Happy to see ICMR's just released paper on SARI testing. http://www.ijmr.org.in/temp/IndianJMedRes000-2449198_064811.pdf Some highlights: since February 15th, India tested 5911 SARI cases. Out of these, 965 were retrospectively tested (1)

We do not know how many SARI cases India had during this time. Although we have an influenza-like illness network, numbers are not freely available. So, it's not easy for outsiders like me to see what SARI patterns looks like in this season (baseline) (2)

However, ICMR says that after it expanded criteria for universal testing of SARI patients, *a majority* of SARI cases at the testing centres (mainly in urban areas) would have been tested. So, that's important to note. We don't seem to have universal SARI testing yet (3)

Anyway, there were 102 COVID-19 patients from 52 districts in 20 states. 40 of these patients had no travel history, but in the case of 59 patients this is unknown yet (4)

Now, remember that these people weren't selected for travel history in the first place. They are simply people with a very severe respiratory illness. And just because some had travel history, it doesn't mean they got it during travel. The paper doesn't make any such claim (5)

The rate of positivity of COVID-19 in SARI cases tested every week since February has been climbing: from 0% to 2.6% in the week ended April 2. It seems like community transmission could be happening a large scale (6)

Especially if you consider the fact that these samples come from public sector hospitals in urban areas (where good private labs may not be sending their samples) (7)

Am I going to insist that ICMR classify regions as undergoing community transmission. Frankly, I don't care anymore. This term has been used too vaguely by everyone, including WHO (8)

But it would be nice to have baseline data from NCDC's ILI network too. What do ILI/SARI numbers look like in this season in other years? What are they looking like in 2020? Is there an unusual spike? That data is a good compliment to what ICMR has released in this paper.