Deepak Sahni, CEO & Founder, Healthians emphasises on the importance of scaling up testing for COVID-19 across the nation along with procurement of testing kits as there is a shortage of testing kits, which would help India in the long run in curbing COVID-19
The lockdown in India to curb the spread of Coronavirus began from the midnight of March 24. With 1.3 billion people advised by the government to practice social distancing and to isolate themselves inside their homes, cases were sprouting up at random, but there was no sharp rise. Originally the nation-wide lockdown was proposed for a period of 21 days but following the rise in the number of COVID-19 cases, it has been extended, with the high possibility of a further extension. While health experts agree that the lockdown has been helpful in slowing down the spread of the pandemic, the peak is yet to come and there is an urgent requirement of healthcare facilities to tackle the deadly situation. India now stands at +1,38,845 COVID-19 positive cases with about 4,021 deaths and the numbers are rising fast.
Coronavirus has a high asymptomatic rate of 60 per cent, meaning 60 per cent of the people who have been infected will not show any symptoms and thus are not aware of the fact that they are carrying the deadly virus. They are more likely to infect others even before they show any symptoms. The only way to detect if someone is carrying the virus is by testing, followed by quarantining the infected to restrict the virus from spreading to the non-infected. It is therefore paramount that frequent random testing of citizens who are not in 100 per cent isolation in last 21 days including healthcare workers and frontline workers like police officials and sanitation staff are conducted to contain the spread. So far, the symptomatic individuals are the only ones who are being tested followed by contacts traced, but when we take in the huge population of India into consideration, that is where the actual problem begins to appear.
Some countries in the world are conducting 44 tests per 1000 population, with the US and Canada doing about 22-24 tests per 1000 people. The current testing rate of India is 0.86 per 1000 people as reported by Our World in Data. For the world’s second most populated country, a testing rate that low could be dangerous. There is a dire need for aggressive testing should India wish to contain the pandemic on time. Greater the number of people screened, the greater the chances of winning the fight against COVID-19.
There are certain limitations which lies ahead when it comes to ramping up testing for coronavirus. The biggest is the availability of test kits for random testing in red and containment zones. There is a huge shortage of testing kits in India currently and procuring more kits should be the top priority for the government. Cost-effective plans to cover up random testing in states and districts will be helpful. The current testing provided by the government is free-of-cost and sharing the cost with states and individuals can go a long way. Voluntary self-testing provisions should also be allowed as percentage of total available kits in the state by making simple online application queue. They will be key in controlling the usage of already available test kits, bring down overall costs and result in mapping and data centralisation regarding the COVID-19 cases in the country.
While the problems of kits gets resolved, private laboratories who have NABL but lack the equipment for conducting RT-PCR tests should be encouraged and upgraded to set up fast-track testing facilities. India would need 1000-1500 laboratories at the very least to scale up the testing capacity to deal with the rising numbers. Publishing the test results and entire documentation is a complex process with lots of paperwork required by the ICMR. Digitisation and few relaxations will speed up the entire process and provide the necessary push to increase the number of tests being conducted in India.
The extensive lockdown has hampered India’s economy and the government has been asking corporations and organisations to restart regular operations, but with limited manpower. Testing the workers and professionals being called back to work is vital to ensure that the workplaces are safer. The organisations should be able to ask the employees coming from red and containment zones to stay at home and provide them with work-from-home facilities to maintain smooth operations.
With scaled up testing, the real number of positive cases will come to light. The average Indian is still learning about social distancing, good hygiene, and the importance of PPE. We are still a month behind global developments and not utilising all the testing capabilities in the country. Though testing of symptomatic individuals and testing in red and containment zones must be the first order of things, we must start large scale community testing. If we accomplish that, we will be successful in identifying the undocumented cases and contain the spread of the pandemic in a much better way.