Increased testing is turning the Covid tide in Gurugram, says admin

A sharp increase in testing, a declining test positivity rate (TPR), and an all time high recovery rate of 84.7 percent — these were the three main numbers that

A sharp increase in testing, a declining test positivity rate (TPR), and an all time high recovery rate of 84.7 percent — these were the three main numbers that officials from the district administration and health department cited at a press conference on Friday, as evidence that Gurugram had turned the tide in its response to the Covid-19 pandemic.

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As per data furnished by the district chief medical officer, Dr. Virender Yadav, Gurugram has (till July 16) conducted at least 69,354 tests, of which 26,125 were rapid antigen tests, conducted in the last three odd weeks. The remainder constitutes RT-PCR tests (recognised as the gold standard in testing for the virus) done by the health department and private labs together.

While dis-aggregated data for RT-PCR tests was not provided, Yadav said that the health department is now conducting close to 540 RT PCR tests per day in Gurugram, at par with private labs. “In all, the district is now conducting over 2,000 tests per day, as opposed to about 600 in June. The improvement stems largely from this increase in testing, followed by tracing and isolation,” he said.

Yadav also added that the district’s overall TPR was just under 10 percent, while the number of new positives each day is within range of daily new recoveries.

The World Health Organization (WHO) had suggested a TPR of 5% over two weeks, while increasing testing.

“The TPR in June 23 ws nearly 14 percent, and we were getting close to 150-200 new cases daily. Our aim is to continuously reduce TPR while increasing tests. We are still getting about 100 new cases every day but that’s not worrying because our positivity rate is low, around nine percent,” he said.

An analysis of health department data shows that the rapid antigen method now makes up a bulk of the district’s tests. Since they were first deployed in Gurugram on June 24 26,125 antigen tests have been conducted, while only 18,522 RT PCR tests were conducted during the same period. However, despite being the primary strategy for containment — as confirmed by multiple officials in the health department — antigen tests have not picked up a significant amount of positive cases, when compared to the RT PCR method.

Within Gurugram, the two have a large discrepancy in their respective positivity rates, which experts say is expected, given that the Indian Council Medical Research (ICMR) validated antigen kits are fundamentally less sensitive and every negative case had to be followed by an RT-PCR test for confirmation.

Of the total antigen tests conducted, 2,470 samples were retested via RT PCR (as people were showing symptoms), which found 283 individuals positive.

It also raised concerns if whether Gurugram was effectively containing the the virus.

As per numbers given by Yadav at Friday’s press conference, 679 positive cases in three weeks were detected via antigen tests (indicating a TPR of 2.5 percent). During the same period, 1909 positives were detected via RT PCR tests (indicating a TPR of 10 percent).

“This is worrying, because a fundamentally less reliable test is being adopted as the district’s primary testing strategy. It is very likely that antigen tests, despite being able to identify several positives at once, are also letting an equal number of false negatives slip through the cracks, which does not really help with cutting chain of transmission,” said Dheeraj Singh, a city-based data scientist tracking state and district trends.

Dr. Jai Prakash Sharma, district surveillance officer, responded, saying, “Antigen tests are not as targeted, whereas an RT-PCR test is done only when there is a higher likelihood of infection. The discrepancy between their positivity rates is not worrying.”

Until July 16, the district had seen 110 deaths, with a case-fatality ratio (CFR) of 1.5%.

CMO Yadav said that, by Monday, they are expecting the district’s mortality rate to dip below 1.5% for the first time in at least six weeks. The mortality ratio came down to 1.49% on Friday itself with two more deaths and total cases at 7,483.

“By Monday, we expect the mortality rate to settle at somewhere around 1.47% percent. Of 110 deaths (till July 16), about 10 deaths have been sudden, where the patient couldn’t be isolated in time. This hasn’t happened in July.”