Testing strategy evolved to keep ahead of disease
India is testing 110,000 samples every day, which can be scaled up to 200,000 soon
NEWDELHI: As India’s daily tests for the coronavirus disease (Covid-19) top 100,000 to ensure that the disease doesn’t spread undetected in the country, a senior government official said on Monday that the testing strategy has evolved over time to try to “remain ahead of the virus” despite constraints in country’s health care infrastructure.
India currently has 609 labs (431 public and 178 private) testing for the highly contagious disease that are testing about 110,000 samples every day. The capacity of the labs is to test 140,000 samples every day, which can be scaled up to 200,000 soon, the official said on condition of anonymity. “It has been a tough balancing act…,” the official said.
Another official said that the experience from the handling of the Swine Flu pandemic of 2009, which killed thousands of people across the globe, resulted in attention being paid to molecular diagnostic facilities in India. He added that the public health system has not been overwhelmed in the Covid-19 outbreak, unlike the 2009 disease spread.
The ramping up of molecular diagnostic facilities was useful when Prime Minister Narendra Modi, early in the Covid-19 outbreak, told the country’s top scientists to expand testing.
“You have to work day and night to save people’s lives. Make every effort. You have my full support,” the official quoted the Prime Minister as having told scientists in the Indian Council of Medical Research and other experts.
Dr Nivedita Gupta, the ICMR scientist who executed the effort to scale up labs across the country, told Vogue’s India website earlier this month: “For this outbreak, we are answerable to the highest level and are being watched by the highest level.”
The decision to implement a lockdown bought scientists time as it slowed down the spread of the disease, officials said.
“We adopted an intelligent testing strategy to remain ahead of the virus. So in the beginning, when the infection was entering the country from abroad, we centered our efforts to set up the initial burst of laboratories in cities… This focus kept on shifting on the basis of our analysis of the likely hot spots of the infection,” another official said, asking not to be named as he was not authorised to speak to the media.
As migrant workers began returning home to states in Uttar Pradesh, Bihar, West Bengal and Odisha, the government’s efforts to ramp up testing ensured these areas did not get overwhelmed. “This has been quite challenging as the labs outside the medical college systems have meagre experience of handling human infectious material,” a health ministry official said.
All underserved areas were mapped and Covid-19 molecular diagnostic capacity grew in “difficult to reach” areas such as Arunachal Pradesh, Nagaland, Sikkim, Ladakh, Goa and Andaman & Nicobar Islands.
In the first week of February, India had 13 labs to test for Covid-19. On March 24, a day before the national lockdown was implemented, the figure stood at 123. The current lab capacity in the country is 609.
The first official quoted above said most states have been working with the National Tuberculosis Elimination Programme (NTEP) to deploy TrueNAT machines for Covid-19 testing. Through this machine, testing is done in such areas where modern virological laboratory in private or public doesn’t exist, the official added.
The machine has been tested and validated by ICMR to screen people for SARS-CoV-2.
The official said that there are 367 of these machines in different states for TB diagnosis. Supplies of 608 additional TrueNAT machines – each has a capacity for 10-12 tests in a day – are being mobilised to be ready for deployment in June, the official added.
“The most important thing now to focus on is putting in place aggressive containment measures in identified hot spots so that these don’t leak into green zones. The moment will come when lockdown is lifted, so we will have to prepare our strategy focusing on areas from where no cases have been reported that can be opened up for commercial activities, and to ensure the red zones are converted to orange and then green zones,” says Dr Randeep Guleria, director, All India Institute of Medical Sciences, Delhi.