As each country debates own testing strategy to combat Covid-19, the Indian Council for Medical Research (ICMR) has decided to monitor community transmission by random sampling rather than expanding testing. This decision has been taken to avoid “futile testing” as well as hospitalisation for mildly symptomatic, positive patients, ICMR scientist Nivedita Gupta said, adding that the random surveillance strategy was used in China as well.
“This has been sufficiently debated. Till date we have not documented community transmission. Why should we go on testing people who have no history of travel or any contact with an actual case?” Gupta said. “In this process, in a huge country like India, I’m not able to test people who genuinely may need testing because I’m wasting it on futile testing. Though we are maintaining a stringent inventory, we also need to make sure that we are not in a situation where I exhaust all my capacity in futile testing and, tomorrow, if there is an upsurge in cases, I say that I have exhausted all my (testing kits)… For the whole country, I cannot put in place (maximum) aggressive measures, because I have to be rational in a country like India.”
India has conducted roughly 6,000 tests so far, lower than the US (8,000), Japan (9,600), France (12,000), the UK (13,000), and Italy (23,000). South Korea has conducted as many as 2 lakh, which experts see as the reason for their significantly declining numbers.
The government currently has 1.5 lakh testing kits, with a capacity of roughly 6,000 tests per day, and has ordered 1 million more. Gupta said the ICMR is also in discussion with private facilities to provide testing, and this could be in place in a week.
NITI Aayog member V K Paul said the government is set to examine commercial testing kits for their “accuracy and validity” as well, in a bid to ensure that a sufficient number of such kits is available. India is currently using kits developed by the National Institute of Virology in Pune. Asked if India had sufficient kits, Paul said, “For the present, they are sufficient. We are obtaining more… we will see if these (commercial kits) are accurate according to our needs… We are also examining the relevant cost of these kits,” Paul told The Indian Express.
Testing kits for coronavirus are manufactured mainly by American healthcare company Roche and some Chinese firms.
The Health Ministry maintains that the country is at stage 2, “local transmission at the community level”, or virus among those connected to someone with a travel history. “Community transmission” means any transmission that cannot be sourced back to an imported case from a traveller, and is feared to be the next level of Covid-19 spread.
The ICMR will begin receiving results from the second surveillance period — March 1 to 15 — Tuesday. If they detect any positive cases, in those localised areas, potentially everyone would be tested. Gupta said they hold a review every five days, and are prepared to find some amount of community transmission in certain places.
Explained: When to test and whom
The ICMR’s Integrated Disease Surveillance Programme labs currently randomly test 10 samples every week of patients with severe acute respiratory illness pneumonia as well as influenza-like illnesses.
Gupta also pointed that with the incubation period between the infection and appearance of symptoms roughly two to 14 days, a negative test could end up giving a “false sense of security”. And, if that person would want to be tested again, it would be a waste.
Explained: Coronavirus testing in India, elsewhere
A government source said that if commercial kits are approved by the ICMR, the testing process could be opened up to the private sector since “anyone can procure the kits then”.
Paul also said that apart from examining the option of commercial kits, the government has placed an order to import from Germany a key component used in coronavirus testing, which would reach in the next couple of days. “The ICMR has placed an order for a million of those,” Paul said.
Asked about private labs being allowed to test for coronavirus, he said mass, open access to tests is “unnecessary” and may interfere with contact tracing. “Our strategy is for Stage 2. Our priority is to contain and trace contacts,” he said.
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