No pool testing in Maha as ICMR yet to give approval

Twenty-two days after the state government announced it would start pool testing, not a single pool test for Covid-19 has taken place as the Indian Council of Medical Research (ICMR) is yet to give Maharashtra the go-ahead for the same.

According to ICMR guidelines, to conduct pool testing, less than 2% of the total tests conducted should be positive. The state’s percentage of positive cases is more than that at present, said a senior state government official.

“I have been following up on the matter but ICMR is yet to approve pool testing in the state,” said public health minister Rajesh Tope. Till Saturday the state conducted 2,61,783 tests, of which 30,706 (8.52%) was positive.

Pool testing involves checking up to five samples in a single test. The pool testing algorithm involves the Polymerase Chain Reaction (RT-PCR) screening of a specimen pool, comprising multiple samples. In case a pool test comes positive, each sample is tested individually. At present, one sample is tested at a time.

“With the new form of testing, the state’s capacity would increase 10 fold. Pool testing could help us identify new clusters or hotspots faster,” said a senior health official.

After a meeting with Union health minister Dr Harsh Vardhan on April 24, Tope had announced that the state would start pool testing and clinical trial of plasma therapy soon. Clinical trials of plasma therapy have started but there has been no progress on pool testing.

The ICMR guidelines state that pool testing should be used only in areas with a low prevalence of Covid-19. It further states that in areas where 2-5% of the samples test positive, pooling for PCR screening may be considered only in community surveys or surveillance among asymptomatic individuals. The guidelines strictly exclude pooling samples of individuals in known contact with confirmed cases.

“All over the state, the percentage of positive reports is more than 2% and that’s why we are not eligible to conduct tests. The state can do it on its own but we prefer to follow the guidelines issued by ICMR as it is the technical nodal agency. There are also different issues involved in this such as accuracy of tests, number of samples being used for testing, etc,” said a senior official from the medical education department.

He said that pool testing will help in multiplying the number of tests conducted. For instance, labs which have a capacity of 100 tests a day, will be able to conduct up to 1,000 tests daily.

The state has enhanced its testing capacity from 100 samples a day to around 22,000 a day. This includes 57 laboratories (33 government and 24 private) with RT-PCR tests, six laboratories (three government and three private) of CB-NAAT tests, and two private laboratories for Truenat testing. All are approved by ICMR as Covid-19 tests.

“When we started, we had only one functional lab at Kasturba Gandhi Hospital with a capacity of 100 samples a day. The capacity has gone up 220 times in about two months. We lead in India and have more capacity than many countries. Testing in Maharashtra is strictly as per ICMR guidelines,” said another official from the state medical education department.

To assess the spread of infection among the masses, the state government last month had announced that it would conduct antibody testing. This too could not be started as ICMR found that the testing kits were faulty.