Anup Malani on India's COVID-19 Testing Strategy

Rethinking Covid-19 testing strategy

Since March 24, India has expanded its daily testing capacity from 0.01 tests per 1,000 people to 0.077 per 1,000, as of May 23, according to Despite criticism from multiple quarters that testing remains inadequate, some local health departments, including in Mumbai, have issued stern warnings to physicians violating testing guidelines. Why has the mere act of conducting a diagnostic test become so contentious?

Let us first examine the value of testing for Covid-19. Broadly speaking, there are two kinds of tests. Virological tests look for the SARS-Cov-2 antigen (RT-PCR, LAMP assays or point-of-care tests like the TrueNAT tests), a piece of the virus RNA in the patient’s bloodstream. The presence of the antigen indicates that the person has the virus and is likely still infectious, regardless of symptoms. Serological tests look for antibodies, proof of the body’s immune response to the infection. A positive antibody test means that the person had the infection, and from what we know so far, is likely immune to it for some time.

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