Tamil Nadu testing kits procurement process faces further hurdles

The state awaits 400,000 RTKs or antibody tests from China in order to scale up testing across the state, as 34 districts have been affected by the virus.

Even as the number of confirmed Covid-19 cases crosses the 1000-mark in Tamil Nadu — the total number of cases currently stands at 1173 — and chief minister E Palaniswami on Monday announced that the lockdown in the state will continue till April 30, the delay in procurement of rapid testing kits (RTKs) continues to play spoiler in the state’s efforts to flatten the curve in the spread of coronavirus.

Doctors wearing protective suits preparing their kit before they start collecting swab from people, who are under home quarantine, to test for COVID-19 in Ahmedabad on Tuesday. (ANI)

The state awaits 400,000 RTKs or antibody tests from China in order to scale up testing across the state, as 34 districts have been affected by the virus. RTKs return results on the presence of antibodies in the blood within hours as compared to the RT-PCR (Reverse transcriptase polymerase chain reaction) tests that are currently being used and which take up to a day to provide results of nasal and throat swabs.

Click here for the complete coverage of the Covid-19 pandemic

“The consignment which was to come to India is not for Tamil Nadu alone. Unconfirmed reports from the vendor’s side suggest seven lakh kits were supposed to be shipped out, of which five lakh was for the government of India, one lakh for Tamil Nadu and another one lakh for other states. Unfortunately, due to some issues, these never made it out of China,” a state official in the know of the matter and who did not wish to be named, said.

Tamil Nadu health secretary Beela Rajesh on Monday said that kits are expected to reach the state within two days, but Tamil Nadu has already expanded its testing pool using existing RT-PCR tests. “We have ordered rapid test kits that will serve as a screening and surveillance tool. We have already ordered four lakh kits, and they will reach us in a day or two. But we are not waiting for that [to scale up screening]. The confirmatory test is our PCR test and that is now deployed as part of a large-scale massive testing. We are testing Influenza-Like Illness cases, SARI cases, those in containment zones who are high risk and low risk. Everyone is being tested using a confirmatory test,” she said.

On Saturday, Tamil Nadu chief secretary K Shanmugam told reporters that China had diverted kits meant for India to the United States of America.

“Perhaps you can make a few thousand kits here and there, but we cannot match the volume of our requirement. We will need at least 10-15,000 kits per day. If we have to screen Thoothukudi town alone, we will need at least 5000 kits immediately,” the official quoted above said.

Thiruvananthapuram-based HLL Lifecare Limited, which is expected to start making antibody test kits from its Manesar, Haryana plant this week, has received an order of 200,000 kits from the Centre.

Doctors and infectious disease specialists that HT spoke to agreed that the current scale of testing was nowhere near what is needed to flatten the curve.

“We need at least 50-60 million tests if we are looking at mass screening across the state which is nowhere near what we have,” one expert who did not wish to be named said. While acknowledging the lockdown has had an effect on flattening the curve, experts said that the challenge is the spurt in cases that will come in after the lockdown lifts.

Ram Gopalakrishnan, an infectious diseases specialist at Apollo Hospital, said that RTKs were useful epidemiological tools as they helped detect the prevalence of disease, “especially when looking for a disease in an area in which no disease has been reported, it is very useful.” However, social distancing remained the primary way to flatten the curve, he said.

“These two things (lockdown and testing with contact tracing) the government is doing, and it just needs to be done more efficiently and for longer to flatten the curve. There is no new technology or tests or strategy, just focusing on doing what was already recommended, much more efficiently that is all that is needed.”

V. Ramasubramanian, consultant infectious diseases at Apollo Hospitals said: “Even if we don’t do tests, the emergency ward will start to see people coming in sick which we haven’t started seeing yet, and that is reassuring. This is because it looks like we have flattened the curve but how long is the curve going to last like this?”