Thoughts on Random Testing and Herd Immunity

Different countries are tacking the COVID-19 issue differently. Some are testing extensively, while others, like India, are finding all kinds of excuses not to test extensively. Previously, if you were tested COVID-19 positive, you were discharged from the hospital only if you tested negative in two consecutive tests which were 24 hours apart. Now if you test negative just once, you are sent home. Moreover, if you have a mild case or are asymptomatic, you are sent home even without a test. If you are asymptomatic you don’t even need to be admitted into a hospital anymore. You can “take care” of yourself at home itself.

All this has resulted in a number of positive cases which is far lesser than the real number of infected people in the country. I say this because in order to get an idea of how widespread the virus is, you need to do random testing of people in different parts of the country. That isn’t being done and I don’t think the government wants to do it. At the moment, if you want to test yourself you can’t simply walk into a testing facility and get yourself tested. You need to get a doctor to prescribe you a test. A doctor won’t do that unless he finds you symptomatic.

I’m of the opinion that the virus has already spread widely into the population. I believe we are well on the path of attaining herd immunity. I believe India will attain herd immunity well before any vaccine is released. It’s a belief. Nobody knows for sure. But every belief has some form of reasoning or logic behind it. Here is mine.

Till recently Goa prided itself with the fact that we hadn’t reported any new COVID-19 case in weeks. Then we started letting in people by bus and train and suddenly the number of cases spiked to 50. The Goa government decided to subject everyone entering the state to a COVID-19 test. What people don’t realize is that this is probably the first random test carried out in the country by a state government. Random people from different parts of the country were tested at the Goa border and a decent number of them were found to be COVID-19 positive. If you conduct similar random tests all across the country, I’m pretty sure you will find similar results.

It’s important to note that the Goa government conducted proper COVID-19 tests on the border. They didn’t screen people using temperature guns like other states. People were made to pay Rs 2000 for the test. Those who were tested on the Goa border most probably wouldn’t have been able to get a doctor to prespribe a test for them because they were asymptomatic. So in that sense, what happenned at the Goa border was truly a random COVID-19 test. I’m not sure if the Goa government even realises what they have done.

I see this as good news. Given the low fatality rate in India, it means that Indians are fighting this virus much better than people in other countries. This means that as more people get infected, fight the virus and build anti-bodies, the faster we will achieve herd immunity.

I think the way forward is to open up the economy, strictly enforce social distancing and ban all large gatherings while doing everything to isolate people above 60 years old, those most vulnerable to this disease. Social distancing is crucial to arrest the rate of spread of the virus. Herd immunity needs the virus to spread, but not at an uncontrollable rate. Otherwise we risk overloading our already fragile healthcare system which could lead to deaths which could have been prevented.