India Has Not Reported 3.4 Million Covid Cases

From 100% PCR tests at the very start of the pandemic, India is now down to less than 60% PCR tests - while Antigen tests have risen sharply from a negligible number to now almost 5.5 crores, which accounts for over 40% of total tests.

India's Covid tally stands at 91,77,840. (File)

New Delhi:

There are two ways to fudge the actual number of Covid cases. The first, more obvious way is to reduce the number of tests being conducted, as Donald Trump repeatedly suggested. The second, less obvious and more insidious way is to increase the number of Antigen tests and reduce the number of PCR tests.

As we all know, Antigen tests do not detect the Covid virus as well as PCR tests. In fact, the separate data, published by only a few states, on PCR vs Antigen test results, shows that PCR tests have a positivity rate that is 2.5 to 3.5 times higher than Antigen tests (for example, in Delhi the positivity rate for PCR tests is 14% while the positivity rate for Antigen tests is 4%).

From 100% PCR tests at the very start of the pandemic, India is now down to less than 60% PCR tests - while Antigen tests have risen sharply from a negligible number to now almost 5.5 crores, which accounts for over 40% of total tests. And, every week, there is a continuous rising trend of Antigen testing.

1. SIGNS OF POOR TESTING

This table clearly shows the good, the bad and the ugly states. Bihar, Telangana, Gujarat, Delhi and UP are India's 5 worst states with less than 50% PCR tests. Tamil Nadu and Rajasthan are excellent with 100% PCR tests.

Signs of poor testing

States ranked by the lowest % of pcr tests

Ranked
worst to best
state% PCR tests
1Bihar15%
2Telangana17%
3gujarat22%
4delhi31%
5uttar pradesh44%
6kerala48%
7chhattisgarh51%
8west bengal55%
9andhra pradesh59%
10maharashtra60%
11jammu and kashmir64%
12assam66%
13haryana71%
14odisha73%
15jharkhand86%
16karnataka88%
17madhya pradesh91%
18punjab96%
19rajasthan100%
20tamil nadu100%
All India Average: Bigger States58%
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Source: ICMR data 

2. UNDER-REPORTING OF COVID CASES

States with a high level of Antigen testing are likely to miss a large number of positive cases. Once again, Bihar - especially during the run up to elections - was the worst state in India in under-reporting Covid cases. The true number of Covid cases in Bihar was an outrageous 132% of the officially reported cases. Telangana and Gujarat have also grossly under-reported the Covid pandemic in their states.

% under-reporting of covid cases

States ranked by the % of under-reported covid cases

Ranked
worst to best
state% under reported
covid cases
1Bihar132%
2Telangana123%
3gujarat109%
4delhi85%
5uttar pradesh59%
6kerala53%
7chhattisgarh49%
8west bengal43%
9andhra pradesh37%
10maharashtra36%
11jammu and kashmir32%
12assam29%
13haryana24%
14odisha22%
15jharkhand10%
16karnataka9%
17madhya pradesh6%
18punjab3%
19rajasthan0%
20tamil nadu0%
All India Average: Bigger States39%
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Source: ICMR data 

3. MASSIVE NUMBER OF COVID CASES NOT REPORTED

But what do these percentages mean in actual numbers?

India has not reported 3.4 million Covid cases because of the deliberate increase in the use of the unreliable Antigen tests.

The official number of Covid cases in any state depends of course on the population of each state, how badly Covid has spread in the State, all tempered by the extent of Antigen testing in that state.

Maharashtra and Delhi have the highest actual numbers of missing Covid cases - together missing over 10 lakh Covid cases.

