State stepping up tests to 3,000 daily

It now has the infrastructure and paraphernalia to do up to 5,000 tests a day

Kerala has decided to do more diagnostic RT-PCR (reverse transcription polymerase chain reaction) testing for COVID-19 and increase the number of tests per day to 3,000 as the influx of non-resident Keralites from abroad and other parts of the country where disease transmission is intense has necessitated a better containment strategy.

On Tuesday, an expert committee headed by B. Ekbal, member, State Planning Board, pointed out at a review meeting convened by Chief Minister Pinarayi Vijayan that community transmission could not be ruled out in the State now and that testing had to be augmented in a big way.

He said it was highly likely that community transmission had already happened in the State as several isolated cases had surfaced in the community with no known source of infection. He advised that rather than ponder whether community transmission had become a reality, the State should act urgently and increase testing.

The Chief Minister said here on Wednesday that in the initial stages of disease transmission, the State had been facing an acute shortage of PCR testing kits and RNA extraction kits. However, the State does not have a shortage of test kits now. It has a stock of 88,781 PCR kits, 10,0112 RNA extraction kits, and 1,28,450 swabs. There are 14 labs in the public sector and six in the private sector. The State has the capacity to do up to 5,000 tests daily. It has thus been decided that 3,000 tests would be done daily.

Public health experts have been pointing out that in the second stage of disease containment, the State is not using PCR testing adequately.

Sentinel surveillance

On one side, in the absence of reliable antibody tests, on April 23 the State started sentinel surveillance studies using PCR to determine community transmission by collecting 900 random naso/oropharyngeal samples every week from all districts, from high-risk groups like health-care workers and those with high social exposure . This was augmented to 3,000 samples a week on May 14.

In between, Kerala also did a one-time sample study (augmented sample survey) on April 26 when 3,000 samples were collected in a day from districts and sent for testing.

However, till May 13, the average daily PCR samples tested by the State has remained at 800-1,000. It was only since May 14, when the imported cases of COVID 19 began to spike, that this was moderately increased to 1,000-2,000 samples.

As on May 27, Kerala has tested 58,866 routine samples and 9,095 samples as part of sentinel surveillance.

Even when it was pointed out that Kerala was doing comparatively fewer tests in the country (1,195.7 per million. In comparison, neighbouring Tamil Nadu was doing over 4,000 tests per million), the State argued that its test numbers were in proportion with its active cases detected.

The expert committee has now recommended that the sentinel surveillance and augmented surveillance studies be doubled and that all persons in the “vulnerable” categories who come to primary health centres with influenza-like illnesses (ILI) be tested for COVID-19. All districts should initiate ILI (influenza-like illness) surveys for which mobile sample collection vans should be readied.

The committee also suggested that an ILI self-reporting app may be thought of.