On Monday, 16 March, the Ministry of Health and Family Welfare confirmed that India had 110 cases of the novel coronavirus, of which 97 remained active cases. As the number of positive cases rise, people have questions regarding testing -FIT attempts to answer some of your FAQs.
Where Can I Get the COVID-19 Test?
The primary test is currently being carried out at 57 government laboratories, 51 of which are controlled by the Indian Council of Medical Research (ICMR). The list of all labs can be found here. You will have to call the helpline numbers released by state governments or central helpline numbers released by the Health Ministry. They will guide you to the nearest testing facility.
Of the 51 ICMR labs, 31 labs can confirm a case - which means that after the patient’s primary test is positive, then the secondary round of testing confirms COVID-19.
At first, the ICMR-National Institute of Virology (NIV), Pune which serves as the apex center for all labs, was the only one to conduct the secondary testing and confirm a COVID-19 case.
As the cases ramped up, testing was increased in another 13 and then another 15 labs - making a total of 31- that were quipped with secondary testing facilities.
Additionally, NCDC Delhi is also engaged in testing, which makes a total of 57 labs.
For a macro view of all this, India has a network of public health laboratories under the Department of Health Research and ICMR with 106 virus research and diagnostic labs (VRDLs).
On top of all this, 56 DHR/ICMR VRDLs and 1 facility at Leh have been designated to help with sample collection and facilitate the transport of samples to a testing lab via Government health authorities, as per ICMR.
How Much Does It Cost?
The testing for COVID-19 is totally free for the patient and it is done in government labs via government hospitals or sample collection centers as of now.
What Types of Tests Are There? How Are They Conducted?
There are 2 types of tests:
The Primary test- A health professional collects samples of saliva or mucus from a patient’s nose or throat, or both. The nucleic acid from the sample is then extracted and sent for testing where it is screened against the Wuhan strain of the coronavirus.
Secondary test- Once a patient is confirmed through the primary testing, their sample is re-tested here. Once this comes out to be positive as well, doctors can say that the patient is infected with the novel coronavirus.
How Long Does the Primary and Secondary Testing Take?
Primary testing takes around 2-4 hours, and secondary testing in the 31 labs that are doing it takes another 3-4 hours. However, the process is slowed down if you are tested in a lab that does not have secondary testing capacities as the samples are taken to NIV or another lab with secondary testing.
What Is the COVID-19 Testing Strategy in India?
Currently, India is following a restricted and specific protocol and only testing symptomatic people who have travelled abroad recently.
According to the ICMR, since there is no community transmission of the virus as yet, the main persons being monitored are those who have travelled abroad to high-risk countries in the last 14 days and those that have had contact with such people.
These people are advised self-quarantine for 14 days, and THEN if they show any symptoms they are to be tested in the labs.
ICMR director general Balram Bhargava said, “The testing protocol is a moving target. The testing strategy will be revised in a week’s time if it’s needed and having looked at the circumstances.”
Why Are Only People Who Travelled Abroad Being Tested?
Because of no community transmission.
Both the Ministry of Health and Family Welfare and ICMR say that since the cases in India are all imported cases, the focus in on screening those who have travelled abroad and those who came in contact with them.
Dr Bhargava explained the trajectory of a virus saying that it comes in 4 stages.
Dr Bhargava said that we have started prompt action - like shutting down schools, universities, cinema halls and more - at stage 2 which is great. “Italy and China resorted to extreme measures and national shutdowns when they were at stage 4, so we are at a good place.”
Also Read: COVID-19: 30 Kerala Medics Under Observation
Who Can Do the Tests? Can I Go to a Private Lab?
As of now, only government labs are running the testing for coronavirus. According to Dr Nivedita Gupta of the ICMR, “We don’t need private labs yet as the current infrastructure is being grossly underutilised.”
ICMR and NIV are not using commercial testing kits and so far, the testing material is made in India although probes from Germany are being imported. ICMR added that the testing stock was sufficient as of now.
What Is the Capacity per Lab?
"We are conducting 60-70 tests every day across the entire network of 51 labs as of now as not more than 60-70 cases are being received.” said Dr Gupta. Each lab has the potential to conduct 90 tests.
But there are plans to scale this up if the situation intensifies.
India can currently conduct up to 10,000 tests a day. The ICMR laboratories have about 100,000 testing kits and an additional 200,000 have been ordered, said RR Gangakhedkar, ICMR chief epidemiologist.
How Many More Labs Are We Expecting?
Dr Gupta says that the plan is to escalate secondary testing capacities to all 51 labs so that the results are known faster. For now, there seems to be no need to increase labs.
What Happens When You Are Tested Positive?
Once you test positive in the primary testing, your sample is taken for secondary testing.
Once confirmed to be positive there as well, you would be confirmed as having been infected with the novel coronavirus. You will then be kept in under isolation in the hospital, and treated until you recover.
Do Medical Insurance Policies Cover COVID-19?
On 4 March, the Insurance Regulatory and Development Authority of India (IRDAI) instructed all insurances to extend claims of hospitalisation or medical expenses incurred during the treatment of the novel coronavirus.
How Does ICMR Test for Community Transmission?
Community transmission is a big worry, as reports from abroad suggest that the virus can often travel through asymptomatic or mildly symptomatic people.
ICMR has been conducting random sampling of patients with flu-like symptoms and no travel history abroad to outbreak zones to rule out community transmission. This began on 15 February, where each of the 51 labs were expected to test 10 random samples. Since the virus has moved more aggressively, ICMR has increased this to 20 samples per week. Since then, this exercise has been increased in capacity.
“Our current testing strategy will completely change if there are any positives in the random samples,” said Dr Gupta.
When Should I Get Tested?
If you have any symptoms like a dry cough, difficulty breathing, fever and fatigue it is best to go straight to a doctor and then a testing facility.
But Dr Gupta added that in the panic, everyone - even those who don't show symptoms - shouldn't rush to get tested. “The goal is that we avoid indiscriminate testing,” says Dr Gupta, “We need to rationalise."
Additionally, testing asymptomatic patients may give a sense of false hope as it could throw up what the ICMR calls ‘false negatives.’
“An asymptomatic person is not going to have a high viral load in the beginning but may develop stronger symptoms toward the end of the 14-day quarantine period. So we are only looking at symptomatic patients for now. This way we can also search for their close contacts to contain the spread faster,” says Dr Gupta.