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India estimates 6.4 million Covid-19 infections by early May: National Sulfur Survey

The much-anticipated findings of the first national serum study conducted by ICMR, published in the Indian Journal of Medical Research, show that 0.73% of adults in India were exposed to SARS-CoV-2, totaling 6.4 million infections from The beginning of May.

The study was conducted from May 11 to June 4 and involved 28,000 individuals whose blood samples were tested for IgG antibodies using the COVID Kavach ELISA kit.

Also, seropositivity is highest in the age group 18-45 years (43.3%), followed by those between 46-60 years (39.5%) and is lowest among persons over 60 years of age (17.2%).


By the beginning of May, a total of 64,688,388 adult infections had been estimated in India, the study report said.

“The findings of our study showed that overall seroprevalence in India is low, with less than one percent of the adult population exposed to SARS-CoV-2 by mid-May 2020.

“The low prevalence observed in most areas indicates that India is in the early stages of the epidemic and the majority of the Indian population is still susceptible to SARS-CoV-2 infection,”

; the study report said.

He emphasized the need to continue to implement context-specific mitigation measures, including testing for all symptoms, isolating positive cases and monitoring high-risk contacts to delay transmission and prevent congestion in the health system.

Men living in urban neighborhoods and occupations at high risk of exposure to potentially infected individuals are associated with seropositivity.

According to the study report, sulfur prevalence varies between 0.62 and 1.03% in the four layer areas.

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The stratification of areas such as zero cases (15 areas), low (22 areas), medium (16) and high (17) was performed based on the reported number of Covid-19 cases as of 25 April.

Based on the total corrected seroprevalence of 0.73% and the reported number of Covid-19 cases, it was estimated that for every confirmed RT-PCR case of Covid-19 in India, there are 82-130 infections.

As part of the study, a total of 30,283 households from 700 clusters in 70 districts of the four strata were visited. About a quarter (25.9%) of the surveyed clusters are from urban areas. A total of 28,000 people have agreed to participate, the report said.

Almost half (48.5%) of the participants were between 18 and 45 and 51.5% (14,390) were women. Overall, 18.7% of the participants had an occupation with a high risk of exposure to potentially infected persons.

The study notes that there may be insufficient detection of Covid-19 cases in zero-layer areas due to low testing, as well as poor access to test laboratories.

In four of the 15 districts in this stratum, Covid-19 testing laboratories were not available at district headquarters and samples were transported to state central hospitals for diagnosis.

Current findings of seropositivity in the strata of areas with zero to low incidence of Covid-19 underscores the need to strengthen surveillance and increase testing of suspected cases in these areas, the study report said.

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