COVID-19: Testing criteria for private labs opened up

The Union Ministry of Health and Family Welfare (MoHFW) has issued guidelines to private hospitals to ‘test’ COVID-19 patients even if they do not have a history of international travel or contact with a confirmed case.

Till now, the government has restricted the testing criteria for its own labs to such suspected patients only. Even in a press conference on March 20, 2020, the ministry said it was not going to expand criteria for public sector labs.

“All pneumonia patients must also be notified to National Centre for Disease Control or Integrated Disease Surveillance Programme so that that they can be tested for COVID-19,” the government said in an advisory issued to private hospitals on the evening of March 20.

This would mean the opening up of testing criteria for the private sector, Association of Healthcare Providers (AHPI), said. AHPI is an association which represents India’s private hospitals.

“If a patient has a serious respiratory illness for which the tests of all other ailments, including swine flu have been proved to be negative, we have every reason to believe that it is a suspect COVID-19 case,” Giridhar Gyani, director general of AHPI, told Down To Earth (DTE).

Private healthcare providers had held a meeting with MoHFW’s top brass on March 19.

Another senior member of AHPI, who attended the meet, told DTE that the government had informed them it was not expanding the testing criteria for its own labs at the moment since it did not have enough kits.

“They wanted the private sector to start and see results. Accordingly, the government may decide,” the member said on the condition of anonymity.

Sufficient beds, ICUs?

The government has also asked private hospitals according to the advisory to see to it that no suspected COVID- 19 patient is turned away from any hospital.

Incidentally, out of the four people dead due to COVID-19 in India, at least two were shunned away by private hospitals. They had initially gone there for treatment and lost valuable time in going from one hospital to the other.

There are also reports of even doctors, who were suspected COVID-19 patients, being turned away by private hospitals.

“Now that the government has asked us to prepare, we will do it,” Gyani said. He added that private players had advised the government to earmark one or more entire hospitals in a city (depending on population) for COVID-19 treatment rather than isolating a few beds in all hospitals.

“This will help in focussed treatment of patients. Secondly, it would minimise the chance of infection being transmitted to other wards of the hospital where non-COVID patients are admitted. It will make overall management easy and smooth,” Gyani said.

On ICU-bed availability, Gyani said there were seven-eight lakh beds in the government sector. Out of these, 10 per cent or 70,000-80,000 were ICU beds. Of these total beds, 20 per cent had ventilators attached to them.

This was clearly not enough if community transmission were to take place, he said. The possibility of community transmission happening in future has not been ruled out even by the Indian Council of Medical Research.

There are seven-eight lakh beds in the private sector as well. But at least 20 per cent of them are ICU beds and at least 10 per cent have ventilators. “I believe if community transmission becomes a reality, even the combined strength of private and government sector may not prove to be sufficient,” Gyani said.

Lav Agarwal, joint secretary of MoHFW was asked in a press conference on March 20 as to how many beds had been isolated. “We can assure you there is a sufficient number which is progressing with the evolving situation,” he said, refusing to divulge actual numbers.

Price cap for tests

Gyani said the government had fixed the price cap of Rs 5,000. “It was not very feasible for us. But if the government provides us testing kits at subsidised rates, we might be able to manage at this cap,” he said.

ICMR Director General, Balram Bhargava had appealed to private labs on March 17 to conduct tests for free as ‘they had expressed desire to the government to serve the nation’. At government labs, the test is being conducted for free.

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