You have to wonder why India isn't reporting many deaths yet.
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Their test to death ratio is quite good. I heard from a friend who recently moved from India that their counting of deaths is not all that good though. So it may be hard to say whether ratio is really around 1000.
However, if they can maintain a daily test to death ratio of over 1000 (daily tests / daily deaths), they have some hope of limiting their outbreak (it is dropping below that, which is not a great sign). That being said, it is a very large country, so you have to be careful to apply this ratio on a regional basis. Local outbreaks could become extremely bad if testing is not as readily available in those areas.
Would be great if they could scale their capacity to over 3000 tests per death.
With just about everything reopening over the last month and no real sign of renewed exponential growth in cases I'm starting to question my "observed reality"!
Our test to death ratio is now about 450. This is starting to be respectable. It’s unclear whether that will be sufficient to snub Rt enough that continuing increase in capacity will be able to outpace case growth. On one hand, the increasing level of testing relative to cases continues to exert increasing pressure on the virus. On the other hand, increased reopening will result in increasing numbers of cases.
I think that if we had very strict mask wearing policies *everywhere* and other public health interventions solidly in place, I think we could relatively easily be successful with current case levels (they will continue to drop and the testing will further suppress them as the testing becomes even more significant relative to the number of infections). Unfortunately we don’t have that!
Right now, we probably have about 4 tests per infection (assuming 1% IFR), to test close contacts (we have about 20 tests per case). That seems like it could be just enough, especially if we assumed really close contacts of known cases were infected. There is still the question about what the multiplier is to actual cases right now...it is possible it is as low as 2 to 3x now (it used to be as high as 10x, probably). These numbers suggest the ratio is currently about 4x (~800 deaths per day right now, implies about 80k cases per day, and we’re finding about 20k). Obviously untracked cases are a big problem, which is why we’d definitely like more test capacity right now. But a certain number of these are family contacts, which should die out (not literally, hopefully).
I think if we are seeing continued case decline in most locations in two weeks, we may well be on the way to success here. It will be a long drawn out “success” with a lot of unnecessary deaths, relative to the optimal solution, but would be better than a huge second wave.
It would certainly help if everyone wore their masks and face shields and gloves, though.