We hope to conquer COVID-19 but there is a possibility that the virus will spread. Countries like China, South Korea, and the USA are suggesting mass testing of at least 5% of the population, both symptomatic and asymptomatic. With this in mind, India needs to plan to test 68.5 million people in total, of which 46.6 million people are in rural India- tier 3 cities, tier 4 cities, taluk, small towns and villages. The question arises, whether mass testing can be accessible to these remote areas of the country, and if so which tests will be most suitable to assess these population numbers.
Attached is a PowerPoint that outlines various methods for COVID-19 testing, patient testing flow charts and representative costs. It also outlines an alternative screening method called SWADESH-Protocol.
RT-PCR method is currently the only confirmatory test for COVID-19. Mass testing of 5% of India’s population would cost roughly Rs 32,520 Crores. An efficient filtering system seems pertinent to reduce the number of people getting confirmatory testing.
Point-of-Care Testing Kits (Rapid Card Method), is a suitable screening tool but is qualitative and will need confirmatory testing using RT-PCR. Awaiting confirmatory testing will cause a delay of 4-5 days in treatment of critical patients. The POCT or Rapid Card Method will cost approximately Rs 9,110 Crores to test 5% of the population.
SWADESH-protocol, the alternate methodology suggested in this PowerPoint, tests inflammatory markers through CBC, CRP, SpO2 and X-Ray and classifies a patient’s likelihood of contracting an infection as Deep Red, Red, Amber, and Green; where Deep Red- is highly likely, Red- is likely, Amber- is suggestive, and Green- is unlikely of infection.
This color-coded grading system will help trace and treat the infected population. All of the Hematology, Biochemistry, and Radiology Testing mentioned in SWADESH-Protocol is already available in all parts of India. It will cost approximately 5,240 Crores to test 68.5 million people.
(Writer is Raju Venkatraman, Chairman, Medall Healthcare. Views expressed are a personal pinion.)