Once again Tamil Nadu and Rajasthan are the two most responsible and honest reporting states, along with Punjab - accurately measuring and reporting on the number of Covid cases in their states.

massive no. of covid cases not reported

states ranked by the no. of under-reported covid cases

Ranked worst to beststatecovid cases not reported (in lakhs)official no. of covid cases reportedactual no. of covid cases
1maharashtra6.417.624.0
2delhi4.35.19.4
3telangana3.22.65.8
4andhra pradesh3.28.611.8
5uttar pradesh3.15.28.2
6bihar3.02.35.3
7kerala2.95.58.4
8gujarat2.11.94.0
9west bengal1.94.56.4
10chhattisgarh1.12.23.2
11karnataka0.78.79.4
12odisha0.73.13.8
13assam0.62.12.7
14haryana0.52.12.6
15jammu and kashmir0.31.01.4
16madhya pradesh0.11.92.0
17jharkhand0.11.11.2
18punjab0.01.41.5
19tamil nadu0.07.67.7
20rajasthan0.02.32.4
All India Average: Bigger States34.386.9121.2
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Source: ICMR data 

4. STATES RANKED BY GENUINE TESTING LEVELS

The true ranking of any state in how well it is testing its population is the number of PCR tests being conducted.

Tamil Nadu stands out far above the rest of India - it is the only state to have conducted over 1 crore PCR tests, also reflecting the highest number of tests per head of population with nearly 1,400 tests per ten thousand of its citizens. Karnataka is the second-best state with over 13,00 PCR tests per ten thousand citizens.

Bihar, Telangana and Gujarat are the worst in the numbers of PCR tests per head of their population.

Overall, India is not using PCR tests enough - only 550 of every 10,000 citizens of India are being tested using PCR.

states ranked by genuine testing levels

lowest to highest number of pcr tests by population

Ranked worst to beststateNo. of pcr tests per 10,000 populationTotal No. of pcr tests (in lakhs)
1tamil nadu1,390108
2karnataka1,31088
3andhra pradesh99354
4delhi95418
5punjab93028
6odisha86740
7assam81429
8jharkhand79931
9haryana78022
10jammu and kashmir75610
11kerala59421
12maharashtra46757
13rajasthan46137
14chhattisgarh37911
15madhya pradesh36631
16uttar pradesh32978
17west bengal29129
18gujarat21514
19telangana1857
20bihar14818
All India Average: Bigger States5517.34 Cr
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Source: ICMR data  

5. STATES UNDERESTIMATING THEIR TRUE POSITIVITY RATE

The official figures on India's positivity rate are misleading. The true positivity rate is much higher. Once again, the PCR tests reveal the truth.

For the country as a whole, the true positivity rate is nearly 140% of the officially declared rate (for example, just to be clear, the official positivity rate for all-India is 6.9%, while the true positivity rate is 9.6% i.e. 9.6% is 139% of 6.9%).

States underestimating their true positivity rate

States ranked by the extent of hiding true positivity rates

Ranked
worst to best
statetrue positivity rate as a %
of the official positivity rate
1Bihar232%
2Telangana223%
3gujarat209%
4delhi185%
5uttar pradesh159%
6kerala153%
7chhattisgarh149%
8west bengal143%
9andhra pradesh137%
10maharashtra136%
11jammu and kashmir132%
12assam129%
13haryana124%
14odisha122%
15jharkhand110%
16karnataka109%
17madhya pradesh106%
18punjab103%
19rajasthan100%
20tamil nadu100%
All India Average: Bigger States139%
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Source: ICMR data 

Explaining the math:

  1. Data is sourced from the Indian Council of Medical Research or ICMR.
  2. Missing or underreported cases are calculated using a standard procedure:

       a) Using official data from some states (only a few states publish separate positivity rates for RPCR vs Antigen, others publish the combined average positivity rate of both kinds of tests). This data shows that the true positivity rate, as measured by PCR testing, is on average 3X the positivity rate as measured by Antigen testing (Antigen positivity rates are known to be low because Antigen tests have a high rate of false negatives).

       b) But all states publish the number of PCR tests and the number of Antigen tests. Once we know what percentage of tests are PCR vs Antigen, a standard mathematical formula is used to convert the combined positivity rate (for both sorts of tests) into how many cases would be reported if only PCR tests were used.