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. 2020 May;151(5):424-437.
doi: 10.4103/ijmr.IJMR_1896_20.

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

ICMR COVID Study Group (In alphabetical order: Priya Abraham†, Neeraj Aggarwa l2, Giridhara R. Babu 7, Suganya Barani 8, Balram Bhargava 4, Tarun Bhatnagar 8, Ajay Singh Dhama 3, Raman R. Gangakhedkar 2, Sidhartha Giri 2, Nivedita Gupta 2, Karishma K. Kurup 5, Ponnaiah Manickam 9, Manoj Murhekar ††, Varsha Potdar 1, Ira Praharaj 2, Kiran Rade 6, D.C.S. Reddy 11, V. Saravanakumar 10, Naman Shah 12, Harpreet Singh 3, Jeromie Wesley Vivian Thangaraj 8, Naveen Yadav 8), COVID Epidemiology & Data Management Team @, COVID Laboratory Team*, VRDLN Team$  1 ; @COVID Epidemiology & Data Management Team (in alphabetical order): Tanu Anand, Harish Kumar Butollia, Pranab Chatterjee, Himanshu Chauhan, R Deepa, Amirthammal Gunasekaran, Daisy A John, Shashi Kant, Sanket Kulkarni, Vinit Kumar, JP Muliyil, Ravindra Mohan Pandey, Swarup Sarkar, Sujeet Singh, Sanjay Zodpey; *COVID Laboratory Team (in alphabetical order): Srima Adhikari, Jyotsna Agarwal, Naveen KumarAgarwal, Saurabh G Agarwal, Prerna Aggarwal, Anurag Agrawal, Arti Agrawal, Safaa Muneer Ahmed, G Ambernath, Nitin Ambhore, VP Amudha, Sohini Arora, Ashok, Anita, Awanti, Veer Badriyah TA, Amrita Kumari B, Maneesh Bagai, Dipa Baido, Baijayantimala, Rupinder Bakshi, Bhaswati Bandyopaghyay, Avi Kumar Bansal, Abhik Baneerjee, Sonal Bangadi, Anurag Bansal, Shakeera Banu, Mahesh Baragundi, Pradeep Barde, Purabi Barman, Purnima Barua, Sharad Bhalla, Bharat, V Kusuma Bharathi, Anudita Bhargava, M Bhaskar, Sandeep Bhatia, Sima Bhatt, Binita, Ritu Bist, Debasis Biswas, Samrat Biswas, SK Biswas, Biswa Borkakoty, Siddhesh KC, Harish Chander, Jagdish Chander, R Sree Charan, Krishna Chandran R, Chandrasekar, Leena Chatterjee, Mitali Chatterjee, Bhaskar Narayan Chaudhuri, Sandeep P Chaudhari, Aparna Chaudhary, Nirupauma Chayani, VV Chincholkar, Deepinder Kaur Chhina, Elantamilan D, Ashwin Dalal, Mandeep Dalal, Lalit Dar, Aseem Das, Pradeep Das, Poonam Das, Suryasnata Dass, P K Dash, Somnadh Dash, K S Dayanidhi, Mandeep Dalal, Deepa, R Deepa, Vijayshri Deotale, Kairavi J Desai, Archana Deshpande, Smita Deshpande, Yogita Desai, Krupi Desai, M Neelaveni Devi, Sarada Devi, Sulochana Devi, Dhanapa,l Kanwardeep Dhingra, Rahul Dhodapkar, V DilliRani, Anupa Dixit, Nandini Dugal, Shanta Dutta, Sarjana Dutt, Anjum Farhana, Bashir Fomda, Shantala G, Rajni Gaind, Shelly Sharma Ganguly, Neeta Gangurde, Amit Garg, T Geethanjali, Paramjeet S Gill, CP Girish Kumar, Varun Goel, Shiv Gopal, Parijat Goswami, Puneeth Gonnabatuhulla, Kiran Gosavi, Navin Grover, Baldev Raj Gulati, Pooja Gumaste, Anjali Gupta, Minakshi Gupta, Piyali Gupta, Ekta Gupta, Srinita Gupta, Rattan Gurnani, Bijayesh Haldar, Haritha, Krishnan H Harshan, Beena Philomina J, Amita Jain, Manoj Jais, Pratik Jariwala, SC Jaryal, Tanuja Javadekar, Jayalakshmi, Jayshree, Daisy A John, T Jeyamurugan, Neerja Jindal, Ameeta Joshi, Pankaj Joshi, Jyothi, Lakshmi Jyothi, Lancy Justus, Nayana Ingole, Jyoti Iravane, Anil K, Anju Kagal, Iravathy Goud kalal, Usha Kalawat, Deepjyoti Kalita, P Kamala, N Kamath, Rajesh Kannangai, Santosh Karade, Jatinder Kaur, K. Kaveri, Kavitha, S Kavitha, Maithili Kavathekar, K Kesavarao, Rashmi Khadapkar, ID Khan, Shoeb Akhtar Khan, Neeta Khandelwal, PK Khatri, Nilofar Khayyam, D Kishore, Sandeep V Kokate, Prasanthi