Coronavirus update: With 400,000 kits, Tamil Nadu to ramp up Covid-19 testing

Updated on Apr 11, 2020 02:05 PM IST

India has been using the RT-PCR, or reverse transcriptase polymerase chain reaction, test on nasal or throat swab samples of suspected patients to test for Covid-19. These tests can take between 12-24 hours to show results.

B J Government Medical College's Molecular lab prepares for coronavirus testing at Sassoon hospital in Pune on March 19, 2020.(Pratham Gokhale/HT Photo)
B J Government Medical College's Molecular lab prepares for coronavirus testing at Sassoon hospital in Pune on March 19, 2020.(Pratham Gokhale/HT Photo)
Hindustan Times, Chennai | BySowmiya Ashok

Tamil Nadu has tested 8410 samples for Covid-19 as of Friday, of which over 10% of cases have tested positive. While nearly half or 4167 of those tested are people who attended the Tablighi Jamaat conference in New Delhi in March, which was seen as priority testing by the state, the government is now looking to expand testing across the state.

The first step towards large-scale testing was to procure 400,000 rapid test kits. An official at the Tamil Nadu Medical Services Corporation (TNMSC) told Hindustan Times that the state has also procured 100,000 more real-time PCR kits.

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India has been using the RT-PCR, or reverse transcriptase polymerase chain reaction, test on nasal or throat swab samples of suspected patients to test for Covid-19. These tests can take between 12-24 hours to show results. In comparison, the rapid antibody tests identify disease-fighting antibodies in blood samples and can deliver results in 45 minutes to two hours. According to an ICMR advisory, rapid testing kits (for antibody tests or blood tests) need to be deployed in areas where mass testing is required, such as evacuation camps, large cluster areas, and camps for migrant workers.

“Our priority is to stop the spread of any new cases outside containment zones or quarantined areas. That is the main objective,” chief secretary K. Shanmugam told reporters on Friday. “TNMSC has started preparatory work from January. Whether it is PPE kits, triple masks, or ventilators, we have been procuring them directly. The order for testing kits were also made directly (with suppliers) apart from the ones we will receive from the Central government,” he said,

Chief minister E. Palaniswami had said last week, “Once the test kits arrive, we will be testing the family members of those who are already tested positive for COVID-19. After that, tests will be performed on those who have come in contact with these people. Then people living in the areas around the spot will be subjected to testing. That is why we have procured 4 lakh rapid test kits.”

While Palaniswami had said the pandemic is at Stage 2 or local transmission and that it has chances of moving on to the next stage, the chief secretary told reporters on Friday that not one case of severe acute respiratory infection (SARI) tested over the last 24 hours showed a positive result. “There are only 23 cases overall in the state for which there is difficulty in determining with certainty how the person became infected,” he said. “At this stage we are not at Stage 3 (community transmission).”

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“We are going to increase testing centres to all government medical colleges. We are also encouraging private labs with accreditation to apply to be testing facilities,” director of public health K. Kolandaisamy told HT. “Now the infection is clustered in containment zones, so we are only taking samples from there and apart from testing SARI cases,” he said.

Tamil Nadu has 220 containment zones. There are 19 testing facilities across the state – 12 government, 7 private -- at this stage.

Dr. Ram Gopalakrishnan, an infectious disease specialist at Apollo Hospital who is a committee of healthcare and medical experts that consults with the government, told HT that there was a need to test more people with existing PCR tests and conduct serology tests on a widespread basis as soon as kits are available.

“There is no question that there is community transmission within hotspots. While it is probably also true that there is little or no community transmission in areas outside these hotspots, we don’t know unless we test more on a systematic basis,” he said. “The government criteria was quite restrictive till a couple of weeks back, now they have liberalised testing. They have also introduced serological tests which will certainly help make the diagnosis much easier. The government has its own constraints, there is a shortage of kits. Their concern is if we just open up testing all kinds of wrong testing will be done, kits will get exhausted and people who truly need tests will not have them.”

Also read: How false negative results are complicating Covid-19 testing

The lockdown was a game changer as it halted the spread of the coronavirus, but widespread testing, aggressive contact tracing and isolation was the only way to fight the pandemic effectively, Gopalakrishnan said. “If this gets into hospitals, we are finished, healthcare workers will be the first to be wiped out,” he said. “This will always be a low-grade chronic illness and that is the best case scenario. If you have this as a low-grade sporadic illness like H1N1 influenza has become then the hospital systems can handle it.”

Neuberg Diagnostics in Royapettah in Chennai is amongst the private laboratories approved to test for Covid-19. “We were one of the first ones in Tamil Nadu to get approval. Currently we are carrying out the RT-PCR tests as antibody tests are not approved for private labs in India,” its chief operating officer Aishwarya Vasudevan said. “Over the weeks, the guidelines have been constantly changing depending on the changing nature of the virus. Currently with the support the state government, we are encouraging walk-ins as well as samples from hospitals.”

Also read: Covid-19 cases near 2,000 in Maharashtra; cross 900 in Delhi, Tamil Nadu

Neuberg Diagnostics has done close to 1000 tests so far. Vasudevan said that there was scope for widespread testing in India. The country has one of the largest number of RT-PCR machines but only 56 private labs are approved to test, so far.

“Of course there is scope for ramping up testing. The government will have to help link it to the private sector,” she said. “But the routine sample testing business (outside of Covid-19 tests) has come down by 80-90% and we still have about 60% of fixed costs to run our operations,” she said. The lab has been testing samples of patients with Below Poverty Line cards for free.

The expert committee on Friday recommended extending the lockdown in the state by another fortnight to the end of April. After a meeting with the committee Palaniswami said that the final decision on whether the lockdown will be extended or not would be made after cabinet consultations on Saturday.

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