THE SHARPE surge in demand for at-home antigen testing kits amid the third Covid wave has become a cause of concern for the state health department. Officials believe that many positive cases are going unreported as those testing positive are not informing the agencies. The Covid-19 national task force too has flagged the issue.
Even as active Covid-19 cases in Maharashtra rose five times in the last month, the demand for at-home antigen testing kits also spiked. As per Sujit Jain, director, MyLab Discovery Solutions, the demand for CoviSelf has surged by nearly 200% in the third wave. However, the public health department has no mechanism to record Covid positive cases which is causing under-reporting of the actual daily burden in the state.
As per the protocol, each of the easy-to-use testing kits has a unique QR code to ensure traceability and genuineness. A user is instructed to log into the apps of the respective brand, such as Mylab CoviSelf, CoviFind, through their mobile numbers. Then they have to scan the unique QR code. After running the test, they have to take a photo of the test on the card through the app to confirm the result.
“When you take the test, you have to download the app and take a picture of the result. The report is submitted to the ICMR website directly. We take undertakings from all our retailers and customers,” said Jain.
However, it is not mandatory for the users to upload their results. A test drive by The Indian Express confirms the same. If the ‘T’ (Test) line appears on the card, the suspected patient is considered positive of novel coronavirus.
As the test results are already visible on the card without uploading it on the app, users may keep away from doing so to avoid quarantine and subsequently, flout the Covid-19 safety protocols.
“A minute portion of users do that but similar issues are being observed among RT-PCR users where they hide their positivity reports. Most users are submitting their test results on the app,” said Jain. “However, we are coming up with new advertisements to encourage people to submit their reports,” he added.
These lapses have also caught the eye of the National Covid-19 task force. As per sources, last week, the task force flagged the issue. “We are aware of the situation and will take the required steps to ensure that the positive cases don’t go unreported,” said Dr Pradip Awate, state surveillance officer.
Officials also pointed out that due to such under-reporting, the health department is also failing to track close contacts, which can increase transmission of the virus.
“There is no data entry from home testing kits. It is a screening test, not a confirmatory test. We don’t know about
those who are using self-testing kits. If those testing positive don’t follow isolation rules, they will end up infecting their close contacts,” said Suresh Kakani, additional commissioner, Brihanmumbai Municipal Corporation (BMC).
This will also affect quarantine surveillance in the state. For instance, in Mumbai which has turned into the epicentre in the third wave, the BMC issued fresh guidelines that the whole building or a wing will be sealed if over 20% of the occupied flats have Covid-19 patients. However, BMC will not be able to effectively guage the spread of Covid-19 in communities for want of actual data.
Dr Suresh Chandra Singh, who has worked with Indian Institute of technology, Bombay (IIT-B), on Covid antigen kits as the chief scientist, said, “The whole idea behind self-test is to quickly detect and isolate infected patients.
But now, people are using these kits to go undetected from surveillance. Most of the asymptomatic patients are taking medicines from local doctors. Then they step out and end up infecting others as carriers.”
In the second wave, when the laboratories were overwhelmed with daily RT-PCR tests, self-test kits that provide results within 20 minutes were considered as the game-changer in Covid management in India. In May 2021, the Indian Council of Medical Research (ICMR) approved the country’s first self-testing kit for home use—CoviSelf, manufactured by Pune-based Mylab Discovery Solutions. Many others were approved subsequently with the cost per kit varying from Rs 220 to Rs 500.
The sensitivity of an antigen test is around 65%, lower than the RT-PCR test which has an 85%-96% sensitivity. “A major drawback of the kits is that it has a high chance of missing a positive case if the viral load is low as it doesn’t amplify the RNA of the virus. So, if a person tests negative, it doesn’t mean they are not infected. In such a situation, an RT-PCR test is essential,” said Dr Awate.