Delhi will begin deploying rapid testing kits (RTKs) across the Capital’s 77 Covid-19 containment zones on Sunday with state health minister Satyendar Jain saying that the administration has received 42,000 antibody kits — a development that came after the Indian Council of Medical Research (ICMR) revised its guidelines to allow the diagnosis tool in hot spots.
Health care workers will carry out random tests in all containment zones – nine new areas were added to the list on Saturday – simultaneously, Jain said on Saturday. “We have received 42,000 rapid testing kits from the Centre. Today (Saturday), all our technicians are being trained on how to use the kits, the precautions to be taken and other nuances. From tomorrow (Sunday), rapid testing will begin in the containment zones,” the Delhi health minister said.
On Thursday, India received a batch of 550,000 RTKs from China after two deadlines for the shipment were missed. ICMR officials have said that RTKs are not meant for diagnosis but should ideally be used for surveillance purposes to establish trends.
It initially wanted to use the kits in parts of the country unaffected by Covid-19 or not significantly affected to asess the extent of the disease’s spread. The apex body for biomedical research, however, revised guidelines after states appealed that they be allowed to be use RTKs in hot spots so that containment efforts stepped up accordingly.
“I am writing to you with reference to the rapid antibody test kits for Covid-19 testing. It is understood that many states intend to use these kits in affected areas… The National Task Force at ICMR has carefully reviewed the data evolving from various countries on use of such kits. Based on available evidence, the testing strategy for Covid-19 has been revised…,” ICMR director general Dr Balram Bhargava said in a letter to all state chief secretaries and principal health secretaries.
ICMR recommended that since the gold standard front-line test for Covid-19 was real-time polymerase chain reaction (RT-PCR) test, which is aimed at early detection, the rapid antibody test could not be a substitute for it.
“The rapid antibody test is a supplementary tool to assess the prevalence of the diseases within a specific area or perimeter. The rapid antibody test will only be of utility after a minimum of seven days of onset of symptoms,” it said.
Unlike the RT-PCR, which detects the virus’s genetic material (RNA) in swabs to diagnose a current Covid-19 infection, rapid tests detect antibodies in the blood and indicate if a person has been infected in the past and has developed immunity to the virus. It can show results within 30 minutes. Once a person tests positive after the antibody test, an RT-PCR test is done to confirm the result.
Till 8pm on Saturday, five district magistrates in Delhi told HT that they received a communication from the state health department that RTKs would be provided to them. “But we have not been told how many kits we will get,” one of the DMs said on condition of anonymity. A senior health department official, who asked not to be named, said the number of kits allotted to every containment zone will be directly proportional to the Covid-19 cases detected in the area.
The nine new containment areas named on Saturday were: North-east A-97,98 and 99 near Buland Masjid; Shastri Park; A Block, Khizrabad, New Friends Colony; Israel Camp, Rang Puri Pahari; Budh Nagar, Inderpuri; Oberoi Apartment; G-1 2nd Floor Mansarovar Garden; E-51 and E-21 street 8, Shastri Park and T-606 street-18 Gautam Puri.
Rajasthan has received 10,000 RTKs so far, and on Saturday it tested 5,000 people in Jaipur’s walled city, from where the most number of cases have been reported in the state.
In Uttar Pradesh, the first tests from the kits in Meerut and Saharanpur came back negative, an official said, adding that 8,500 kits received will be used in each of the 17 worst-affected subdivisions. The Chhattisgarh government will procure high-quality kits from a South Korean company within 10 days, the state’s health minister TS Singh Deo said.
Chhattisgarh will be the second state after Andhra Pradesh to import kits from South Korea. Andhra Pradesh received 100,000 kits from South Korea on Friday and they were dispatched to districts on Saturday. “The rapid antibody tests will improve the efficiency of the testing significantly,” special chief secretary (health) KS Jawahar Reddy said at a review meeting.
A Punjab government official said the state received 10,100 RTKs from ICMR and these were being used for testing in 24 hot spots. Officials in Bihar, Uttarkahand and Himachal Pradesh said while they received the kits, the numbers were inadequate.
“The number of kits we have received (3,400) so far is too little against our demand,” said National Health Mission director in Himachal Pradesh, Nipun Jindal. Bihar has so far received 6,240 RTKs. Karnataka’s health and family welfare secretary Jawaid Akhter said the 11,400 kits given by the Centre were being checked for efficacy. Kerala received 25,000 kits, a senior official of the health department said, adding that the kits will be used in worst-hit Kasargod and Kannur districts. The Maharashtra government, however, said it did not receive the kits it demanded.
ICMR experts say data about these rapid tests is still emerging and the understanding of their utility for diagnosis, evolving. Currently, the rapid tests are mainly useful for epidemiological studies (to know the distribution, patterns and determinants of disease conditions), and surveillance purposes, to get real time data.
“Many states want to go in for aggressive testing in containment zones and want to make use of rapid testing in these areas as they have to test almost everyone with influenza-like illness in those areas. We have drafted the new protocol keeping in mind the requests of the states. However, rapid diagnostic test is ideally a surveillance tool,” an ICMR official said.
As per the new ICMR protocol, only those showing symptoms of influenza-like illnesses such as fever, cough and cold over the last seven days or more in hot spot areas should be tested. Those who are found positive in the test must be quarantined for at least seven days. Those who test negative should also remain under home quarantine for at least seven days if they are in hot spots.
