent work, followed closely by Punjab and Madhya Pradesh.
Explaining the math:
The number of missing or under-reported cases are calculated using the following procedure:
Firstly, the official data from some states are used. It is to be noted that only a few states publish separate positivity rates for RPCR vs Antigen, while others publish the combined average positivity rate of both kinds of tests.
According to this data, the true positivity rate from PCR testing is average three times the positivity rate from Antigen testing. Again, Antigen tests have a high rate of false-negative so Antigen positivity rates are in fact, low.
However, all the states publish the number of PCR tests and Antigen tests. Once we find out what percentage of tests are PCR vs Antigen, a standard mathematical formula is performed. This formula converts the combined positivity rate (for both kinds of tests) into the number of cases that would have been reported if only PCR tests were conducted.