Abstract
COVID-19 has spread across the globe with higher burden placed in Europe and North America. However, the rate of transmission has recently picked up in low- and middle-income countries, particularly in the Indian subcontinent. There is a severe underreporting bias in the existing data available from these countries mostly due to the limitation of resources and accessibility. Most studies comparing cross-country cases or fatalities could fail to account for this systematic bias and reach erroneous conclusions. This paper provides several recommendations on how to effectively tackle these issues regarding data quality, test coverage and case counts.
Highlights
Since the inception of the COVID-19 pandemic, both the media and research focus were on China, Europe and the USA primarily due to the large cluster of cases in these regions during the early days
Academic studies started making inferences on the COVID-19 response effectiveness through comparing the disease prevalence and fatality rates between higher and lower income nations in order to investigate the curious case of low COVID-19 infection rates among the low- and middle-income countries (LMICs)
Conducting research on LMICs with limited data could often lead to erroneous findings and biased interpretations, which is becoming a concern with the avalanche of studies published daily
Summary
Pakistan and Bangladesh are among the worst 20 countries affected by the COVID-19 pandemic in terms of total number of cases; they are ranked 138, 139 and 147, respectively, in tests per million population, as of 18 June 2020 [1]. The official press releases in Bangladesh reflected that all collected samples were not tested daily with long backlogs leading to curbing sample collection [4] and resulting in public distress as many non-COVID medical facilities require certification of a negative test result before admitting new patients. Another issue for maintaining a rigorous score of transmission rates is to adequately define both cases and deaths from COVID-19, which varies across borders resulting in inconsistencies among reports [5]. Leadership and political goodwill during such crisis play a crucial role in data collection, testing quality and country-wide coverage [8]
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