Covid-19 update: States to get 500,000 rapid antibody test kits this week

States across the country will soon receive half a million antibody testing kits from the Centre, as India embarks on more aggressive testing in so-called containment zones and clusters.

“We have ordered about 500,000 rapid testing kits that we should get by April 8 or 9, and will be deployed in states as per the requirement,” said Raman R Gangakhedkar, chief, epidemiology and communicable disease, Indian Council of Medical Research (ICMR).

According to an ICMR advisory, rapid testing kits (for antibody tests or blood tests) need to be deployed in areas where mass testing is required, such as evacuation camps, large cluster areas, and camps for migrant workers.

But, the kits being provided may not be enough, with state governments estimating that they need at least two million kits to test health workers and others who are at the forefront of the nationwide effort to combat the spread of Covid-19, and also people in clusters and containment zones.

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India has about 2.2 million health workers, according to Census 2011.

To meet the requirement, states have asked the Centre for more and also placed orders with private firms to provide as “many kits as possible” . Some states such as Andhra Pradesh, Kerala and Telangana have placed orders with firms in South Korea and Hong Kong for antibody test kits.

Kerala, Maharashtra and Rajasthan have already started conducting antibody tests using kits procured from private firms and the ICMR. The tests in most states will be free of cost at government run institutions, and nominally priced at private labs, state government officials said.

India has used the RT-PCR, or reverse transcriptase polymerase chain reaction, test on nasal or throat swab samples of suspected patients to test for Covid-19. These tests can take between 12-24 hours to show results. In comparison, the rapid antibody tests identify disease-fighting antibodies in blood samples and can deliver results in 45 minutes to two hours.

However, since antibodies are usually detectable only after around 7-10 days of being infected by the virus, such tests could throw up false negatives – an infected person may appear normal in the blood test. And they may also throw up false positives -- people who had the infection, but have since been cured (and who, therefore, possess the antibodies required to be immune).

To avoid such false negatives, the ICMR, which is overseeing the country’s testing regime, has asked both government and private laboratories to stick to RT-PCR tests for diagnostic purposes and has allowed antibody tests only in the containment areas and clusters. For now, the ICMR has permitted states to also use the rapid antibody test kit used for tuberculosis patients for Covid-19 patients also.

Last week, the health ministry identified 20 Covid-19 containment areas and 22 potential hot spots in the country.

Delhi chief minister Arvind Kejriwal said 100,000 rapid testing kits will be available with the state government by Friday and the mass testing will start. He added that Covid-19 testing has also been ramped up in the state with 500 tests being done every day. “From next week, 1,000 tests will be conducted per day.”

Mumbai, another Covid-19 hotspot, is gearing up for conducting mass tests too. The Brihanmumbai Municipal Corporation (BMC) has decided to conduct at least 1,000 rapid tests every day but is handicapped by the unavailability of test kits. A senior health official said: “We have given orders to procure the kits but so far no one has responded. Once we get enough testing kits, we will start mass testing.” TP Lahane, director of Director of Medical Education and Research (DMER), said: “We are working on the policy; then the testing will start.”

Uttar Pradesh has placed an order of 500,000 antibody test kits with the ICMR, according to Rukum Kesh, director general of health services. “If required, we will order more,” he said, adding that tests of health workers will be conducted first. On Monday, the number of infections in the state touched 305.

According to Dr C N Manjunath, chief nodal officer for the Karnataka government task force to combat Covid-19, the state has placed an order for 1 lakh antibody test kits which it expects to receive on April 12. Manjunath added that another 10,000 kits have been ordered from a Pune based company, Mylabs Discovery Solutions Pvt Ltd, which will deliver them on April 7. “Till then, we have sufficient stock. Till date, we have tested nearly 10,000 people and once the additional kits come we will scale this up rapidly and we will be testing nearly 80,000 people in the next three weeks.”

Both Andhra Pradesh and Telangana have placed orders for 500,000 kits each. Andhra Pradesh’s special chief secretary (medical and health), KS Jawahar Reddy, said the kits could cost around Rs 20 crore. “We have placed an order with a couple of firms in Hong Kong. We are also trying to tap sources in South Korea and Taiwan. But it will take some time to procure them,” he said.

The Goa government has partnered with a private company to get the antibody testing kits and will start the free tests from Tuesday. State Health Minister Vishwajit Rane said the test kits will help roll out mass testing for “Tier-II” suspects -- secondary contacts and those who are home quarantined.

However, some states, such as Bihar and Odisha, are still assessing the number of kits needed to roll out rapid tests.

“There are chances of false negative in the rapid test. What do you then?” asked Bihar’s principal secretary, health, Sanjay Kumar, adding that Bihar is was waiting for a response from the ICMR on how many kits the state can get.

Odisha’s director health Shalini Pandit said it has not been decided whether rapid antibody tests would be done in the state. Madhya Pradesh’s health commissioner, Faiz Ahmad Kidwai, said the state will go ahead with the rapid testing once the kits are procured.

The ICMR is also ramping up Covid-19 tests and has increased its testing capacity to 25,000 tests in a day in two shifts, Gangakhedkar said. Close to 200 government and private labs are authorised to conduct the Covid-19 diagnostic test.

Union health ministry joint secretary, Lav Agarwal, said that all the states have been asked to form a district-specific containment plant even for districts that have no reported cases so far. “Our strategy is to remain proactive and overprepared to deal with any eventuality.”

(With inputs from health bureau and state bureaus)