Rapid testing may begin on Thursday for those in high-risk areas
India is likely to start rapid antibody testing on Thursday, with people in high-risk areas (containment zones), “large migration gatherings” and evacuation centres expected to be the first to get undergo this simple blood test that checks the presence of antibodies created by the body to fight the Sars-Cov-2 virus.
The country’s apex biomedical research organisation, ICMR, on Saturday released an advisory on how and where rapid test kits can be used.
At the same time, the number of conventional RT-PCR tests being done have increased, with the total test utilisation capacity going up from 10% to about 50% in the past two weeks, according to government documents.
The National Task Force constituted to review the testing guidelines did not ease its parameters, and did not open antibody tests to the private sector, despite recommendations from a high-level technical experts committee that wanted these tests to be available to “everyone at risk”, including those outside hot spot areas.
“We are expecting the kits to arrive by Wednesday, and after that the Union health ministry will take a call on where all to deploy these kits in the field,” said Dr Raman R Gangakhedkar, head, epidemiology and communicable diseases division, Indian Council of Medical Research.
“The government’s primary focus has been places from where large number of cases is being reported, large gatherings and evacuation centres. Another focus area for which our experts recommended rapid testing is for patients suffering from influenza like illness (ILI) with an objective to be used as a more effective monitoring tool in these areas,” said Luv Agarwal, joint secretary, Union ministry of health, during Sunday’s media briefing.
“These will be our criteria for distributing the kits once we get the supply,” he added.
According to home ministry data, there are about 28,000 relief camps set up across the country that houses close to 1.25 million migrant workers. The government is also planning more evacuation fights from UK and other places to bring back stranded Indians.
“This is the category of people that falls under those who need rapid testing. At this stage this group is our primary concern and extended it for all is not on the cards. There is a task force that is constantly evaluating the situation, and will take a call as and when required ,” said a senior health ministry official.
There are also about 20 existing and 22 potential hot stops that state governments are currently tracking.
Unlike the reverse transcription-polymerase chain reaction (RT-PCR) test that detects the virus’s genetic material (RNA) in throat and nasal swabs to diagnose a current Covid-19 infection, rapid antibody tests indicate if a person has been infected in the past and has developed immunity to the virus.
Experts say they can also be used as a screening test for the infection -- antibodies typically show up a week after the infection.
The simple blood test (samples can be collected by just a finger prick) which takes 15-20 minutes to give results, identifies people who were infected at least a week before the test, and also those who were infected but never diagnosed, helping map undetected infections and giving the correct extent of the spread of the disease.
Some states such as Kerala are procuring the antibody kits on their own for surveillance purposes.
“We are expecting delivery of Rapid Test kits (blood based) for use in response to Covid-19 situation. ln this regard, National Task Force deliberated with experts for ascertaining use of these rapid test kits. Draft of the suggested algorithm was also discussed in detail with technical experts from the ministry and inputs were included in the final version which is feasible for implementation in the field conditions...,” wrote secretary Department of Health Research, Dr Balram Bhargava to health secretary Preeti Sudan.
In his letter, Dr Bhargava also spoke about how the overall testing for Covid-19 using real-time RT PCR was increasing (up to 50% capacity as against 10% when), and that close to 130 government laboratories would approach their full capacity soon.
ICMR has been evaluating the rapid test kits, and has already validated seven testing kits, and also put up a list of kits that have CE-IVD (European Union) approval that can be used
“India has taken a decision to use antibody tests which could be a game-changer. The currently used test (PCR) tells us who are currently sick. We are seeing only the tip of the iceberg. These antibody 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. It’s a great tool for surveillance, and building up epidemiological data,” said Lalit Kant, senior infectious disease expert.
Dr Sanjeev Khosla, director, Council of Scientific and Industrial Research- Institute of Microbial Technology, which is one of the government labs identified for Covid-19 testing, said: “ ICMR’s initiative to involve all government-accredited labs is a welcome step… would increase the testing rate among suspected patients. In the initial phase the institute plans to prepare to carry out 50 to 100 samples daily, and the capacity can be ramped up subsequently.”