Test, test, test

Govt must enable pvt participation in COVID preparedness

There is little doubt that the most important aspect of epidemic management at this point for India is ramping up testing swiftly. As of now, the number of positive cases of infection by novel coronavirus in India is not very large. But the problem is that this might well be an artefact of relatively limited testing. This is in spite of the fact that the government has repeatedly insisted that there is a fairly large buffer of test kits. If that is the case, testing should be ramped up. It is possible that one reason is that the autho­rities wish to preserve this buffer in case the community spread of novel coronavirus becomes undeniable and large — in other words, if individuals who ha­ve not travelled abroad or are not linked to a previously known case begin to de­velop symptoms of COVID-19. This is a misguided strategy. In fact, the best-use scenario, as observed in countries like South Korea, is massive testing early on.

For the mass-use of testing kits, they must be both cheaper and widely available. For this to happen, there is no doubt that the private sector will have to be involved. It is extremely unlikely that the state sector will be able to produce what is required purely on its own. Yet it has been reported that private companies that wish to become part of this production process of test kits are facing major hurdles in getting the required approvals. Surely this should not be an additional hurdle at this point in time? India’s usual and problematic approach to the ease of doing business cannot be permitted to hold up matters of such supreme national and humanitarian importance. It appears that several companies have run from pillar to post, seeking validation of their test kits, but only the National Institute of Virology, or NIV, is capable of providing the necessary validation — and the NIV appears to be overrun at the moment. The immediate task for the health authorities must be to designate alternative reputable sources for this necessary validation and get kits out to where they are needed. If necessary, the government must agree to purchase them in bulk at a fair price — or subsidise their purchase by private testing labs in such a way that anyone who wishes to be tested can be tested. The Indian Council of Medical Research had suggested free testing for novel coronavirus, but this will naturally lead to rationing or refusal by the private sector in the absence of government subsidies.

This delay should be a salutary lesson and one not repeated in other aspects of pandemic preparation. India has some time to ramp up its abysmally low critical care bed numbers — there are only 2.3 critical care beds per 100,000 in India, well below the rest of the world. Naturally, both these and quarantine areas can be created at short notice in partnership with the private sector. The highest levels of the government must take control of this process to ensure that there are no further bottlenecks of the sort that have affected test kit production. India needs more testing capabilities to minimise the damage caused by COVID-19. So far the government has done well to take preventive measures. Intervention should now move to the next stage.