NEW DELHI (AP) – On New Year’s Eve, the Indian government wrote to states urging them to promote the use of COVID-19 home tests, especially for people experiencing symptoms, in an effort to avoid straining local health systems.
During last year’s delta-driven rise, an explosion in cases overwhelmed hospitals and test labs. But last month, as new infections driven by the omicron variant skyrocketed, the number of people testing themselves at home across India rose.
In the first 20 days of January, about 200,000 people shared their test results with India’s health agency – a 66-fold increase over the whole of 2021. The strategy apparently worked. Those who tested positive with rapid, though less accurate tests, were told to isolate themselves at home, allowing hospital beds to remain available to the most vulnerable.
But experts say that number is probably only a fraction of the actual number of tests used. Despite rules requiring people to share their findings with authorities, many do not. This means that the country’s already uneven test data is even less accurate and that future clusters may go undetected.
This is a problem that some states in India are already highlighting. In Maharashtra, the state health official appealed to Dr. Pradeep Vyas recently for all users to report their results. And since testing does not distinguish between omicron and the deadly delta variant, which also continues to spread in India, he warned that there are still vulnerable people in need of hospital treatment.
“Suddenly, there may be stress on our health infrastructure,” he wrote in a letter to authorities last month.
Since January, state pharmacists have begun keeping records of those who buy home tests. But this is not the case in most Indian cities.
“If I were to guess, maybe only 20% of people who use home tests report it,” said K Srinath Reddy, president of the Public Health Foundation of India, adding that each test result should ideally be reported so that the authorities can detect the virus. . .
“If you do not report it, your sample cannot be sent for genomic analysis, and then you may miss tracking clusters and variants,” he said.
In interviews with The Associated Press, several people in the capital New Delhi admitted that they tested positive using home tests, but did not share their results with the authorities.
With the highly contagious omicron variant still spreading across Asia, several countries are making a difficult trade-off between accuracy and speed, implementing the flexible home tests to ensure patients do not flood hospitals.
In South Korea, officials said Wednesday that free rapid test kits for coronavirus would be available in kindergartens, elementary schools and senior welfare centers from next week after an unprecedented wave of omicron infections. Authorities recently began moving away from a predominantly PCR testing strategy to rapid testing, although some experts warned that the latter did not reliably detect early omicron infections. People can buy home tests at pharmacies and grocery stores or take the tests for free at public health offices and test stations, where anyone with a positive result then gets a PCR test.
Indian officials rely on a centralized database where people upload their test results using a mobile app. MyLab, the first company approved for its COVID-19 home test, produces 500,000 tests a day. Sales have increased tenfold compared to the last quarter, says Saurabh Gupta, strategy manager at MyLab. India has approved eight home tests so far, at a price between $ 2 and $ 33.
Despite the increased use of home tests, experts say they are not as accurate as lab-driven PCR tests and have a greater chance of reporting false negatives.
Parul Saxena, a housewife in New Delhi, took a home test last month, which turned out to be negative. But as she continued to have body aches and fever, she went in for a PCR test, which confirmed what she was feeling all along – that she was positive for COVID-19.
India’s Ministry of Health did not respond to questions sent via email.
Another concern is that home tests are inherently more difficult to adjust – which needs to be done as the virus develops. While the accuracy of both home and laboratory tests is affected when a virus develops, rapid tests may not be able to detect a new variant, said Vineeta Bal, who studies immune systems at the Indian Institute of Science Education and Research.
After last year’s catastrophic delta rise 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 maximum of over 300,000 cases last month. Experts have warned that India, like elsewhere, was likely to lack cases even before the advent of home tests.
But some say that it is not necessary for all positive cases to be reported to the authorities. Officials can continue to study the spread of the virus through robust random sampling, said Dr. Jacob John, who studies viruses at Christian Medical College in Vellore, a city in southern India.
Reddy, the public health expert, questioned the importance of case counts at this stage of the pandemic in India.
“Right now, this is not going to be the top priority – the important thing is to make sure that if people get very sick, there are enough health facilities,” he said.
Ashley St. John, an associate professor at Duke-NUS Medical School in Singapore, agreed that other factors are 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 developing symptoms or serious illness. We have also come to accept that the virus is endemic and cannot be detected in any person.”
Kim Tong-hyung in Seoul, South Korea, contributed to this report.
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