Delhi Covid-19 testing labs at capacity, home collections hit

Covid-19 testing labs in the national capital are swamped with samples, forcing many to reject requests for home collection and return results after delays stretching to days, a problem that could jeopardise efforts to contain the outbreak as infected people remain unaware of their need to isolate and their contacts are unreached.

The Capital conducted over 100,000 tests thrice in the last seven days. In the first week of March, it was at an average of around 63,500 a day.

Officials said the delays are hitting the government’s containment and contact tracing measures. “Earlier, we used to get all the test reports within the day; now it takes at least 48 hours or even more. It is across government and private sector labs, we send our samples to both, because they are flooded with a lot of samples,” said a senior district official, asking not to be named.

The official added, “This does impact the containment measures. We can only create the containment areas once we get the report. We also ask all contacts to remain in quarantine till their test results come back, but without the test report many do not take it seriously.”

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The Delhi health minister had said that 20 to 30 contacts were being traced and tested for each positive case when the current surge began.

One of the bottlenecks, the official said, was with a particular lab SpiceHealth, which promised results within hours. The official website of the laboratory on Monday had a message stating: “Due to sudden spike in Covid-19 cases in India, we have been inundated with RT-PCR samples to test. Providing an accurate test report is paramount to us. So, while we are trying our best to share your reports soon, expect them to be shared within 48 hours.”

The Delhi high court in October last year asked the government to ensure that Covid-19 reports are made available within 24 hours.

Typically, RT-PCR tests take at least 4-5 hours after a sample is collected. The process involves data entry, which need to conform to a format laid down by the Indian Council of Medical Research, before batches are processed in the RT-PCR devices. The last leg of the process, analysis of the report, too adds to the turnaround time.

The Union government has advised states to carry out at least 70% of the tests using this method since it is more accurate than the rapid antigen tests.

A senior official from Delhi’s health department said the laboratories were working at “optimum level”. “We are now using all our labs to an optimum level. In addition, we are also using the capacity of some laboratories in the NCR region. The government has also directed laboratories to increase their testing capacity,” this person said.

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The owner of one of the laboratories approved to conduct RT PCR tests in Delhi-NCR said on the condition of anonymity that it was difficult to increase capacity. “How can we increase capacity? All governments have capped prices for tests; the prices are so low we can barely make ends meet. Where will we find the investment to set up new machines? A new RT-PCR machine along with an RNA extractor costs ₹50 lakhs. And, this does not factor in the money needed for the physical infrastructure for housing the machine, the manpower needed to run it,” said this person.

Another private laboratory owner, who too asked not to be named, said: “The number of samples that we are getting has shot up – from 1,500 to 2,000 a day in one of my labs to nearly 8,000. All my employees are overworked, they are doing double shifts in order to process the samples.”

Experts said several issues may come up due to this crunch in testing capacity.

“The number of tests is going up, but no one is talking about quality. Do we have so many good quality kits available, enough trained manpower to collect samples, run the test, and analyze the report? Instead of numbers, we need to focus on reliable, valid tests,” said Dr Jugal Kishore, head of the department of community medicine at Safdarjung hospital.

“In addition, we should do targeted testing of those who are symptomatic instead of testing every one. We needed to target the contacts, and follow the test, trace and treat when the number of cases were low. Now, the infection has already spread everywhere,” he added.