This map shows why India urgently needs more Covid-19 testing centres

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India’s most populous states are the least prepared to deal with the coronavirus outbreak.

With just three facilities, Uttar Pradesh, the most populous state, has one Covid-19 testing centre per 77 million people, according to statistics shared by the Indian Council of Medical Research (ICMR). In Bihar, the third-most populous state, the density is even worse at one centre for every 122 million people.

In Maharashtra, the second-most populous state, which has the most number of confirmed coronavirus cases in the country (36), there are just three centres for its nearly 122 million population.

Overall, there are just 62 testing sites in India for a population of 1.3 billion, and each of the facilities can assess only between 60 and 70 samples a day.

The government has said that it is trying to set up more testing centres. At least nine more centres will be operational soon, according to ICMR, of which two will be in Delhi and one each in Bihar, Chhattisgarh, Jammu & Kashmir, Karnataka, Maharashtra, Tamil Nadu, and Uttar Pradesh.

Despite these additions, many regions will still be left off the grid.

Small union territories like Dadra & Nagar Haveli and Daman & Diu have no testing provisions at all. It’s the same for the 36-island archipelago Lakshadweep, which has decided to take its own precautions by banning entry for foreign tourists since March 9.

Just two of the seven sister states in the northeast—Assam and Meghalaya—have centres. The same day as Lakshadweep closed entry, Mizoram sealed its international borders with Bangladesh and Myanmar. Though there were no positive cases reported in the state up until March 15, 117 people were placed under home quarantine as a precautionary measure. In the same region, Sikkim, Nagaland and Arunachal Pradesh have closed their borders to foreign and domestic tourists.

Given the scale at which the coronavirus pandemic has wreaked havoc across the globe, India’s scanty testing network might prove to be a terrible nightmare soon.

Dangerously slow progress

Testing is way lower in India than elsewhere in the world. For instance, while South Korea has been conducting 10,000 tests daily, India had tested just 5,900 individuals until by March 13.

One barrier could be that the tests provided by the government, albeit free for the public, comes at a sizeable cost. The first assay is Rs1,500 ($20) and subsequent, confirmatory assays can cost another Rs3,000. “ICMR strongly appeals that private laboratories should offer COVID19 diagnosis at no cost,” the apex body for biomedical research in India said in a March 17 statement.

Also, the process is not speedy enough, and making matters worse, suspects are not honouring quarantines diligently. For instance, the 76-year-old man who went on to become India’s first coronavirus fatality had submitted his sample on March 9 and was discharged from the hospital on his family’s insistence. By March 11, when his results returned positive, he had interacted with dozens of people.

Meanwhile, several others with the disease are fleeing isolation wards citing abysmal hygiene levels and reckless staff at public hospitals.

Those eligible to be tested at all are few and far between. The country is only testing people who have travelled to a high-risk place or have knowingly come in contact with an affected person. Asymptomatic patients are currently not being tested in India.

“There is a real concern that the government is not expanding testing parameters to include everyone because they want to keep the numbers low,” an epidemiologist working with a global-health organisation said told the Caravan magazine on the condition of anonymity. “If you are not looking for cases, you are not going to find any cases. How can the government know that there is no community transmission, when they are not testing enough people?”