Abstract
India has gradually increased its testing capacity of COVID-19 by mid-September 2020. However, the level of testing is substantially low in comparison with many high- and middle-income countries. Evidently, the pandemic in India is likely to be prolonged and affect millions in comparison to other countries, due to its huge population size. The possibility of a sudden upsurge of infections may turn overwhelming, jeopardising the health system, if an appropriate testing policy is not immediately adopted, given that the public health expenditure capacity of India has remained at a suboptimal level. Against this backdrop, a descriptive analysis has been carried out using the published data of the number of infections, tests and daily COVID-19 cases and public health expenditure data published by different sources and available in the public domain. The analysis suggests that a differential strategy is required to deal with the situation, which varies across states and depends upon the health spending capacity of individual states and their population size, among other factors. The specific strategy recommendations would be as follows. First, the testing rate should not be too high or too low, and this can be assessed using a marker: marginal return on testing. Second, India should follow the upper-middle-income-country standard in assessing the testing rate. Third, as a long-term strategy, there is a need to strengthen the public health system to avert a future catastrophe in the form of such pandemic.
Highlights
As of 15 September 2020, globally, 30 million people have been infected with the novel coronavirus disease (SARS-CoV-2, commonly known as COVID-19), with a death rate of 3.1%
The analysis suggests that a differential strategy is required to deal with the situation, which varies across states and depends upon the health spending capacity of individual states and their population size, among other factors
The evidences and arguments presented in this article suggest that there is no ‘one-size-fits-all’ strategy for deciding the number of tests to be done for all states of India
Summary
As of 15 September 2020, globally, 30 million people have been infected with the novel coronavirus disease (SARS-CoV-2, commonly known as COVID-19), with a death rate of 3.1%. A study carried out by Husain et al (2020) in the month of May concluded that the lockdown had reduced the number of COVID-19 cases by 23.65–337.73 lakh in Class I cities and towns, when COVID-19 was primarily found to be spreading in the cities and towns, and averted about 0.01–0.10 lakh deaths. This lockdown has destabilised the economy and shattered the poor health system of the country in the form of disruption of various health-related services, which is expected to have long-term effects on the demographic rates. The study further argues that such disruption of services might destabilise the process of demographic transition, in the states that are in the second stage of demographic transition characterised by high fertility and high under-five mortality
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