New Delhi, Feb 17 (BUS): On New Year’s Eve, the Indian government wrote to states to encourage them to promote the use of home testing for COVID-19, especially for people with symptoms, in a bid to avoid straining local health systems.
During last year’s surge due to Delta, an explosion in cases flooded hospitals and testing labs. The Associated Press (AP) reported that in the past month, as the number of new infections fueled by the omicron variant rose, the number of people testing themselves at home increased across India.
In the first 20 days of January, about 200,000 people shared their test results with India’s health agency – a 66-fold increase compared to the whole of 2021. Those who tested positive quickly, though less accurate tests were asked to self-isolate at home, allowing hospital beds to remain available for the most vulnerable.
But experts say that number is likely to be just a fraction of the actual number of tests used. Despite rules that require people to share their results with authorities, many do not. This means that already incomplete testing data for the country is less accurate and that future populations may not be detected.
It is a problem that some states in India are already regressing. In Maharashtra, state health officer Dr Pradeep Vyas recently appealed to all users to report their findings. Since the tests do not differentiate omicron from the more deadly delta variant, which also continues to spread in India, he cautioned that there are still vulnerable people who need hospital care.
“Suddenly there may be pressure on our health infrastructure,” he wrote in a letter to the authorities last month.
Since January, pharmacists in the state have begun keeping records of who buy home tests. But this is not the case in most Indian cities.
“If I had to guess, it’s probably only 20% of people using home tests,” said K Srinath Reddy, head of Public Health India, adding that every test result should ideally be reported so that authorities can trace the virus.
“If you don’t report it, your sample can’t be sent for genetic analysis, and then you might miss tracking groups and variants,” he said.
In interviews with the Associated Press, several people in the capital, New Delhi, admitted they had tested positive using home tests but had not shared their results with authorities.
As the highly contagious omicron variant continues to spread across Asia, more countries are making a difficult trade-off between accuracy and speed, and are deploying smart home tests to make sure patients aren’t overwhelmed by hospitals.
In South Korea, officials said Wednesday that free rapid test kits for the coronavirus will be available in kindergartens, primary schools and major social care centers from next week after an unprecedented wave of oomicron infections. Authorities have recently begun to move away from the mainstream PCR testing strategy to rapid tests, even as some experts have warned that the latter does not reliably detect early omicron infections. People can buy tests at home at pharmacies and stores or have the tests run for free at public health offices and testing stations, where anyone with a positive result gets a PCR test.
Indian officials rely on a central database where people upload their test results using a mobile application. MyLab, the first approved home testing company for COVID-19, produces 500,000 tests per day. Saurabh Gupta, head of strategy at MyLab, said sales jumped tenfold compared to the previous quarter. India has approved eight home tests so far, priced between $2 and $33.
Despite the increasing use of home tests, experts say they are not as accurate as PCR tests performed in the laboratory and have a greater chance of reporting false negatives.
Parul Saxena, a New Delhi housewife, took a home test last month which turned out to be negative. But when she continued to have body aches and a fever, she went for a PCR test, which confirmed what she had been feeling all along — that she tested positive for COVID-19.
The Indian Ministry of Health did not respond to questions sent via email.
Another concern is that home tests are inherently more difficult to adapt – something that needs to be done as the virus evolves. Vinita Pal, who studies immune systems at the Indian Institute of Science Education and Research, said that while the accuracy of home and lab tests is affected when the virus develops, rapid tests may not be able to detect a new variant.
After a disastrous increase in the delta last year and a sharp rise in omicron infections to start 2022, cases in India have now stabilized with many cities reopening restaurants, schools and workplaces. On Thursday, India recorded 30,757 new cases and 541 deaths – down from a high of 300,000 cases last month. Experts have warned that India, like anywhere else, will likely be missing out even before home tests appear.
But some say it is not necessary to report all positive cases to the authorities. Officials said they could continue to study the spread of the virus through robust random sampling Dr. Jacob John, who studies virology at the Christian Medical College in Vellore, a city in southern India.
Reddy, a public health expert, questioned the significance of the number of cases at this stage of the epidemic in India.
“Right now, that’s not going to be the biggest priority – the important thing is to make sure that if people get very sick, there are enough health care facilities,” he said.
Ashley St. John, associate professor at Duke-NUS Medical College in Singapore, agreed that other factors were more relevant.
“I think our concern about having very accurate data on positive case numbers has diminished as vaccination rates have increased,” she said. “We know that many vaccinated individuals can test positive even without symptoms or severe illness. Also, we have moved to accept that the virus is endemic and untraceable in every person.
MI