As incomplete as our understanding of the SARS-Cov2 virus behaviour is, one tool has remained a constant through all these months. Testing was vital in February; it is vital in November. But while India was woefully short of diagnostic kits then, there’s an oversupply today.
As of 29 October, more than 300 different kits for RT-PCR RT-PCR Reverse transcription polymerase chain reaction , rapid antibody, and rapid antigen tests have been approved by the Indian Council of Medical Research (ICMR), the apex and lone agency granting permissions to kit manufacturers and distributors.
As the number and variety of kits exploded, their prices crashed. From Rs 4,500 ($61) for an RT-PCR test in a private diagnostic lab in April-May, state governments are now capping prices at Rs 800-900 ($11-12.5). Reagents that cost $3-4 per kit then, are being sold for less than a dollar. The crucial PCR machines that cost upwards of Rs 20 lakh ($27,000) early this year, have seen their maximum retail prices (MRP) slashed by 50-60%.
Sometime this week, Agappe Diagnostics will launch a new Covid-19 test in the Indian market using RT-LAMP technology, a new assay to test the genetic material of the virus. The 25-year-old Kochi company, in association with Japan’s Eiken Chemical, has also built accompanying equipment for these tests. More suitable for rural areas or tier 2-3 towns, Agappe’s tests and equipment don’t require the extreme low temperatures that PCR tests can’t do without.
More tests are under development and will hit the market in due course. However, it’s time to pause in this phase of the pandemic, and evaluate the quality of kits floating around, something which was impossible to contemplate even two months ago.
“All district collectors had to do then was to show they were doing a good job. Everything was very transactional, nobody looked at any kind of data or had any long-term view,” says a senior executive of a diagnostics chain in western India. He is referring to the July-August period, when the Centre passed the baton to states. “I know of instances where tens of thousands of samples were collected but not tested… It was a mad rush to do more and more tests, and get more budget.”
The Covid-19 situation on the ground is not dire today. Or at least it doesn’t seem so based on conversations with at least 17 path labs, kit makers, and Covid researchers across five states.
Understandably, ICMR has slowed its approval process and become a little more stringent.