Six private laboratories in India were given the go-ahead to begin testing for the coronavirus by the Union government on Sunday. TNM spoke to A Velumani, Promoter, MD, CEO and Chairman of Thyrocare, a private laboratory chain headquartered in Mumbai that has been authorised to carry out testing.
Testing at the laboratory begins on Monday. “Thyrocare has the capacity to do 300 tests per day. This can be amplified to 3,000 per day in ten days’ period,” says Velumani. However, testing for SARS-CoV-2, the virus that is responsible for the pandemic, isn’t like any other laboratory test where a patient can walk in and get tested. “Only a patient referred by a doctor based on clinical diagnosis can be tested. This is to avoid rush,” says the Chairman of Thyrocare.
As per the Indian Council of Medical Research’s (ICMR) latest guidelines, a suspected patient can be tested only if they present with symptoms of the virus -- fever, cough, breathing difficulty -- and have travel history and contact history. Those who are asymptomatic and have direct or high-risk contact with a confirmed coronavirus patient can also be tested. Anyone hospitalised with severe acute respiratory illness should also be tested, as also health care workers who are symptomatic, state the guidelines.
Given that the virus is highly contagious, Velumani notes that there are biosafety and biosecurity precautions that need to be taken while collecting the sample. Thyrocare, he says, can pick up samples from 5,000 hospitals spread across the country. “The hospital can call our call-centres. We can lift samples from the door of the hospital. And within five hours of testing, we can release the report,” says the Chairman.
As far as costs go, the Health Ministry has capped the price of testing at Rs 4,500. Velumani explains, “In terms of an ordinary blood test, collecting a specimen is only 10% of the total value. But for COVID-19, the testing part and the specimen collection is 50% each.” Thyrocare prices their test at Rs 2,500, allowing hospitals to charge Rs 2,000 for collecting the samples.
Lockdown, logistics and importing kits
But there are huge challenges in terms of execution, says Velumani, “Technicians need to be covered from head to toe in personal protective equipment (PPE). Everything needs to be discarded once used. PPEs are in short supply as people are hoarding.”
Perhaps the biggest challenge for private laboratories is the lockdown. “In normal circumstances you can scale up (testing). Locking down is scaling down,” he says, pointing to the limited flights making it challenging to receive samples from hospitals across India.
And although laboratories constitute an essential service, Velumani explains that they face a number of blocks. “Don’t stop goods from traveling,” he appeals to the government.
The supply of testing kits poses another huge challenge for private laboratories. The guidelines issued by the Union Health Ministry state that diagnostic kits need to be US FDA (Food and Drug Administration) or European CE certified. “That limits the number of players and creates a monopoly. This increases costs,” he says.
Thyrocare is getting its testing kits from Altona, a German brand. “But these are in short supply,” says Velumani. All international flights have been barred from landing in India for a week beginning March 22 as a measure to contain the coronavirus. “The government has to look into helping international cargo to land. The country that exports the kits also needs to allow airports to function and flights should be available to remove all uncertainties.”
The Thyrocare Chairman points out that while there are local solutions available as far as testing kits go, these are not approved by the government. “The Ministry has to review that. If the local players can release kits, then it is fine.” He concludes, "Since the disease has a lot of implications -- psychological, financial etc, it is not right to allow everyone to test for COVID-19.”