Geographical access to COVID-19 testing centers in India.

BACKGROUND

Geographic accessibility to testing constitutes an important part of pandemic preparedness. However, there is no data on access to COVID-19 testing centers in India. Our study looks at the current geographical accessibility to these testing centers across 36 states and union territories (UTs) and 735 districts.

METHODS

We acquired the testing center geocodes from the Indian Council of Medical Research. We took motorized and walking travel-time friction surface rasters from the Malaria Atlas Project 2019 and high-resolution population estimates from WorldPop 2020. Using these, we examined the density of centers per million population and the travel time to the nearest center. We assessed the Access Population Coverage (APC), defined as the proportion of the population within 30 minutes by walking and 60 minutes by motorized transport from the nearest COVID-19 testing center.

RESULTS

India has a density of 1·62 testing centers per million. The national median travel time (IQR) to the nearest COVID-19 testing center was 400·28 minutes by walking and 50·42 minutes by motorized transport. 11·08% of the population were within 30 minutes of a testing center by walking (range across districts: 0–100%). 85·88% of the population were within 60 minutes of the nearest testing center (range across districts: 0–71·86%). The APC was 81·51% within 60 minutes by motorized transport in rural vs. 97·87% in urban areas.

CONCLUSIONS

There are wide disparities across states/UTs and between rural and urban areas in accessibility to testing centers. Policymakers should note these disparities when setting up new testing centers. TRIAL REGISTRATION: Not applicable.