Gagandeep Kang, Director, of the Translational Health Research Institute, who has extensive experience in working on community health and played a key role in developing an indigenous rotavirus vaccine, says India should be testing many more persons for symptoms of COVID-19 than it is now.
Is India testing for community transmission as aggressively as it should?
No. As a first step, India has been tracing importations (cases with a travel history from abroad). We are now beginning to test for influenza-like illnesses through the influenza surveillance network.
COVID-19 | Interactive map of confirmed coronavirus cases in India
We are told that about 150-250 samples were tested in February by the Indian Council for Medical Research (ICMR) and in the coming week they are going to be doing moreof that testing. Singapore went about finding cases and tracking them. Finding contacts and tracing was the best step. South Korea expanded drive-through testing. After a while people started to present themselves for testing. It was made easy for people to get tested. We are in a situation now that if you land up at a private hospital with what absolutely fits the case definition, you will be referred to a government hospital. There are media reports that some in Tamil Nadu are being turned away even if they have symptoms and a travel history.
Is it that Indian authorities would like to do much more community testing, but cannot? Or is it part of a larger strategy to wait and gradually ramp up testing?
Newspaper reports suggest that the health ministry says it has done a risk assessment and the testing strategy in place follows from this assessment. Now what that assessment is, we don’t know. We don’t know, for instance, if there’s a plan that once we reach an ‘x’ number of positive cases there will be a different approach to testing. We are today at over a 100 cases. What we can do is be rational and test as many as we can. What is wrong with testing? Why would you not test? If a person know what’s causing their fever and cough, you can do something about it. You are now in a situation where people worry, they don’t know if they are positive. They wait till they get really severe. Then they eventually go to a public hospital and get tested. You are expanding your timeline and decreasing your chances of picking up cases early. In a best case scenario, all this testing is unnecessary and what you are doing now is perfect. But even then, what have you lost by doing additional testing? You’ve wasted some money on kits, you’ve wasted some people’s time but you’ve bought reassurance that the virus isn’t there. If it’s there, then you have to do something about it. You can do contact tracing and then recommend quarantining or isolation or whatever’s appropriate for that person.
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