IN THE middle of processing a batch of 34 samples for the coronavirus, a sample of a critical patient was sent for testing as an emergency and at this private laboratory, instructions were immediately issued to use the GeneExpert machine that uses a cartridge-based system, commonly used to detect tuberculosis.
“There was no other option. We had to process a quick report and in this regard, the GeneExpert machine, which has now been allowed by ICMR (Indian Council of Medical Research) to detect SARS-CoV2 (novel coronavirus), came to our rescue. You can directly introduce the swab into the cartridge and start processing. While the cost is high, we value our commitment to society to pitch in during the pandemic,” said Dr Awanti Golwilkar-Mehendale, chief of laboratory at AG Diagnostics, which was the first private laboratory in Pune to get the go-ahead to start conducting COVID-19 reverse transcription polymerase chain reaction (RT-PCR) tests.
“National Institute of Virology (NIV) and, also government-run BJ Medical College and Armed Forces Medical College (AFMC) had already initiated their operations. But in the private sector, we were the first to get permission from ICMR to start COVID-19 testing. We started performing the PCR test from March 26,” Dr Golwilkar-Mehendale said.
She added, “Initially, the load was not much and due to the manual extraction of the viral nucleic acid from the clinical sample, the capacity was 30 to 50 samples per day; but now, this has been upgraded to more than 80 samples with automated extraction processes in place.”
Even as the laboratory conveyed its willingness to chip in, as they had already been authorised to test for H1N1 virus, Dr Golwilkar-Mehendale said their wellness clinic was not functioning, and due to the lockdown and fear due to the virus, there were limited walk-ins at the out-patient department.
“The workload has gone down drastically and is only about 25 to 30 per cent of what we routinely have,” Dr Golwilkar-Mehendale said, adding that there was mounting pressure of high operating costs due to the rent of the main lab premises as well as premises of more than collection centres, in addition to staff salaries and other expenses, including personal protective equipment, N95 masks and reagents.
While government-run labs are also overburdened, private sector labs are stretching their limits to provide quality testing for COVID-19 in the shortest turnaround time. Across Maharashtra, till May 6, out of 1,90,879 lab samples, 16,758 have tested positive for the virus. With minimum 700 samples tested daily at NIV and around 200 to 250 at BJ Medical College, AFMC also takes on its fair share apart from other private players such as Suburban, SRL, Metropolis, Thyrocare and others.
While home-based sample collection has its own challenges, the lab is tied up with various hospitals and, according to Dr Golwilkar-Mehendale, they either help train hospital staff for swab collection or send their own teams to collect samples.
Even in the red zones and containment areas, teams have been sent to collect swabs on request of the Pune Municipal Corporation. At the lab, strict quality controls are maintained during the entire process in the molecular department, including unidirectional air flow in the PCR rooms that keeps it from mixing with general air-conditioning.
Dr Madhuwanti Abhyankar, head of microbiology and molecular departments at the lab, said close to 100 samples were tested daily but samples kept coming.
The doctor also said while they aimed at giving reports within 12 hours, at times it took 24 hours to ensure the entire cycle was complete. However, the advantage was that screening and confirmatory tests were done at the same time for each sample, the doctor added.
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