Laboratory surveillance for SARS-CoV-2 in India: Performance of testing & descriptive epidemiology of detected COVID-19, January 22 - April 30, 2020

Abstract

Background & objectives: India has been reporting the cases of coronavirus disease 2019 (COVID-19) since January 30, 2020. The Indian Council of Medical Research (ICMR) formulated and established laboratory surveillance for COVID-19. In this study, an analysis of the surveillance data was done to describe the testing performance and descriptive epidemiology of COVID-19 cases by time, place and person. Methods: The data were extracted from January 22 to April 30, 2020. The frequencies of testing performance were described over time and by place. We described cases by time (epidemic curve by date of specimen collection; seven-day moving average), place (area map) and person (attack rate by age, sex and contact status), and trends were represented along with public health measures and events. Results: Between January 22 and April 30, 2020, a total of 1,021,518 individuals were tested for severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2). Testing increased from about 250 individuals per day in the beginning of March to 50,000 specimens per day by the end of April 2020. Overall, 40,184 (3.9%) tests were reported positive. The proportion of positive cases was highest among symptomatic and asymptomatic contacts, 2-3-fold higher than among those with severe acute respiratory infection, or those with an international travel history or healthcare workers. The attack rate (per million) by age was highest among those aged 50-69 yr (63.3) and was lowest among those under 10 yr (6.1). The attack rate was higher among males (41.6) than females (24.3). The secondary attack rate was 6.0 per cent. Overall, 99.0 per cent of 736 districts reported testing and 71.1 per cent reported COVID-19 cases. Interpretation & conclusions: The coverage and frequency of ICMR's laboratory surveillance for SARS-CoV-2 improved over time. COVID-19 was reported from most parts of India, and the attack rate was more among men and the elderly and common among close contacts. Analysis of the data indicates that for further insight, additional surveillance tools and strategies at the national and sub-national levels are needed.

Household Transmission of COVID-19: A Cross-Sectional Study

“…11,17,19,20,22,25 The majority of the cases in this study were in the working-age group (19-49 years) which was also similar to the previously reported studies. 11,22,25 This study reports a low mean room per person data. As per international standards, the data quoted by the "Organization for Economic Co-operation and Development (OECD)", the average home contains 1.8 rooms per person.…”

Social Network Analysis of COVID-19 Transmission in Karnataka, India

“…It is plausible that these latter were also contacts of SARS-CoV-2 carriers. The age and sex profile of our study set matches nationwide surveillance data from India, reported by Abraham et al, with median age and age-distribution close to our sample, and a similar high attack rate in males [17].…”

Social network analysis of COVID-19 transmission in Karnataka, India

“…Deaths, however, occurred overwhelmingly among elderly patients. The age and sex profile of our study set matches nationwide surveillance data from India, with median age and age-distribution close to our sample, and a similar high attack rate in males [17].…”

“…Field workers, trained to elicit travel and contact history, carried out telephonic and house-to-house surveys to identify primary and secondary contacts of positive cases. On average, 47.4 contacts were tested for each confirmed case [17]. Data collected at the community level was collated by the State War Room.…”