Testing times for covid warriorBengaluru: Karnataka has shifted its Covid-19 testing strategy by pushing for more rapid antigen tests, to cope with heightened pressure to ramp up testing as the state experiences a sharp rise in coronavirus infection.
ET has gathered that the state has now set a target of 35,000 antigen tests per day starting next week and has procured 200,000 kits to be distributed to 30 districts. The target for Bengaluru city is 11,500 antigen tests per day.
“In the task force meeting we have decided to procure an additional 400,000 antigen test kits in order to ramp up testing in containment zones,” the medical education minister’s office said.
In the last six days, the state has tested a total of 24,000 samples on antigen. Samples tested on RT-PCR on Thursday were 21,000. RT-PCR testing volume has remained constant for the last 10 days.
While the time-consuming RT-PCR is considered the gold standard in Covid testing, the rapid antigen tests are less sensitive and not so accurate. According to the Indian Council of Medical Research (ICMR), the sensitivity of antigen is 50.5% to 84%.
The ICMR in its advisory has said people who get positive results on the antigen test need not be retested using RT-PCR, but those who get negative results must be retested. The state health department, however, has tweaked the guidelines and said only symptomatic negative reports on antigen must be tested using RT-PCR. This, some say, could lead to many asymptomatic cases testing negative and they could possibly spread the infection to others.
State officials said scaling up antigen tests would serve many purposes. It will reduce the backlog of samples, minimise the time taken to test samples and ease the burden on government and private labs, many of which are testing more than their capacity.
“We are universally testing SARI (severe acute respiratory infection) and ILI (influenza-like illness) cases. So, if an antigen test is negative in a person with respiratory or influenza-like symptoms, then the sample will be tested again on RT-PCR. We will continue to test 60% of samples on RT-PCR and 40% on antigen,” said CN Manjunath, the in-charge of lab testing in the state.
Karnataka is using RT-PCR and antigen alongside CBNAAT and TrueNAT tests, but these two tests are done in relatively small numbers. The backlog of samples was 25,178 as on July 20. Data show that some testing labs were exceeding their capacity, while some had not geared up yet. For instance, the Nimhans lab has tested 125% of its capacity, and private labs like Narayana Netralaya, Xcyton Diagnostics, St John’s Medical College, KIMS and Cancyte Technologies are taking an extra load ranging from 248% to 186% of their capacity.
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Lack of enough man power in India is turning out to be an issue. Perhaps, this is due to non-involvement of various private diagnostics labs or perhaps many of the private labs don't want to offer their services to Covid testing.A covid warrior had to struggle for three days running from one fever clinic to another to get a covid test done. The fever clinics he visited were empty, and yet he was sent back due to the non-availability of doctors. The techie, who has been volunteering with the DIPR, is down with fever, muscle pain and severe headache since last Friday.
‘Rapid’ antigen test results come after 2 days
Akash’s father tested positive for Covid-19 on Monday when the entire family took rapid antigen tests at the Thindlu Public Health Centre (PHC) near Vidyaranyapura. Akash’s wife and daughter were asked to go home after they were informed that they will get the results within a few hours. The Bruhat Bengaluru Mahanagara Palike (BBMP) staff called the family only on Wednesday morning and said that Akash’s four-year-old daughter has tested positive and hence, the mother and the child will be taken to the Covid Care Centre (CCC).{Shouldn't testing positive on antigen means that they already have anti-bodies and currently are not carrying an active infection?}
We don't hear these issues in Western countries. USA was/is doing a lot more testing than we are and I wonder how long is the delay between sample submission & test result.Dr CN Manjunath, director of Sri Jayadeva Institute of Cardiovascular Sciences and Research and nodal officer for testing in Karnataka, said, “The antigen test is immediate or better than RT-PCR. What is happening is, the staff is collecting the data and then process and updating them and then, they are informing the patients, which is probably taking time. Maybe the communication process is slow and is taking time to reach people.
“Also, this is not about shortage in laboratories. These lab technicians get infected a lot of times and go into quarantine. So, there are a lot of internal logistical issues. However, they should speed up the communication process,” he added.
Dr Satyanarayana Mysore, HOD of Pulmonology at Manipal Hospital, said, “The process of swab collection is taking time. Secondly, these are bio-hazard samples and technicians need to be careful before they get infected. Also, we need a doctor (a micro-biologist) to sign the report. I guess the delay in timing is happening because of this. In some places, once the samples are collected, there are no porters available to take the samples to the laboratories. Overall, communication with patients and citizens need to be faster.”