Koli, Vinita Kothari, Meka Koumudi, Mohan Kumar, R Senthil Kumar, Sharath Kumar, P Sravan Kumar, Suresh Kumar EK, D Pradeep Kumar, Ranjeet Kumar, AV Seshu Kumar, S Kumar, P Ratna Kumari, Kumari, Yogendra Kumar, Pradip Kundu, Jyothi Kunduru, Shoba Kurian, Jyothi Lakshmi, G. Jyothi Lakshmi, S. Lalitha, V Madhavi Latha, Madhavi Latha, Shailesh Lichade, S Madhavi, Udaya Kumar Madhurachari, Tapan Majumdar, Paras Mandalecha Paras Mandalecha, Dhruti Manek, Sasidhar Majeti, Malathi, Bharti Malhotra, Paras Mandalecha, Manoj, Devajyothi Majumdar, Supriya Malvi, D Therese Mary, Haris Mazoor, Guruprasad Medigeshi, M Lucy Nirmal Medona, Jeya Meenak, Deepak Kumar Mishra, Meena Mishra, Vaibhav Mishra, Kavitha MP, Prakash Modi, Mohanasundaram, Dharitri Mohapatra, Monica, Sandeepan Mukherjee, AK Munirajan, Varsha Munj, DS Murthy, Anitha Mutha, Vijaya Lakshmi Nag, Mythily Nagasundaram, M Ramamurthy Naik, Nair, Reena Nakra, Gopal Nath, Rajender P, N Shekhar Pal, Samiran Panda, Ajay Parida, Banojini Parida, Arunima Patel, Jaimin Patel, Parthiben, Shilpa Paranjape, Dipankar Pattanik, Manish Patel, Parimal H Patel, Sachin Patel, Vainav Patel, Binod Kumar Pati, Asha B Patil, Niranjan Patil, Nikhil Patkar, Beena Paul, Nikhil Phadke, AC Phukan, Prabha, Monika Prabhakar, Jaya Prakash, RS Prasad, Ranjit Prasad, Sujay Prasad, Amresh Puri, Manju Purohit, Vijay David Raj, Raghu, Rajan, Rajesh, S Rajesh, Y Rajini, Rishabh Rajput, Raju, Giri Raju, B Jabardhan Raju, Sunil Raju, C Ramachandra, SV Ramamurty, Vandana Rana, Vidhya R Rani, VV Ramanchndra Rao, Elmy Samsun Rasul, V Ravi, RK Ratho, Sharmila Raut, Vinita Rawat, Raja Ray, Ujjwayini Ray, S Subba Reddy, Mahesh Reddy, A Sugunakar Reddy, Raveendra HR Reddy, Sowjanya Reddy, PR Rekha, Savi Rodrigues, Anusha Rohit, Shabnam Roohi, krishna S, Lavanya S, Pushkala. S, Mahesh Sabeetha, Deepak Sadwani, Arvind Sahu, Sunitha Sahu, Apurva Sarin, Sahu, VP Sarasu, Saranya, S Saravanan, Raman Sardana, Arunabhao Sarkar, Dibyendu Sarkar, Smita sarma, Satish, Partha Sarathi Satpathi, Savitri, Shailaja Saxena, Sonal Saxena, Saubhik Sengupta, Rajeev Seth, Purvi Shah, Sweta Shah, Sandip C shah, SK Shahi, Nazira Shaikh, P Shankar, Ajanta Sharma, Anshu Sharma, Pooja Sharma, Shashi Sudan Sharma, Jayanthi Shastri, Nikita Sherwani, Shivaleela, Jayasree Shivadasan, Shreekumar, Ajith Singh, Binay Kumar Singh, Dig Vijay Singh, RK Manojkumar Singh, Satyendra Narayan Singh, Shashi P Singh, Simrita Singh, Sudagar Singh, Varsha A Singh, VB Singh, Sivakumar, Rakesh Srivastava, Sudha, C Sugumari, Sukanta Sinha, Ghanshyam Sone, KN Sridhar, CN Srinivas, S Srinivasan, Sandeep Kumar Srivastava, Sunija, K Sunitha, A Surekha, Sreekar, Namita Srivastava, M Mary Sujatha, B Usha Sundari, Swarnalatha, VP Sugnan, Sunita, Rupali Suryawanshi, Swarna, Venkatesha DT, Ajay Tahlan, Anil Tarigopula, Thilakavathi, Utpal Tatu, MS Tevatia, Narendra Vijay Tirpude, Tiwari, Srikanth Tripathy, Jyotirmaryee Turuk, Robin Tuli, Milind Ubale, Ujjala, Nawaz Umar, Banappa Unger, Sireesha Vaidya, Niraml A Vaniawala, V.Vasuki, NPB Veenakumari, M Veeraswamy, MM Vegad, Rosy Vennila, Ranjan Verma, Santwana Verma, Vijaya, A Vijayalakshmi, RD Vishwakarma, Veena Volvoikar, Chand Wattal, Madhu Yadav, Sarita Yadav, Vijay Yenagi, Kamraan Zaman, GB Zore; 1 Virus Research & Diagnostic Laboratory Network (VRDLN) Team (in alphabetical order): Arvind Bhushan, Swati Gupta, Harmanmeet Kaur, Jitendra Narayan, Salaj Rana, Neetu Vijay
Affiliations

