India’s department of health research on Tuesday “appealed” to private laboratories to offer tests for the novel coronavirus “at no cost” to patients, surprising some labs that pointed out that the government hasn’t validated commercial tests yet and free tests are impractical.
The Indian Council of Medical Research said high-quality private labs could adopt commercial tests validated by the ICMR and use them under the ICMR’s prescribed testing criteria and protocols, increasing access to tests. It has also asked labs to make arrangements for home pickup of suspects’ samples.
While the proposal appears designed to expand public access to tests at a time India’s count of coronavirus patients is expected to burgeon, medical diagnostics specialists said the appeal and the conditions set by the ICMR would restrict testing to government labs.
The count rose on Tuesday to 138 patients, including 14 patients who have been discharged and three patients who died. After two deaths last week in Karnataka and Delhi, the health ministry documented on Tuesday a third death in Mumbai.
The Union health ministry issued a circular on Tuesday stating that travel of passengers from Afghanistan, the Philippines and Malaysia to India is prohibited with immediate effect.
“No flight shall take off from these countries to India after 1500 hours Indian Standard Time (IST). The airline shall enforce this at the port of initial departure,” it said. “This instruction is a temporary measure and shall be in force till 31st March 2020 and will be reviewed subsequently.”
Later, PTI quoted external affairs minister S. Jaishankar as saying the government has approved AirAsia flights for Delhi and Vizag to bring back Indians stranded at Kuala Lumpur airport. Over 200 Indians are stuck at Kuala Lumpur, media reports said.
The ICMR on Tuesday iterated its earlier testing criteria that only patients with a recent history of international travel and symptoms of cough, fever or shortness of breath would be eligible for testing.
The health ministry said it would be mandatory for private hospitals and medical practitioners to alert local district authorities about any coronavirus patients.
It said hospitals and medical practitioners would need to ask patients with symptoms of cough, fever and shortness of breath whether they have had a recent foreign travel history, isolate such patients in hospital as suspects and send their samples for tests.
At present 72 labs — in government research centres or medical colleges — monitored by the ICMR are offering diagnosis for the coronavirus and an additional 49 labs under other government agencies will be operational within a week, ICMR officials said.
In these labs, the first screening test costs Rs 1,500 and the confirmatory test Rs 3,000.
The tests are free to patients as the government bears the entire cost.
The officials said the existing network could handle up to 1,400 samples a day. The engagement with the private labs is intended to increase access to tests, the ICMR said in a media release.
“The ICMR strongly appeals that private labs should offer the tests at no cost,” it said.
The ICMR has said it will provide private labs protocols for tests if they procure “primers, probes and reagents” for the coronavirus test. But senior diagnostics lab experts point out that private labs are not equipped to make their own primers and probes the way the ICMR’s research labs do, and instead, will need to rely on commercial tests.
“Labs like ours can offer commercial tests. We need to procure primers, probes and kits from diagnostic makers abroad,” said Navin Dang, a senior microbiologist and head of an accredited private diagnostic facility in New Delhi. But the ICMR has not validated any such test yet.
An ICMR official said the National Institute of Virology, Pune, was assessing commercial tests offered by companies from Europe, the US and South Africa, but the process is not complete yet.
“While the current primer-and-probe tests take about six hours, some of the commercial tests claim they can yield test results within 30 minutes,” he said.
Dang, among other private lab proprietors, also pointed out that it would be impractical for private labs to offer coronavirus diagnosis free of cost. “Thousands of patients would queue up — even those with minor infections, and no private lab could afford this.”
A senior health ministry official on Tuesday declined to say whether the government would subsidise or pay for tests in private labs. “It is an appeal the ICMR has made,” Lav Agarwal, joint secretary in the ministry, said.
More social distancing
The Centre’s department of personnel and training on Tuesday announced additional social distancing measures, including discouragement of visitors to offices, avoidance of non-essential office travel, and officials who develop symptoms have been advised to stay home. Older employees have been asked to take extra precautions, such as not exposing themselves to direct contact with the public.
