COVID-19 testing: Which Country is testing how many?
Sai Krishna Muthyanolla
March 30, 2020
In terms of the COVID-19 testing, there are wide variations among countries. While some countries have been aggressive with their testing strategy, some others have been conservative. Here is a look at the status of testing in various countries including India.
Thenumber of confirmed cases of COVID-19 across the world are increasing at arapid rate. Asper WHO’s
dashboard on 29 March 2020, there are over 6.34 lakh confirmedcases in 202 countries. This exponential increase over the past few days can beattributed to USA and Western European countries like Italy, Spain, Germany,France etc.
Meanwhile,countries in Latin America, Africa and South Asia have been reportingcomparatively lower numbers. While there are multiple reasons cited for thewide variance in confirmed cases, the difference in the number of tests beingconducted by each country to identify positive COVID-19 cases is also consideredone of them.
How is each country testing? Are there wide variations between the countries? Are the positive cases identified proportional to the numbers being tested? Here is detailed analysis.
No
comprehensive data available for testing numbers
Testingis critical to identify if a person is infected with COVID-19. Studies indicate that it could take anywhere between 2-14 days after the exposure for thesymptoms to be visible. Hence, testing helps to:
However, the rationale & the testing strategy followed by countries varies widely.  While few countries have been aggressive on this front by facilitating the conduct of tests for anyone who suspects to be infected, few other countries like India have laid down certain criteria for testing. Further, testing is offered for free in some countries while in a few others, there is an associated charge. Availability of testing kits and other resources also seem to influence the policy being followed by the county for optimum use of the limited means available or testing.
So,what is the number of tests being carried out by each country?
Currently, there is no centralized database which tracks the number of tests being conducted by each country. Unlike the database for the number of positive COVID-19 cases and the deaths, WHO does not maintain any database for the number of tests being conducted in each country. However, few countries have from time to time published the details of the tests being conducted which remains the only reliable source. In absence of any official aggregator of such data, few private organizations are making an effort to collate the information.
The information which is available is not up to date and is quite dynamic. The latest information available for each of the countries is for different dates and hence cannot be compared. There are chances that a country might have stepped up testing after the publication of such data.
However, a brief look at the tests data may indicate a general trend in the testing strategy followed by various countries.
Germany
& Italy are among the countries with high number of tests in Europe
Italy is the worst-hit country due to COVID-19 with more than 10 thousand deaths being recorded. Italy along with USA are the new epicentres of spread of the virus beyond China.
Apartfrom Italy, many of the European countries especially the West Europeancountries have recorded high number of positive cases of COVID-19.
Germanywhich has the 5 highest number of COVID-19 positive cases hasconducted the highest number of tests of around 4.83 lakhs. It is followed byItaly with 4.29 lakh tests. Spain which has the next highest number of COVID-19cases in Europe after Italy has conducted 3.5 lakhs tests. Switzerland, UnitedKingdom and France are the other European countries which have conducted morethan 1 Lakh tests, as per the latest available reports. Russia which has around1,500 positive cases have conducted around 2.43 lakhs tests.
Country
No. of Tests
Latest Date
Austria
46,441
29.03.2020
Belgium
44000
28.03.2020
Czechia
40700
28.03.2020
Denmark
18810
28.03.2020
France
101046
24.03.2020
Germany
483295
26.03.2020
Italy
429526
28.03.2020
Netherlands
46810
26.03.2020
Norway
82584
28.03.2020
Poland
38674
29.03.2020
Portugal
32754
28.03.2020
Russia
243377
28.03.2020
Spain
350000
21.03.2020
Sweden
24500
25.03.2020
Switzerland
106000
29.03.2020
United Kingdom
120776
28.03.2020
South Korea
and USA among countries which did extensive testing
Overthe last one week, U.S.A has overtaken China as the country with the highestnumber of COVID-19 positive cases. The exponential increase in the number of positivecases can be attributed to the increase in the number of tests being done. Asper the official reports, as on 29 March 2020, more than 7.62 lakh
tests were conducted in USA, which is the highest acrossthe globe.
Althoughthe situation now appears to be under control, South Korea happens to be one ofthe earliest countries hit by COVID-19. Its geographical proximity with Chinabeing one of the reasons for the early outbreak. However, they have conductedaggressive testing to identify and control the pandemic, which is reflected inthe 3.94 lakh tests conducted here. Meanwhile, China, where the outbreak firsthappened has conducted 3.2 lakh tests in the Guangdong province alone. Datafor other provinces is not available.
