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Coronavirus: 'Home collection is ideal way to minimise risk'

By PRASANNA D ZORE
March 28, 2020 09:23 IST
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'A probable positive patient walking into a centre is not an ideal situation.'

IMAGE: Medical personnel take a sample for testing for coronavirus from a patient in the isolation ward at the Patna Medical College and Hospital, March 14, 2020. Photograph: Aftab Alam Siddiqui/ANI Photo

"There is resentment from residential societies, but there is also a growing understanding that testing is required for patients who may be having the symptoms so that they can get the treatment that they need. We are seeing a change in perception as we explain to them that all safety protocols are followed," Dr Nilesh Shah, Group President, Metropolis Healthcare -- the Mumbai-headquartered company which has 124 clinical laboratories and 2,400 collection centres in seven countries -- tells Prasanna D Zore/Rediff.com.

 

What are the challenges before you as a laboratory that has ICMR (Indian Council for Medical Research) approval to conduct the coronavirus tests?

Metropolis was one of the first few private labs to be approved for covid-19 testing on March 21 and we have been going full swing since then.

As an approval criterion, ICMR has approved labs that have NABL (National Accreditation Board for Testing and Calibration Laboratories) accreditation and have previously conducted swine flu testing.

The logic behind this move is that the sample collection guidelines and protocols for swine flu and covid-19 are very similar.

The challenge for all laboratories, in the beginning, was to set up isolation units for testing samples.

Because unlike swine flu, where a vaccine is available, there is no such safe zone with covid-19 samples.

Besides that, training of technicians and preparing them for this challenge is very important.

When did you start with covid-19 tests given that you got the approvals on March 21? How many tests per day have you conducted thereafter? In how many cities will you be offering your services?

We are unable to share the number of tests conducted thus far.

We began testing from March 23. We are equipped to offer these tests in Mumbai and Pune (where testing has begun). In a few days we will be starting in Chennai, Bangalore, Delhi, Rajkot.

When your employees go for home sample collection, what kind of response do they get from the residential society members and from the members of families whose sample swabs are taken by your trained technicians?
What challenges do they face?

There is resentment from residential societies, but there is also a growing understanding that testing is required for patients who may be having the symptoms so that they can get the treatment that they need.

We are seeing a change in perception as we explain to them that all safety protocols are followed.

This is our helpline number for patients: 8422 801 801.

What precautions do your lab officials take while going for home sample collection?
What kind of protection suits/kits do they wear while going for such home collection?

Our lab officials are fully protected with protective gear, masks, and goggles. No part of the body is exposed.

The technician must be in full gear while collecting samples. The gear is then disposed of as per bio-safety guidelines.

Metropolis is offering home collection of samples and this is the most ideal way to collect samples to minimise the risk of infection.

A probable positive patient walking into a centre is not an ideal situation and at present, we are collecting samples from home. We are currently undertaking home collection in Mumbai and Pune.

A doctor's prescription and a valid government ID is a must for the lab to conduct covid-19 test for a patient.

How are you training your staff to prepare for covid-19 tests?

Our staff is already trained to collect swine flu samples. Our technicians underwent rigorous training for the collection of samples for covid-19, especially the precautionary measures that are needed to ensure there is no room for infection.

Could you explain in detail what kind of precautionary measures your trained technicians take so that there is no room for infection?

The trained technician will be wearing a special protective gear to ensure the safety of the technician and the patient.

Samples are collected from the nose and throat and are transported in a special Viral Transport Medium, following all the (ICMR) guidelines.

Samples are collected from home, hospitals or dedicated collection centres.

At the lab, the sample is opened only in a special bio-safety cabinet and tested as per protocol.

Test results are notified to ICMR immediately.

What are the ICMR guidelines for conducting covid-19 tests?
Can anybody ask for this test or do they need to have travel history plus a physician's prescription and symptoms?

ICMR guidelines for testing include recent travel history, contact with someone who has travelled recently, contact with a confirmed patient.

Doctor's prescription is mandatory for all covid-19 tests.

Form 44 needs to be submitted by the lab which furnishes all details like onset of symptoms, travel history and other details like age, gender, contact address, etc. This is important for ICMR to establish contact tracing.

How many tests can you conduct a day?

We can conduct up to 1,000 tests in a day now.

What exactly is the covid-19 test? What kit do you use? How long does it take for the covid-19 (positive or negative) test?

Reports are released within 24 hours. All positive test results are notified to the ICMR immediately.

We have procured kits that have been approved by the ICMR. The test is based on real-time PCR (polymerase chain reaction) technology.

The test includes two parts -- screening and confirmatory -- and both the tests are done together for the best possible outcome for the patient.

What is the cost of covid-19 tests given that there is an ICMR-imposed cap of Rs 4,500? How much does it cost for Metropolis to conduct this test

The pricing has been approved by the (Union) ministry (for health and family welfare) considering all the costs involved for testing right from kits, protective equipment and the investments in ensuring bio-safety guidelines.

The price covers both screening and confirmatory test done by molecular biology technology. The screening test is priced at Rs 1,500 and the confirmatory test is Rs 3,000 and as per guidelines, both tests need to be performed.

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PRASANNA D ZORE / Rediff.com
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