With an aim to remove all impediments in testing, theUnion health secretary Preeti Sudan and director general of Indian Council of Medical Research (ICMR) Dr Balram Bhargava on July 1 appealed to the states to take immediate steps to facilitate and ramp up testing. The two key persons have reiterated that ‘test-track-treat’ is the key strategy for early detection and containment of the pandemic.Though the details of the appeal looks comprehensive and readily implementable, not all the guidelines given can be easily translated into feasible and practical solutions due to innumerable issues best known to the states.
However, it would be rewarding to re-run the details of the content in the appeal. This is important for the simple reason that the overall recommendation can serve as an ideal objective of each of the states including the Northeast region. Pointing out that in some states, the capacity utilization of the testing labs, particularly the ones in private sector, is grossly sub-optimal, states have been strongly advised to take all possible steps to ensure full capacity utilization of all COVID-19 testing laboratories in the state.States have been advised to facilitate testing at the earliest by enabling all qualified medical practitioners, including private practitioners, to prescribe COVID test to any individual fulfilling the criteria for testing as per ICMR guidelines.
Given the increasing inflow of returnees to the states in the Northeast region, one is not sure how fast can the Northeast states react to the advice. ICMR has strongly recommended that laboratories should be free to test any individual in accordance to the ICMR guidelines and state authorities must not restrict an individual from getting tested, as early testing will help in containing the virus and saving lives. While RT-PCR is the gold standard for diagnosis of COVlD-19, ICMR has recently approved the use of a point-of-care Rapid Antigen Test for early detection of COVID-19. The test is quick, simple, safe and can be used as a point-of-care test in containment zones as well as hospitals, as per criteria specified by ICMR for testing. While this piece of recommendation looks perfectly ideal, the tardy performance of the testing centres needs to be rectified and orient itself towards swift delivery.
More kits are being validated by ICMR to increase the available options to the citizens. ICMR has so far approved a total of 1,056 laboratories for COVID-19 testing. Of this, 764 labs are in the public sector and 292 are in the private sector. How far the number given here caters to the actual needs of the states with hundreds reportedly waiting for test results to be delivered? It has been reported that many of those stationed and lodged at the institutional quarantine centres were yet to receive their test results even after their quarantine periods were over. This is why there is a need to look at the pace of delivering the results even if samples were collected in a phased and prompt manner.
In order to facilitate testing, states have also been advised to make efforts in 'campaign mode' by setting up camps/using mobiles vans in high incidence areas to collect samples of all symptomatic individuals as well as their contacts, and get those samples tested by using rapid antigen tests. The positive individuals should be treated according to the treatment protocol and the negative ones should be tested for RT-PCR. Also,the rate for RT-PCR test by private labs should be finalized by the states.They have been further advised to make it mandatory for all labs to upload the testing data on the ICMR database as well as report to state/district/cityauthorities for surveillance and contact tracing.In addition to ramping up and facilitating testing, states have also been urged to pay attention to 'contact tracing' as it holds the key to containing the virus. States have also been asked to maintain strict vigil and continue to make all possible efforts for effective management of COVID-19.
