Fewer samples have been tested for coronavirus disease (Covid-19) in Delhi over the past few days with the number falling from an average of about 7,000 samples at the end of May to around 5,000 samples on June 10.
The biggest hurdle, according to laboratories, is the cumbersome RT-PCR mobile app, which has made the process of entering test data tedious; but not entering the data isn’t an option. The state government barred some labs from testing because they were not using the app.
“Every single detail is documented and sent to the authorities concerned, however, it may not be in the format that the government wants because of logistical issues. If you want to punish well-meaning people for that then there is nothing we can do about it,” said an administrator in a Delhi hospital that treats Covid-19 patients. This person asked not to be identified.
The app, which shares its name with the reverse transcription, polymerase chain reaction test which is the gold standard for identifying Covid-19 cases, was launched by the centre on April 30, to remove any discrepancies in sharing of Covid-related data by approved laboratories.
The app is meant to be used by labs across India.
{{/usCountry}}The app is meant to be used by labs across India.
{{/usCountry}}Data is to be filled at the point and time of sample collection and that poses a problem.
The head of a Delhi laboratory that does Covid tests rattled off the issues on condition of anonymity: poor connectivity; the fact that phlebotomists (who collect data) walk, wearing PPEs (personal protective kits) and all to collect samples because it is sometimes difficult to find parking; that they do not want to stay in the infection zone for a minute longer than required but feeding data through the app takes about 10 minutes extra.
“The attrition rate of phlebotomists has gone up. It’s difficult to find new ones,” this person added.
It’s not as if it is easier to do this with inpatients in hospitals, said the head of a laboratory at a private hospital who asked not to be named. “Imagine a nurse going inside the ICU with a mobile phone to feed in patient data at the time of sample of collection. You cannot do it later because you get a one-time password in the patient’s phone that you have to quickly feed in. These practical problems nobody seems to think about.”
Before the introduction of mobile-based application, labs were feeding patient data into web portals created by the Indian Council of Medical Research (ICMR) and respective state governments.
The head of another Delhi laboratory who too spoke on condition of anonymity said “mobile phones can be potential carriers of disease-causing microorganisms.”
“I don’t carry my phone while stepping out these days because there is enough evidence to show how mobile phones can be carriers of disease-causing microbes including viruses. The phone surface can be contaminated and can act as a source of infection,” says Dr Shobha Broor, former head of microbiology department, All India Institute of Medical Sciences, Delhi.
The cumbersome data entry process and the paperwork involved means laboratories get to test fewer patients, said the head of a third Delhi laboratory who asked not to be named.
“It takes about 10-12 hours from the point of sample collection to a report getting ready, and most of the time is spent in paperwork, which makes for a huge volume of work in a day. It’s but natural then that it will affect the number of tests being done in a day leading to fewer tests being done.”
Some laboratories have hired data entry operators specifically for doing Covid-19 related paperwork. “I have hired some 100 operators for the purpose to handle the huge work load that technicians are not trained to do,” a lab owner added.