Introduction In an increasingly globalized world, no country can remain immune to the effect of the COVID-19 pandemic. The pandemic has exposed the need for effective public health surveillance in the interest of global health security. However, current indicators are limited in doing a comparative intercountry assessment and comparison because of variation in testing rates and reporting standards. Hence, this study attempts at addressing this gap. Methods The study proposes incremental change in cases per testing rate (ICTR) as an indicator for doing cross country comparison of the pandemic progress. The equation for calculating this indicator is explained in this study. This is followed by measuring its strength of association and predictive power for determining change in SARS-CoV-2 cases in five countries (USA, UK, India, Pakistan and Bangladesh). Results and discussion ICTR was found to have a significantly higher strength of association and predictive power (than the existing indicator- test positivity rate) for determining change in cases over different time periods. Using ICTR, cross country comparison was done for the five countries for15 months to draw deeper insights into the progress of the pandemic. Conclusions The study finds ICTR to be a suitable indicator for inter country comparison and intra country monitoring of the pandemic, which would be useful for global COVID-19 surveillance. Key words: Incremental analysis, SARS-CoV-2, low-middle income country, high income country, testing rate, test positivity rate, surveillance.
A Novel Indicator for COVID-19 Pandemic Assessment and Comparison