Increase the test, now | HT Editorial – Editorials
India’s hesitation in adopting massive tests for the coronavirus (Covid-19) even when it spreads is endangering the lives of millions of people who may be infected but don’t know it. So far, India has limited evidence for those with a travel history from affected countries, their contacts, and symptomatic health workers dealing with Covid-19 patients. The government has argued that it is not possible to evaluate everyone. It has plans to expand diagnostic laboratories that test Covid-19 from 63 to 121, and is implementing mechanisms to allow 51 private laboratories to test. Officials have suggested that if India begins evaluating people with symptoms, the system will not have sufficient capacity to evaluate once community transmission begins.
However, the government must reconsider its approach. A new analysis of data from China shows that for every confirmed case, there are another five to 10 people in the community with undetected disease. Many people with mild or symptom-free symptoms remain undiagnosed but infect others. In China, this led to almost 80% of new cases. Community randomized testing of 1,100 patients in intensive care units, as India is doing, is too small a sample for a population of 1.37 billion. The first 500 random cases have been negative, but this should not make the government happy. To address the capacity problem, there is only one way out: to involve the private sector substantially. The government is considering the option now, but it should move quickly. India has purchased a million diagnostic kits, but the overburdened government sector doesn’t even have the human resources to scale up to a few thousand tests. Even when just over 10% of its diagnostic capacity of 6,000 tests per day is used in the laboratories of the Indian Council of Medical Research, diagnostic reports for tests take several days to generate.
Rapid mass testing in South Korea has reduced new infections and death rates to less than 1%, compared to the world average of about 4%. Makeshift fever clinics in China, which offer rapid tests, reduced new cases on Monday to 21, compared with 62 in the United States and 344 in Italy, where the epidemic was out of control due to delayed diagnosis. The World Health Organization has urged countries to evaluate each suspected case. India must redefine its outdated test parameters to allow for walk-in testing. It has allowed two laboratories to perform rapid tests, but this is not enough. This is the biggest health emergency in living memory. As long as there are quality measures and infection control, it should not matter if the tests are done in public or private hospitals, as it saves lives. .