Among the other countries, Canada and Australia have been proactive in conducting the tests with 1.84 and 1.38 lakh tests. Iran, which is among the countries with highest COVID-19 positive cases, as per a report on 14 March 2020, conducted 80 thousand tests. Latest data is not available.
Meanwhile, the testing is quite low among the other Asian countries. India and Pakistan, which are among the highly populated countries in the world have conducted only 27.6 thousand and 13 thousand tests respectively and in each country, the number of positive cases has crossed one thousand.
Brazil has conducted the highest number of tests among Latin American countries with more than 45 thousand tests. The testing is yet to pick up in African countries. South Africa conducted more than 7 thousand tests so far.  In a tweet on 16 March 2020, United Arab Emirates stated that they have conducted 1.25 lakh tests.
Country
No. Of Tests
Latest Date
Australia
138623
28.03.2020
Brazil
45708
20.03.2020
Canada
184201
28.03.2020
China (only Guangdong province)
320000
24.03.2020
India
27688
27.03.2020
Iran
80000
14.03.2020
Japan
27005
27.03.2020
Malaysia
35516
28.03.2020
Mexico
4259
28.03.2020
Pakistan
13231
28.03.2020
Philippines
2686
29.03.2020
South Africa
31963
28.03.2020
South Korea
394141
29.03.2020
Taiwan
29389
28.03.2020
Turkey
55464
28.03.2020
U.A.E
1,25,000
16.03.2020
USA
762015
29.03.2020
Norway, UAE
& Switzerland conducted the highest tests per million population
The total number of tests conducted by a country is a measure of volume and does not completely reflect the extant of tests in proportion to the population of that country. For example, USA may have conducted the highest number of tests. However, countries like Belgium & Croatia despite conducting a fewer number of tests may fare better in terms of covering a greater chunk of their population.
Hence the number of tests conducted per a million (10 lakhs) of the population is a more appropriate measure.  By taking into consideration the respective population of the countries and the total COVID-19 tests conducted by the country, the number of tests conducted per million is calculated.
Among the countries which have been considered for this analysis, Norway records the highest with 15,386 tests per million followed by UAE and Switzerland. Australia & South Korea have also fared well in terms of tests conducted per million population.
The highly affected European countries of Italy, Spain have conducted around 7 thousand tests per million followed by Germany and Austria.  Meanwhile, India with its huge population and fewer number of tests being conducted so far averages around 20 tests per million. Pakistan, Brazil and Mexico the other largely populated countries follow suit.
Meanwhile,China (Guangdong province) and USAthe main epicentres of the pandemic were able to conduct around 2,800 and 2,400 tests per million.
Kerala has
conducted the highest number of tests in India
In its notification on 27March 2020, Indian Council of Medical Research (ICMR) has stated that 27,688samples have been tested for COVID-19 so far. As in the case of countries, thestates within India have been inconsistent with publishing the informationrelated to samples tested. Only a few states have furnished this information.
Among the states whose information is available, Kerala has conducted the highest number of tests with 5,432 samples.  This is followed by Karnataka and Rajasthan with 3,076 and 2,325 tests respectively. Maharashtra which along with Kerala is among the states with a high number of positive cases has not furnished details of the number of tests carried out.
From the available data, aproportional correlation is observed between the number of tests conducted andthe number of COVID-19 positive cases.
Need for
conducting more tests within the country as well as globally
The case of USA, wherein the number of COVID-19 cases has increased exponentially with the increase in the number of tests underscores the need for increased testing. Increased testing might help understand the prevalence of the virus more accurately. South Korea acts as a positive example where proactive testing has helped to identify and restrict the spread.
Meanwhile, Italy and Spain have also witnessed an increase in the number of positive cases proportional to the tests being conducted. These examples offer learnings for countries like India, Pakistan, Brazil, Argentina, Bangladesh, etc. with higher populations to increase testing for COVID-19.
Many of the countries in South & South East Asia, Latin America and Africa have reported a low number of COVID-19 cases which could be due to a fewer number of tests. One can only ascertain the actual spread once testing improves.
Even within India, the states which have conducted a greater number of tests have reported a higher number of cases. The data on the number of tests conducted in states like U.P & Bihar with huge populations is unavailable. The lower number of positive cases recorded in these states could be due to lower testing.
The availability of test kits is a major challenge affecting many countries, forcing governments around the world to prioritize testing. The need of the hour is to identify means to increase the number of test kits or develop effective testing strategies that allow for a greater number of people to be tested. Until this is resolved, and the testing numbers increased, we may never know the actual spread of COVID-19.
Featured Image: COVID-19 testing