Underreporting COVID-19: the curious case of the Indian subcontinent

Biswas, Raaj Kishore; Afiaz, Awan; Huq, Samin

doi:10.1017/s0950268820002095

Cited by 41 publications

(37 citation statements)

References 9 publications

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“…However, studies showed there concern about probable under reporting bias in the COVID-19 data of Bangladesh due to resource constraints ( 72 ). Self-reported syndromic data also suggests an earlier spread of the outbreak in Bangladesh ( 73 ).…”

Section: Resultsmentioning

confidence: 99%

Systematic Assessment of COVID-19 Pandemic in Bangladesh: Effectiveness of Preparedness in the First Wave

Saha

Gulshan

2021

Front. Public Health

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Background: To develop an effective countermeasure and determine our susceptibilities to the outbreak of COVID-19 is challenging for a densely populated developing country like Bangladesh and a systematic review of the disease on a continuous basis is necessary.Methods: Publicly available and globally acclaimed datasets (4 March 2020–30 September 2020) from IEDCR, Bangladesh, JHU, and ECDC database are used for this study. Visual exploratory data analysis is used and we fitted a polynomial model for the number of deaths. A comparison of Bangladesh scenario over different time points as well as with global perspectives is made.Results: In Bangladesh, the number of active cases had decreased, after reaching a peak, with a constant pattern of death rate at from July to the end of September, 2020. Seventy-one percent of the cases and 77% of the deceased were males. People aged between 21 and 40 years were most vulnerable to the coronavirus and most of the fatalities (51.49%) were in the 60+ population. A strong positive correlation (0.93) between the number of tests and confirmed cases and a constant incidence rate (around 21%) from June 1 to August 31, 2020 was observed. The case fatality ratio was between 1 and 2. The number of cases and the number of deaths in Bangladesh were much lower compared to other countries.Conclusions: This study will help to understand the patterns of spread and transition in Bangladesh, possible measures, effectiveness of the preparedness, implementation gaps, and their consequences to gather vital information and prevent future pandemics.

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Section: Resultsmentioning

confidence: 99%

Systematic Assessment of COVID-19 Pandemic in Bangladesh: Effectiveness of Preparedness in the First Wave

Saha

Gulshan

2021

Front. Public Health

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“…The reason is that during an epidemic, crude CFR estimation becomes an underestimate of the actual CFR [ 5 ]. However, there are unreported cases because of both limited tests and asymptomatic or mild patients [ [40] , [41] , [42] , [43] ]. Therefore, after further adjustment for reporting rates lower than 50%, estimated CFRs became less than one-third compared to crude CFR, and survival interval adjusted CFR.…”

Section: Discussionmentioning

confidence: 99%

Finding the real COVID-19 case-fatality rates for SAARC countries

Shah

Ahammed

Anjum

et al. 2021

Biosafety and Health

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The crude case fatality rate (CFR), because of the calculation method, is the most accurate when the pandemic is over since there is a possibility of the delay between disease onset and outcome. Adjusted crude CFR measures can better explain the pandemic situation by improving the CFR estimation. However, no study has thoroughly investigated the COVID-19 adjusted CFR of the SAARC countries. This study estimated both survival interval and underreporting adjusted CFR of COVID-19 for these countries. Moreover, we assessed the crude CFR between genders and across age groups and observed the CFR changes due to the imposition of fees on COVID-19 tests in Bangladesh. Using the daily records up to October 9, we implemented a statistical method to remove the delay between disease onset and outcome bias, and due to asymptomatic or mild symptomatic cases, reporting rates lower than 50% (95% CI: 10%–50%) bias in crude CFR. We found that Afghanistan had the highest CFR, followed by Pakistan, India, Bangladesh, Nepal, Maldives, and Sri Lanka. Our estimated crude CFR varied from 3.708% to 0.290%, survival interval adjusted CFR varied from 3.767% to 0.296% and further underreporting adjusted CFR varied from 1.096% to 0.083%. Furthermore, the crude CFRs for men were significantly higher than that of women in Afghanistan (4.034% vs. 2.992%) and Bangladesh (1.739% vs. 1.337%) whereas the opposite was observed in Maldives (0.284% vs. 0.390%), Nepal (0.006% vs. 0.007%), and Pakistan (2.057% vs. 2.080%). Besides, older age groups had higher risks of death. Moreover, crude CFR increased from 1.261% to 1.572% after imposing the COVID-19 test fees in Bangladesh. Therefore, the authorities of countries with higher CFR should be looking for strategic counsel from the countries with lower CFR to equip themselves with the necessary knowledge to combat the pandemic. Moreover, caution is needed to report the CFR.

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“…The reason is that during an epidemic crude CFR estimation becomes an underestimate of the actual CFR [5]. However, because of both limited numbers of test and presence of asymptotic or mild cases, there exists unreported cases [25][26][27][28]. Therefore, after further adjustment for reporting rates lower than 50%, estimated CFRs became less than one-third compared to crude CFR, and survival interval adjusted CFR.…”

Section: Discussionmentioning

confidence: 99%

Finding the real COVID-19 case-fatality rates for SAARC countries

Shah¹,

Ahammed

Anjum³

et al. 2020

Preprint

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Crude case fatality rate (CFR) is the most accurate when the pandemic is over. Adjustments to the crude CFR measure can better explain the pandemic situation by improving the CFR estimation. However, no study has thoroughly investigated COVID-19 adjusted CFR of the South Asian Association for Regional Cooperation (SAARC) countries. In this study, we estimated both survival interval and underreporting adjusted CFR of COVID-19 for the SAARC countries and observed the CFR changes due to the imposition of fees on COVID-19 tests in Bangladesh. Using the daily records up to 9th October, we implemented a statistical method to remove both the bias in crude CFR, i.e., the delay between disease onset and outcome bias and due to asymptomatic or mild symptomatic cases, reporting rates lower than 50% (95% CI: 10%-50%) bias. According to our findings, Afghanistan had the highest CFR, followed by Pakistan, India, Bangladesh, Nepal, Maldives, and Sri Lanka. Our estimated crude CFR varied from 3.71% to 0.29%, survival interval adjusted CFR varied from 3.77% to 0.3% and further underreporting adjusted CFR varied from 1.1% to 0.08%. We have also found that crude CFR increased from 1.261% to 1.572% after imposing the COVID-19 test fees in Bangladesh. Therefore, the authorities of countries with higher CFR should be looking for strategic counsel from the countries with lower CFR to equip themselves with the necessary knowledge to combat the pandemic. Moreover, caution is needed to report the CFR.

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Underreporting COVID-19: the curious case of the Indian subcontinent

Cited by 41 publications

References 9 publications

Systematic Assessment of COVID-19 Pandemic in Bangladesh: Effectiveness of Preparedness in the First Wave

Systematic Assessment of COVID-19 Pandemic in Bangladesh: Effectiveness of Preparedness in the First Wave

Finding the real COVID-19 case-fatality rates for SAARC countries

Finding the real COVID-19 case-fatality rates for SAARC countries

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