Barely ten days after permitting 16 private diagnostic centers and hospitals in the state to conduct RT-PCR based testing of samples for coronavirus, the Telangana health department preparing to take ‘stringent action’ against several of them over several violations, ranging from poor quality control, poor hygiene, incorrect testing methods and failure to share full data with authorities.
The state has witnessed a sudden spike in the number of Covid-19 cases since June 16, taking the tally to 12,349 on June 26. Of these, 7,436 are active and under treatment. As many as 6,943 positive cases have emerged during the last 10 days after Telangana ramped up its testing.
After the state health department observed a disparity in the figures uploaded by private labs into the ICMR and state portals on June 24, an inspection was initiated by four teams, comprising senior microbiologists and senior officers from the health department across 16 private laboratories.
While the inspection team looked into aspects of infrastructure, manpower, infection control measures and other facilities, including general hygiene, several others issues came to the forefront. The team also scanned the registers and the data uploaded by the labs into ICMR and Telangana state’s portal.
For example, as per the inspection report, when the total tests conducted as per the ICMR portal stood at 9,577, the state portal reflected only 6,733 tests and the records available with private labs showed 12,700 tests were held. Similarly, the number of positive cases as per the ICMR portal stood at 2,076. Whereas the state portal showed positive cases at 2,836 and the lab records suggested 3,571.
According to the ‘inspection report on virus testing by private labs’, the findings of which were examined by an expert committee of microbiology professors along with the director of medical education and the V-C of KNRUHS, the staff was not wearing PPE, safety cabinets were not available and hygiene conditions were poor.
The report shared by Dr. G Srinivasa Rao, the director of public health and family welfare, also said that clear evidence was available to suggest that the staff conducting the tests have not been trained properly in RT-PCR testing for Covid-19. Measures for quality control and validation of tests were not followed in some of the labs, he said.
Suspicion was also raised by the committee that some of the labs have resorted to ‘pooled testing’ where all samples are reported as positive even if one among the lot is positive. This will be further studied by experts using amplification plots generated by the RT-PCR machine.
One of the key findings of the inspection team suggests that “there is a possibility of contamination of samples leading to high positivity rate because safety measures and protocols are not followed meticulously.”
It also found that the test positivity rate would be lesser if the number of all tests done is uploaded. For instance, it said, in the lab at a major hospital, total tests conducted were 3940 but they uploaded only 1,568 tests and showed 475 of them as positive.
Some of the labs were found to be conducting tests for walk-ins, advertising that samples will be collected from different places in the city, while the guidelines clearly say that only symptomatic cases and those admitted in hospitals should be tested, it found.
Based on these findings, the expert committee has recommended stringent action against some of the private labs for violating the norms and not following guidelines. ICMR has also directed the Gandhi Medical College to conduct quality control tests for private labs.
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