Official COVID case counts in Delhi NCR estimated to be understated by over 80% as most with symptoms opt for at-home antigen or no test at all

June 20, 2022, New Delhi: The RT-PCR and Rapid Antigen Test (RAT) have become important to trace if an individual has been infected by COVID-19. Per ICMR’s advisory on ‘Purposive Testing Strategy for COVID-19’, only symptomatic individuals may get tested with RT-PCR, which can be taken in hospital laboratories. Whereas, rapid antigen test has become popular among citizens as it can be taken at home settings. However, the number of rapid antigen tests taken at home by people are not reported in official case counts painting a misleading picture of the COVID situation.

Delhi and NCR cities experienced a massive surge in COVID cases in January this year followed by another surge in April this year when cases did not rise in most states across India. And in just about a month’s time, as COVID cases again rise across most of the country this time, Delhi and NCR cities are surprisingly experiencing yet another surge. With 1500-1800 daily reported cases just in Delhi and another 600-1000 in NCR cities, many are questioning if these reported cases are estimating the spread of COVID accurately.

To understand the on-ground situation, LocalCircles sought inputs from residents of Delhi and NCR cities asking them if they or anyone in their family had symptoms in the last 30 days and how did they get themselves tested in such a situation. The survey received 11,059 responses from citizens located in all districts of Delhi-NCR. 64% respondents were men while 36% respondents were women.

Of those who had COVID symptoms in Delhi-NCR in the last 30 days, only 16% took a RT-PCR, 34% did at-home RAT, and 50% took no test

The question in the survey asked residents of Delhi-NCR, “In the last 1 month when you or family members in Delhi-NCR had some symptoms and needed a COVID test (non-travel), what type of test did you undertake?” In response, 16% said “RT-PCR”, and 34% said “Rapid Antigen Test”. The majority, 50% of residents “Took none of them despite symptoms”. Of those who had COVID symptoms in Delhi-NCR in the last 30 days, only 16% took a RT-PCR, 34% did at-home RAT, and 50% took no test. This question in the survey received 11,059 responses.

The community feedback indicates that most people are either just not getting tested and taking treatment based on symptoms and about one third are taking the at home rapid antigen test. Only 16% are taking the RT-PCR. This means that for potentially 100 people with symptoms, only 16 of them are being registered in the official numbers reported by Delhi Government and other NCR district administrations.

Only 16% cases in Delhi-NCR may be in official figures as increasing number of residents opt for at-home antigen test or no test at all

A similar survey conducted by LocalCircles in April 2022 had indicated 33% of Delhi-NCR residents as saying they took an RT-PCR test after having symptoms. This percentage declined to only 16% in June 2022 indicating that the daily reports released are increasingly becoming unreliable.

In summary, of those who had COVID symptoms in Delhi-NCR in the last 30 days, only 16% took a RT-PCR test while 34% did at-home RAT. However, more worrying is that 50% of residents said they took no test despite having symptoms. A similar survey conducted by LocalCircles in April 2022 had indicated 33% of Delhi-NCR residents as saying they took an RT-PCR test after having symptoms. This percentage declined to only 16% in June 2022. This means that Delhi-NCR official case counts may be understated by 84% as most opt for at home antigen or no test at all. All of this points to an urgent need for authorities of Delhi and NCR cities and the Union Health Ministry to find alternate ways of tracking the extent and spread of COVID. With newer Delta-Omicron recombinants like BA.4 and BA.5 leading to increased hospitalisations in Europe and being reported through genome sequencing in many parts of India, accurate reporting is the need of the hour and critical to handling the pandemic going forward.

Survey Demographics

The survey received 11,059 responses from citizens located in all districts of Delhi-NCR. 64% respondents were men while 36% respondents were women. The survey was conducted via LocalCircles platform, and all participants were validated citizens who had to be registered with LocalCircles to participate in this survey.