It is perhaps just as well that the Centre has decided to push for intensive testing as part of its post-lockdown strategy to contain the spread of coronavirus. There is a paucity of information on the extent of the spread, to overcome which testing is the best way out. The question now before the top health authorities is how to go about ramping testing facilities quickly, without compromising on reliability. There are two broad testing options available: the RT-PCR (or the reverse transcription polymerase chain reaction) method and the antibody-based rapid blood test. The Indian Council for Medical Research has said that the latter should be implemented at a community level, in hotspots and congested zones. This makes sense, as the anti-body test can be done with a simple, portable instrument, which gives a result in 15 minutes. This is meant to be followed by a confirmatory RT-PCR test, as it is believed that the antibody test, while being prompt, is not entirely foolproof. However, the RT-PCR tests are dependent on both the quality and quantity of laboratories. The RNA-based testing method can lead to the virus escaping if it is not properly contained, and the question is whether laboratories here have the facilities to deal with it responsibly, without endangering the health of their staff or the public. The ICMR has said that at present a network of about 200 laboratories (136 run by the government and 59 by ‘accredited’ private entities) are doing the RT-PCR tests — at latest count, about 11,000 a day. A jump in referrals is expected, and community testing will have to play a role amidst the infrastructure constraint.

The crux of the problem is that rapid antibody testing has not picked up at all. This is not least because the Drug Controller General of India (DCGI) seems to be dragging its feet on issuing a licence to even the seven firms whose technologies have been validated by the National Institute of Virology. The DCGI has also issued a separate list of 28 companies stating that they will be issued license after NIV validation. The delay in issuing the final list of approved companies could hurt the testing outreach programme. It is perhaps time for the ‘national task force’ on the pandemic to bring all decision-makers (such as ICMR, NIV, DCGI) on to a single panel to thrash out matters expediently. Random sampling techniques need to be perfected, as suggested by statisticians and experts, to get a clear idea of the spread of Covid. This will enable optimal use of testing kits, which are likely to be scarce till supply bottlenecks persist.

Covid highlights the importance of ramping up indigenous capacity in testing equipment, pharma ingredients and protective gear. Investments in testing facilities, along with a plan to boost start-ups and public sector capacities, will stand us in good stead to deal with pandemics.

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