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Coronavirus in India: Several targets missed, still no sign of rapid testing ki…

CATS ambulance staff in PPE suits and doctors of LNJP Hospital during an altercation outside the special coronavirus screening center, on day eighteen of the 21 day lockdown to limit the coronavieus, at LNJP Hospital in New Delhi on Saturday. (Sonu Mehta/HT PHOTO)

The rapid testing kits, which India was expecting to be delivered on April 5, and then April 8 or 9, will not be here at least until early next week, delaying the country’s efforts to use these to test widely in containment zones that have seen a lot of coronavirus disease (Covid-19) cases .

India ordered 500,000 kits from Chinese suppliers on March 30. Several states are waiting for these kits to arrive, and be distributed to them, so that they can start testing. The states have also been allowed to procure kits on their own — it wasn’t immediately clear which have, and how many at that. Separately, the state-owned HLL Lifecare is set to start production of 20,000 rapid testing kits a day at its Manesar factory on Monday, Hindustan Times reported on Saturday.

In anticipation of the arrival of the kits, India issued an advisory on starting rapid antibody testing on April 4, and revised the testing guidelines on April 9 to include rapid testing of all symptomatic individuals in hotspot areas with symptoms at least a week old.

After the April 5 date passed without delivery, the Indian Council Of Medical Research (ICMR) announced in a press briefing that the manufacturers had assured it that the kits would be delivered either by April 8 or 9. That deadline too passed.

“The kits haven’t reached yet but could reach anytime now,” said Lav Agarwal, joint secretary, health ministry, in a briefing on Friday, April 10.

Unlike the RT-PCR test that detects the virus’s genetic material (RNA) in throat swabs to diagnose a current Covid-19 infection, rapid antibody tests indicate both current and older infections by highlighting the presence of antibodies in blood. The result takes 15-20 minutes.

ICMR first issued a notice seeking applications for delivery of one million rapid testing kits on March 27, but a day later revised it down by half because of the lack of availability.

On Saturday, Dr Raman R Gangakhedkar, head, epidemiology, and communicable diseases, ICMR, said, “The manufacturers assured us that we will get them in a day or two. As and when we get these kits, we will deploy these on field and start rapid testing.”

While the health ministry did not attribute any reason for the delay, people familiar with the matter said there is an acute shortage of rapid testing kits globally. The market is dominated by Chinese manufacturers that are producing these kits and they have been getting orders from all over the world.

“There are several problems — only 5-6 manufacturers have the requisite export license, and the local government has put a cap on the quantity that can be exported. And these handful of manufacturers are trying to fulfil the entire world’s demand,”added one of these people, who works in the testing business and spoke on condition of anonymity.

“What affects supplies is also too many agencies from within the country trying to place orders. It’s not just the Indian government, but also I guess state governments and other labs trying to place orders from a limited pool of suppliers which is delaying the delivery.”

Experts say rapid testing has to be done as soon as possible to find out the prevalence of the disease in India.

Dr Lalit Kant, a senior infectious disease expert, said: “The currently used test – PCR– tells us who are currently sick. We are seeing only the tip of the iceberg. The antibody detection blood test will identify people who already have been infected, even those with mild or no symptoms. It will also help us to know how many have been able to fight off the infection and have become what is called ‘corona-blocker’.”

“These tests are expected to be very economical, simple and give results within 15-20 minutes. It is being used for contact tracing in some countries. Indian health system has lot of experience in doing such tests, like the ones for dengue, chikungunya, so it will be easy to ramp up the screening. Great tool for surveillance, and building up epidemiological data,” he added.


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