Testing enough? With a billion plus populace, failing to ramp up testing will make Covid-19 unmanageable soon

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Indian Council of Medical Research’s warning that India has 30 days to halt the onset of Stage-III or community transmission of the novel coronavirus must kick off wider testing. ICMR has said that disease transmission is now limited to those with travel history to affected countries and those in contact with them. This is not as reassuring as it sounds. For every traveller reaching India and subsequently seeking medical help, there are too many loose ends in their whereabouts for public health authorities to tie up. Moreover, screening efforts at airports miss out many asymptomatic travellers.
This is where wider testing and greater access to testing facilities can nip community transmission in the bud. The 60-odd labs notified by ICMR for testing swabs – and a similar number of sample collection centres – can conduct nearly 5,000 tests daily. But these get just 60-70 samples per day according to ICMR officials. Large, populous states like UP, Bihar and Rajasthan having just 2-3 sample collection centres is woefully inadequate. Government claims it has 1 lakh test kits and made orders for 2 lakh more. However, until March 13 India had performed just 6,500 tests on 5,900 individuals, mostly in 2-3 states, much too few for a 1.4 billion population. Equally important is that test results must return quickly in a matter of minutes or a few hours, not 1-2 days as presently experienced in many places.
South Korea’s success in shrinking fresh cases without resorting to lockdowns was achieved by conducting a whopping 10,000 tests a day. China’s makeshift fever clinics, though initially panned for allowing potential carriers to congregate, prevented overcrowding inside hospitals and offered quick testing facilities. Quick turnaround times ensured patients couldn’t slip away, a problem India faces presently.
News reports and social media accounts in recent days raise doubts about preparedness. Hospitals without adequate doctors and protective gear have been reported in and around the national capital itself. Functioning of state helplines and their capability to address heavy patient load needs scrutiny. Doctors must be able to send more patients for testing and frequently get themselves tested. Roping in the private sector – for setting up fever clinics, manufacturing test kits and handling diagnostic logistics – will improve access. With nearly a million registered doctors and over two million registered nurses and ASHA workers, execution of plans must proceed on a war footing. India shouldn’t become the next big country to be caught napping.
This piece appeared as an editorial opinion in the print edition of The Times of India.

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