印度的COVID-19感染严重低估d’

India’s southern state of Karnataka alone may have had 31.5 million cases of COVID-19 or nearly 95 times greater than have been reported, says a new study that puts a question mark on the 10 million plus cases reported for the whole country so far.

本月出版Journal of the American Medical Association,the study is based ondata来自househol的代表性样本ds in 20 districts of Karnataka, home to 70 million of India’s 1.3 billion people.

As of Monday, 15 February, according to世界计，，，，India had recorded 10,916,589 cases of COVID-19, second only to the US with 28,261,470 cases. Brazil came in third with 9,834,513 cases.

Anup Malani，，，，an author of the study and professor at the芝加哥大学法学院and普里兹克医学院，，，，tellsscidev.netthat while official reports suggest that the virus has infected ten million people in India, the testing rates are low. “Our study has a more precise estimate of the spread ofCOVID-19，，，，” he says.

Researchers collected data from households in urban and rural areas of the state of Karnataka on antibodies for recent and past COVID-19 infection using a test that targets the RBD spike protein and better identifies exposure to the COVID-19 virus rather than other coronaviruses.

马拉尼说，该研究的一个独特特征是，它使用RT-PCR检验测试了相同的个体用于当前感染。他强调：“这种配对允许该研究报告当前的免疫力和预测未来的免疫力，因为当今感染的大多数人口将在几周内加入明天的免疫种群。”

Manoj Mohanan，，，，co-author of the study and associate professor of global health at the Sanford School of Public Policy, Duke University, North Carolina, says that 44.1 per cent of the population in Karnataka’s rural areas and 53.8 per cent in the urban areas tested positive for antibodies to COVID-19 by the end of August 2020.

研究人员发现，农村地区与城市地区的COVID-19与城市地区的接触水平几乎相同。虽然cities人口稠密的农村地区面临额外的风险，因为beplay下载官网西西软件is an essential sector and exempted from lockdown restrictions.

马拉尼说，在卡纳塔克邦，人口中有46％的人口为19，是报告金额的95倍。随后在泰米尔纳德邦进行的一项研究表明，那里有32％的人拥有官方人数的36倍。两项研究均在批准或与州政府合作进行。

马拉尼说：“如果Covid-19的传播广泛得多，它会告诉我们两件事。”“假设死亡统计是正确的，感染死亡率较低。另一方面，印度控制病毒传播的努力比许多其他国家都没有成功。我们需要调查印度如何在下一个大流行中做得更好，尤其是如果比19岁更危险的印度人更危险。”

“We need to investigate how India can do better in the next pandemic, especially if it is more dangerous to Indians than COVID-19”

Manoj Mohanan，，，，Duke University

Malani believes that underestimation, as seen in rural India, is possible in other areas of south and south-eastern Asia. “Low testing rates are common among low- and middle-income countries, and low testing could be a function of low state capacity,” he tellsscidev.net。

High seroprevalence in the rural areas of Karnataka and Tamil Nadu was attributed by Malani to millions of migrants fleeing the cities for rural areas once the lockdown was lifted in May. Although cities were more densely populated, rural areas faced additional risk because agriculture was exempted from lockdown restrictions.

Neelanjan Sircar, professor of economics, Ashoka University, Sonipat, India, says the study allows comparison of rural and urban populations. “We may understand the core trade off in spread of infection between urban and rural areas in India in the following way: urban may be more susceptible to spread due to density of social contact, but they have also seen greater state intervention in stemming spread as compared to rural areas.”

“The study estimates that infection was about 10 percentage points higher in urban areas (54 per cent) as compared to rural areas (44 per cent),” Sircar adds. “This provides evidence that state control measures in urban areas did not fully mitigate the greater risk of spread in urban areas.”

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