As we exit the fourth phase of the national lockdown, it is time to do some reconnaissance: what worked, what didn’t and what is now needed. This exercise entails using data, of which there seems to be an abundance. Technology and consulting companies have raced to produce epidemiological models, contact tracing apps and mobility dashboards. Few have helped thwart the exponential rise of coronavirus infections. This is because the information we need is simply not available.
Predictions about the epidemic in India are based on data directly published by the Indian Council of Medical Research, or from private voluntary initiatives like covid19india.org. One of the early questions an epidemiologist attempting to inform policymaking will ask is how bad the outbreak is in a particular area. What share of the population the disease or has recovered from it? In the absence of tests for everyone, she would like to know how many were tested, and how many were positive. This is the first basic step. Over 60 days into the lockdown, this information is not available, precluding the scientific, clinical and public health community from making any sound estimations about the disease’s spread. Existing sources provide information on the total reported cases per district, but not the number of tests conducted per district. If Solapur had 100 cases last week and 200 this week, one would conclude that cases doubled, unless 100 out of 1,000 tested were positive in the first week, and 200 of 2,000 were positive in the second week, as testing capacity increased. It would then have entirely different ramifications for public health preparedness. Only state-wise tallies of tests done are available, rendering all projections to be educated guesses at best.
It is not sufficient to know how many were tested, but also who was tested. Testing criteria has changed weekly all over the world. We test some symptomatic patients and their contacts, some asymptomatic patients, some returning migrants, and some healthcare workers. This varies from district to district, state to state. Any robust calculation would require knowledge of the characteristics of this testing denominator to make sensible extrapolations for the rest of the population. Who do these positive tests represent. symptomatics, asymptomatics or travellers? What percentage of the population do they represent? Timely and transparent access to such information can greatly improve our understanding of the epidemic.
As we exit the fourth phase of the national lockdown, it is time to do some reconnaissance: what worked, what didn’t and what is now needed. This exercise entails using data, of which there seems to be an abundance. Technology and consulting companies have raced to produce epidemiological models, contact tracing apps and mobility dashboards. Few have helped thwart the exponential rise of coronavirus infections. This is because the information we need is simply not available.
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Predictions about the epidemic in India are based on data directly published by the Indian Council of Medical Research, or from private voluntary initiatives like covid19india.org. One of the early questions an epidemiologist attempting to inform policymaking will ask is how bad the outbreak is in a particular area. What share of the population the disease or has recovered from it? In the absence of tests for everyone, she would like to know how many were tested, and how many were positive. This is the first basic step. Over 60 days into the lockdown, this information is not available, precluding the scientific, clinical and public health community from making any sound estimations about the disease’s spread. Existing sources provide information on the total reported cases per district, but not the number of tests conducted per district. If Solapur had 100 cases last week and 200 this week, one would conclude that cases doubled, unless 100 out of 1,000 tested were positive in the first week, and 200 of 2,000 were positive in the second week, as testing capacity increased. It would then have entirely different ramifications for public health preparedness. Only state-wise tallies of tests done are available, rendering all projections to be educated guesses at best.
It is not sufficient to know how many were tested, but also who was tested. Testing criteria has changed weekly all over the world. We test some symptomatic patients and their contacts, some asymptomatic patients, some returning migrants, and some healthcare workers. This varies from district to district, state to state. Any robust calculation would require knowledge of the characteristics of this testing denominator to make sensible extrapolations for the rest of the population. Who do these positive tests represent. symptomatics, asymptomatics or travellers? What percentage of the population do they represent? Timely and transparent access to such information can greatly improve our understanding of the epidemic.
Source: livemint