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

ICMR COVID Study Group (In alphabetical order: Priya Abraham†, Neeraj Aggarwa l2, Giridhara R. Babu 7, Suganya Barani 8, Balram Bhargava 4, Tarun Bhatnagar 8, Ajay Singh Dhama 3, Raman R. Gangakhedkar 2, Sidhartha Giri 2, Nivedita Gupta 2, Karishma K. Kurup 5, Ponnaiah Manickam 9, Manoj Murhekar ††, Varsha Potdar 1, Ira Praharaj 2, Kiran Rade 6, D.C.S. Reddy 11, V. Saravanakumar 10, Naman Shah 12, Harpreet Singh 3, Jeromie Wesley Vivian Thangaraj 8, Naveen Yadav 8), COVID Epidemiology & Data Management Team @, COVID Laboratory Team*, VRDLN Team$ et al. Indian J Med Res. 2020 May.

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.

Keywords: Attack rate - contact testing - descriptive epidemiology - epidemic curve - positivity - SARS-CoV-2 - testing rate.

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Conflict of interest statement

None

Figures

Fig. 1
Fig. 1
Frequency of testing and positive tests (%) for SARS-CoV-2, India, January 22 - April 30, 2020.
Fig. 2
Fig. 2
SARS-CoV-2 tests per million (total individuals tested) by State/Union Territory, India, January 22 - April 30, 2020. Source: Map outline reproduced with permission from Survey of India, Department of Science & Technology.
Fig. 3
Fig. 3
Contacts tested per confirmed coronavirus disease 2019 case by States/Union Territory, India, January 22 - April 30, 2020. Source: Map outline reproduced with permission from Survey of India, Department of Science & Technology.
Fig. 4
Fig. 4
Coronavirus disease 2019 cases by source of exposure and date of sample collection, India, January 22 - April 30, 2020.
Fig. 5
Fig. 5
Proportion of districts reporting any coronavirus disease 2019 case by State/Union Territory, India, January 22 - April 30, 2020. Source: Map outline reproduced with permission from Survey of India, Department of Science & Technology.
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