16 states use RAT to conduct more than 50% of their Covid-19 tests; Telangana tops with 82%

As many as 16 states tested more than 50% of their suspected Covid-19 patients using the less sensitive rapid antigen test with Telangana topping the list by carrying out 82% of its Covid-19 examination with the antigen tests.

Telangana is followed by Odisha (77.3%), Bihar (75.62%) and Assam (73%), according to a set of official data that DH obtained using the RTI. Other big states with high RAT use are Gujarat (67%), Chhattisgarh (63%), Kerala (57%) and Uttar Pradesh (53.59%).

Till a fortnight ago, the Centre’s advice to the states on testing strategy was to ensure that at least 70% of total tests are conducted using the gold-standard RTPCR method. The strategy was modified to increase RAT used in villages to improve surveillance.

Another area that saw significant use of RAT is the northeast where Assam tops the chart followed by Arunachal Pradesh (72.36%), Meghalaya (66.35%), Tripura (59%), Mizoram (58%) and Manipur (54%).

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The data is part of an official presentation made by the National Centre for Disease Control before a Group of Ministers on May 24.

Among other things, it shows how the states ignored the Centre’s advice and relied heavily on the RAT as a result of which the ground reality may be missing from the official statistics.

For weeks several experts have raised doubts on the quality of Covid-19 data that comes from states like Bihar, Telangana and Uttar Pradesh.

“States that did more RAT have also done more tests per testing lab, more or less. However, the number of tests Bihar did per lab is mind-blowing! Bihar did 1,000 plus daily tests in each of its labs on an average every day from March 2020 while the Indian average was 304 tests,” tweeted health economist Rijo John, a visiting faculty at IIM, Kozhikode.

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Telangana figures pose another big mystery. According to the positivity figures released daily by the Union Health Ministry, the state has no districts with more than 10% positivity between May 4-10. The trend continued in the subsequent weeks like May 9-15; May 14-20 and May 19-25.

But between May 30-June 5, Khammam recorded 16.48% positivity, which is 37 times more than the positivity of 0.44% recorded in the same district between May-19-25. In the same week, 28 districts recorded a positivity between 0-1% and seven of them registered zero positivity.

Bihar and Uttar Pradesh had 30 and 37 districts respectively reporting 10% or more test positivity between May 4-10. The number dropped to 16 and 14 districts respectively in the next few days but since May 19, two of India’s most populous states with poor health infrastructure have no districts in that category. Now they don't even have any district reporting a positivity of 5-10%.

“We may be missing cases where the health systems are less able to support needs, or where people are less likely to seek or have access to health facilities, like in rural regions,” noted Krishna Udaykumar, professor of global health medicine at Duke University, USA.