‘Most state govt hospitals not ready for Covid-19 testing’
As the Centre continues to face criticism of not doing “enough” testing to identify Covid-19 patients, a report by the ICMR shows that state government institutions are not yet ready or willing to carry out tests on their own accord.
In a statement released on 7 April, ICMR had shared details of different hospitals from 15 states detailing their preparedness and intent. These hospitals were identified to add to the 200 plus existing network of hospitals and laboratories that were already carrying out tests in the respective states.
In Sri Krishna Medical College and Hospital, Muzaffarpur, which is one the two hospitals of Bihar shortlisted for carrying out tests, ICMR found that its staff has absolutely no experience of molecular diagnosis of viruses and they were still undergoing training for the same at the Rajendra Memorial Research Institute of Medical Sciences, Patna as on 6 April. Similarly, in the case of Jawaharlal Nehru Medical College, Bhagalpur, it was found that they have no facilities for real-time RT-PCR testing. Real-time PCR is commonly used to measure gene expression and amplify and quantify a targeted DNA molecule.
The most shocking response was received by the ICMR from Sardar Patel Hospital, Ahmedabad. ICMR, said: “No real- time PCR machine, no biosafety cabinet, no trained staff. Not interested in testing.” A similar response was received from SMVS Swaminarayan Hospital, Gandhinagar. ICMR, while commenting on the hospital, said: “No real time PCR machine, no biosafety cabinet, no trained staff. Contacted again on 7 April, no response.”
A biosafety cabinet, which is an enclosed ventilated laboratory workspace for testing pathogens, is the most basic requirement for carrying out such tests. The staff at Patliputra Medical College & Hospital, Dhanbad, Jharkhand, too, were found to have absolutely no experience of molecular diagnosis of viruses.
In Government Medical College, Latur, ICMR found that the hospital had “no equipment or consumables available” to carry out the test.
In Madhya Pradesh, of the four hospitals identified, both the state government hospitals were found wanting, whereas the remaining two private hospitals just needed NABL accrediation. In S.S. Medical College, Rewa, there was no biosafety cabinet, while Bundelkhand Medical College, Sagar could not carry out the tests as “civil work’ was going in the hospital. RD Gardi Medical College, Ujjain, and Sri Aurobindo Institute of Medical Sciences, Indore, both private hospitals, were found to be meeting all the parameters required, except NABL accreditation for molecular diagnosis of respiratory viruses.
ICMR has been considering new centres for Covid-19 testing in districts where the number of suspected cases is more than 100 per day and the nearest testing laboratory is over 250 km away in the plains and over 150 km away in hilly regions. Currently, over 200 laboratories have been identified. To establish a testing centre, availability of a biosafety level-2 laboratory, along with a molecular biology set-up for virological diagnosis and a functioning and calibrated biosafety cabinet type 2A/2B, would be required. The laboratories should also have a cold centrifuge for RNA extraction, and a functional and calibrated real-time PCR machine. The applicants should ensure the availability of staff, like medical microbiologists with experience of work in molecular virology and at least 4-6 technicians, so that they can work in shifts. At Tura Civil hospital, Dermile, West Garo Hills, Meghalaya, the ICMR noted: “Full facility is not yet available, will be again explored after few days.”
In RVRS Government Medical College, Bhilwara, the ICMR found that full set of equipments and consumables were not available to carry out the tests. In Tamil Nadu, out of the three hospitals selected, both Kanyakumari Government Medical College, Nagercoil and Thanjavur Medical College, Thanjavur, were yet to install RT-PCR and biosafety cabinet. Ganesh Shankar Vidyarthi Memorial Medical College, Kanpur, had no real time PCR machine.
While there was no biosafety cabinet at Murshidabad Medical College & Hospital, RG Kar Medical College and Hospital, Kolkata, was unsuitable because of ongoing civil works.