Public health experts suggest more PCR tests as they call into question the efficacy of rapid test kits
The Department of Health Services, however, bets on rapid test kits in the fight against coronavirus even though the National Public Health Laboratory says the validity of RDT kits was based on a small sample size. Beeju Maharjan/TKP
At a time when the government is working to perform more rapid tests for Covid-19, public health experts have warned that it will be a waste of public money and urged the government to focus on ramping up polymerase chain reaction tests instead.
They have questioned the efficacy of rapid diagnostic test (RDT) kits being used throughout the country and said that even if the test kits are reliable, they cannot be used for diagnostic purposes.
"Rapid diagnostic test kits can be used for study to know if the antibody has developed in the population against the disease," Dr Harischandra Upreti, former director at the National Public Health Laboratory, told the Post. "I am wondering why are we stressing more on rapid tests, when several countries and several states of India have stopped using rapid diagnostic test kits."
Several states of India have halted rapid tests including Rajasthan where only 5.4 percent of the tests proved effective.
An official at the Health Ministry said the rapid tests were rolled out after testing just four samples of positive patients—three in Kailali and one in Baglung.
"Of the four samples tested by the rapid diagnostic test kits, results of three were found accurate. One of the test results came negative," said the official who did not wish to be identified.
Dr Runa Jha, director at the National Public Health Laboratory, also admitted that the laboratory had submitted its report to the Health Ministry based on tests carried out on a few samples.
"I cannot tell you the number of tests we performed for validation,"Jha told the Post. "We have furnished the report on the test results to the Health Ministry."
Meanwhile, an official at Nepal Health Research Council, which is entrusted to perform the test validity, said that the council was unaware about the results of rapid tests being carried out across the country.
“We do not have any idea about what is happening,”Dr Megnath Dhimal, chief of council, told the Post.
As of Sunday, over 43,ooo rapid tests had been performed throughout the country, according to the Health Ministry. The government is procuring 100,000 RDT kits through a fast track procedure. Earlier, the ministry had purchased 75,000 kits for $600,000.
Dr Mingmar Gyelgen Sherpa, former director at the Department of Health services, said rapid tests do not mitigate the risk of possible transmission.
"Due to more focus on rapid tests, we are not performing polymerase chain reaction (PCR) tests, which give more accurate results," he said. "Both the number and capacity of laboratories having polymerase chain test facilities should be increased."
Rapid tests give misleading results like in Udayapur where the people residing in a mosque tested negative in rapid tests, only to later test positive when they underwent PCR tests.
There was also the incident in Kailali where a 65-year-old woman, who was allowed to go home after spending two weeks in quarantine based on her negative rapid test results. She later tested positive for the novel coronavirus in a polymerase test.
Dr Sherpa has suggested that the government look into other reliable options instead of rapid tests.
"Earlier, we did not have more options like we have at the present, " he said. “We should not spend money on rapid test kits just for the sake of testing."
Mahendra Prasad Shrestha, director general at the Department of Health Services, however, claimed that the ongoing rapid tests have been yielding accurate results. He went on to say rapid tests are not only reliable but also the only option to stop the risk of Covid 19.
"Polymerase chain reaction is very costly and each test costs Rs 15,000," Shrestha said. "We cannot afford more such tests so we are performing rapid tests."
Frequently asked questions about the coronavirus outbreak
UPDATED as of September 22, 2020
What is Covid-19? Covid-19, short for coronavirus disease, is an illness caused by the coronavirus SARS-CoV-2, short for severe acute respiratory syndrome coronavirus 2. Common symptoms of the disease include fever, dry cough, fatigue, shortness of breath and breathing difficulties. In severe cases, the infection can cause pneumonia, severe acute respiratory syndrome, kidney failure and even death.
How contagious is Covid-19? Covid-19 can spread easily from person to person, especially in enclosed spaces. The virus can travel through the air in respiratory droplets produced when a sick person breathes, talks, coughs or sneezes. As the virus can also survive on plastic and steel surfaces for up to 72 hours and on cardboard for up to 24 hours, any contact with such surfaces can also spread the virus. Symptoms take between two to 14 days to appear, during which time the carrier is believed to be contagious.
Where did the virus come from? The virus was first identified in Wuhan, China in late December. The coronavirus is a large family of viruses that is responsible for everything from the common cold to Middle East Respiratory Syndrome (MERS) and Severe Acute Respiratory Syndrome (SARS). After an initial outbreak in Wuhan that spread across Hubei province, eventually infecting over 80,000 and killing more than 3,000, new infection rates in mainland China have dropped. However, the disease has since spread across the world at an alarming rate.
What is the current status of Covid-19?
The World Health Organisation has called the ongoing outbreak a “pandemic” and urged countries across the world to take precautionary measures. Covid-19 has spread to 213 countries and territoriesaround the world and infected more than 31,405,983 people with 967,505 deaths and 22,990,260 recoveries. In South Asia, India has reported the highest number of infections at 5,557,573 with 88,943 deaths. While Pakistan has reported 306,304 confirmed cases with 6,420 deaths. Nepal has so far reported 65,276 cases with 427 deaths.
How dangerous is the disease?
The mortality rate for Covid-19 is estimated to be 3.6 percent, but new studies have put the rate slightly higher at 5.7 percent. Although Covid-19 is not too dangerous to young healthy people, older individuals and those with immune-compromised systems are at greater risk of death. People with chronic medical conditions like heart disease, diabetes and lung disease, or those who’ve recently undergone serious medical procedures, are also at risk.
How do I keep myself safe? The WHO advises that the most important thing you can do is wash your hands frequently with soap and water for at least 20 seconds or use hand sanitizers with at least 60 percent alcohol content. Avoid touching your eyes, nose and mouth with unclean hands. Clean and disinfect frequently used surfaces like your computers and phones. Avoid large crowds of people. Seek medical attention if symptoms persist for longer than a few days.
Is it time to panic?
No. The government has imposed a lockdown to limit the spread of the virus. There is no need to begin stockpiling food, cooking gas or hand sanitizers. However, it is always prudent to take sensible precautions like the ones identified above.
Arjun Poudel is a health reporter for The Kathmandu Post. Before joining the Post, he worked for Sagarmatha Television, Naya Patrika, Republica and The Himalayan Times.
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