Optimizing testing for COVID-19 in India.
COVID-19 testing across India uses a mix of two types of tests. Rapid Antigen Tests (RATs) are relatively inexpensive point-of-care lateral-flow-assay tests, but they are also less sensitive. The reverse-transcriptase polymerase-chain-reaction (RT-PCR) test has close to 100% sensitivity and specific...
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2021-07-01
|
| Series: | PLoS Computational Biology |
| Online Access: | https://doi.org/10.1371/journal.pcbi.1009126 |
| _version_ | 1819008099088859136 |
|---|---|
| author | Philip Cherian Sandeep Krishna Gautam I Menon |
| author_facet | Philip Cherian Sandeep Krishna Gautam I Menon |
| author_sort | Philip Cherian |
| collection | DOAJ |
| description | COVID-19 testing across India uses a mix of two types of tests. Rapid Antigen Tests (RATs) are relatively inexpensive point-of-care lateral-flow-assay tests, but they are also less sensitive. The reverse-transcriptase polymerase-chain-reaction (RT-PCR) test has close to 100% sensitivity and specificity in a laboratory setting, but delays in returning results, as well as increased costs relative to RATs, may vitiate this advantage. India-wide, about 49% of COVID-19 tests are RATs, but some Indian states, including the large states of Uttar Pradesh (pop. 227.9 million) and Bihar (pop. 121.3 million) use a much higher proportion of such tests. Here we show, using simulations based on epidemiological network models, that the judicious use of RATs can yield epidemiological outcomes comparable to those obtained through RT-PCR-based testing and isolation of positives, provided a few conditions are met. These are (a) that RAT test sensitivity is not too low, (b) that a reasonably large fraction of the population, of order 0.5% per day, can be tested, (c) that those testing positive are isolated for a sufficient duration, and that (d) testing is accompanied by other non-pharmaceutical interventions for increased effectiveness. We assess optimal testing regimes, taking into account test sensitivity and specificity, background seroprevalence and current test pricing. We find, surprisingly, that even 100% RAT test regimes should be acceptable, from both an epidemiological as well as a economic standpoint, provided the conditions outlined above are met. |
| first_indexed | 2024-12-21T00:35:05Z |
| format | Article |
| id | doaj.art-08ae9d37ddaf4f6ba143b3a6c5ee404a |
| institution | Directory Open Access Journal |
| issn | 1553-734X 1553-7358 |
| language | English |
| last_indexed | 2024-12-21T00:35:05Z |
| publishDate | 2021-07-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS Computational Biology |
| spelling | doaj.art-08ae9d37ddaf4f6ba143b3a6c5ee404a2022-12-21T19:21:49ZengPublic Library of Science (PLoS)PLoS Computational Biology1553-734X1553-73582021-07-01177e100912610.1371/journal.pcbi.1009126Optimizing testing for COVID-19 in India.Philip CherianSandeep KrishnaGautam I MenonCOVID-19 testing across India uses a mix of two types of tests. Rapid Antigen Tests (RATs) are relatively inexpensive point-of-care lateral-flow-assay tests, but they are also less sensitive. The reverse-transcriptase polymerase-chain-reaction (RT-PCR) test has close to 100% sensitivity and specificity in a laboratory setting, but delays in returning results, as well as increased costs relative to RATs, may vitiate this advantage. India-wide, about 49% of COVID-19 tests are RATs, but some Indian states, including the large states of Uttar Pradesh (pop. 227.9 million) and Bihar (pop. 121.3 million) use a much higher proportion of such tests. Here we show, using simulations based on epidemiological network models, that the judicious use of RATs can yield epidemiological outcomes comparable to those obtained through RT-PCR-based testing and isolation of positives, provided a few conditions are met. These are (a) that RAT test sensitivity is not too low, (b) that a reasonably large fraction of the population, of order 0.5% per day, can be tested, (c) that those testing positive are isolated for a sufficient duration, and that (d) testing is accompanied by other non-pharmaceutical interventions for increased effectiveness. We assess optimal testing regimes, taking into account test sensitivity and specificity, background seroprevalence and current test pricing. We find, surprisingly, that even 100% RAT test regimes should be acceptable, from both an epidemiological as well as a economic standpoint, provided the conditions outlined above are met.https://doi.org/10.1371/journal.pcbi.1009126 |
| spellingShingle | Philip Cherian Sandeep Krishna Gautam I Menon Optimizing testing for COVID-19 in India. PLoS Computational Biology |
| title | Optimizing testing for COVID-19 in India. |
| title_full | Optimizing testing for COVID-19 in India. |
| title_fullStr | Optimizing testing for COVID-19 in India. |
| title_full_unstemmed | Optimizing testing for COVID-19 in India. |
| title_short | Optimizing testing for COVID-19 in India. |
| title_sort | optimizing testing for covid 19 in india |
| url | https://doi.org/10.1371/journal.pcbi.1009126 |
| work_keys_str_mv | AT philipcherian optimizingtestingforcovid19inindia AT sandeepkrishna optimizingtestingforcovid19inindia AT gautamimenon optimizingtestingforcovid19inindia |