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Government to roll out rapid testing kits without waiting for assessment results

There is political pressure to use these test kits to justify the deal with Omni and also bring the controversial company back for more procurement deals, officials say. Government to roll out rapid testing kits without waiting for assessment results

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Arjun Poudel

Published at : April 9, 2020

Updated at : April 9, 2020 07:30

Although rapid test kits acquired from China have yet to be tested for validity and efficacy, the government is pushing through with using them in mass tests for Covid-19 in two provinces—Gandaki and in Sudurpaschim.

Earlier this month, the government had procured 75,000 rapid test kits from China through a controversial tender with a private company, Omni Business Corporate International. After the tender was heavily criticised for the manner in which it was awarded and questions were raised about the quality of the equipment procured, the tender was annulled. But 75,000 test kits had already arrived and the government had pledged to use them only after testing their efficacy.

Dr Bikash Devkota, spokesperson for the Health Ministry, told the Post that testing had already begun on Tuesday and that health workers have been performing tests and collecting specimens—blood, and nasal and throat swabs.

“Rapid testing has started after the test kits passed the validity test,” Devkota said.

But according to officials at the Nepal Health Research Council and the National Public Health Laboratory, two government-run institutions that have been mandated to assess the kits, testing has not yet begun and will require at least a few more days to complete.

Dr Meghnath Dhimal, chief researcher at Nepal Health Research Council, told the Post that 198 samples for use in the assessment were collected from Kailali and Kanchanpur on Tuesday and more collected on Wednesday. Those samples will now need to be transported to the National Public Health Laboratory, which will carry out simultaneous tests on the samples using the rapid test kits and the tried and tested polymerase chain reaction method. If both methods provide the same results, the rapid test kits will be judged reliable.

“It will take a few more days to start mass testing using the rapid test kits if we are to wait for the result of the validity test and our research report,” Dhimal told the Post. “We will prepare a report from the results given to us by the National Public Health Laboratory and submit it to the government.”

Dr Runa Jha, director of the National Public Health Laboratory, which will be carrying out the tests, also said that the laboratory had yet to complete the tests.

“We will conduct a sensitivity test of rapid kits and produce a report,” Jha told the Post. “We are not going to recommend anything. We will give a report about the kit's sensitivity, for which samples are still being collected.”

Health Ministry officials, however, were insistent that the council had already approved of the tests and that the rapid test kits were being put into use immediately.

“We have rolled out the rapid test kits purchased from China for mass testing,” Dr Roshan Pokhrel, chief specialist at the Health Ministry, said.

A Cabinet meeting on Saturday decided to conduct mass tests in three districts—Baglung, Kanchanpur and Kailali, where a majority of Covid-19 cases have been reported.

There, however, were immediate concerns about which test kits the government was planning to deploy for large-scale testing, as those imported from China by Omni have believed to have quality concerns.

At least two leaders from the ruling Nepal Communist Party told the Post that a section of the party is attempting to push for the use of these test kits, as it not only wants to justify the deal with Omni but is also in favour of bringing the controversial company back in for more procurement deals in the future.

Defence Minister Ishwar Pokhrel, who also heads the coordination committee for the prevention and control of Covid-19, and Health Minister Bhanubhakta Dhakal have both run into controversy over the procurement of the medical equipment.

Two Health Ministry officials said that there is political pressure to roll out the test kits, even though they have yet to prove efficacious.

“If the test kits work fine, it will pave the way to continue with more deals with Omni and the company will be saved from being blacklisted,” an official who spoke on condition of anonymity told the Post.

According to provincial government officials, the rapid tests will be rolled out starting Thursday in a number of districts.

“We are going to start mass testing from Thursday in Kailali and Kanchanpur,” Dr Gunaraj Awasthi, health director of Sudurpaschim Province, told the Post over the phone from Dhangadhi. “We have completed all necessary preparations to conduct rapid tests.”

The tests will be expanded to all nine districts of the province, testing everyone suspected to have come in contact with Covid-19 patients and all those who’ve returned from India, said Awasthi.

Gandaki Province will also be conducting rapid testing soon, as 5,000 rapid test kits will arrive at the province’s health directorate by Wednesday evening, according to Dr Binod Bindu Sharma, health director of Gandaki Province.

“One thousand tests will be performed in Baglung and the remaining test kits will be supplied to other districts,” Sharma told the Post over the phone. “We will prioritise people who’ve returned from India and abroad.”

Public health experts, however, believe that it could be counterproductive to conduct tests without knowing the efficacy of the test kits being used.

“Why did the government decide to perform a validity test and deploy health workers to collect samples if they couldn't wait for the result,” said Dr Baburam Marasini, former director of the Epidemiology and Disease Control Division. “I don’t understand why we are conducting the tests if we do not know the quality of the testing kits?”

Nepal has so far reported a relatively small number of Covid-19 cases—eight live cases with one recovery, but in the absence of widespread testing, there are fears that the number could be higher.

Anil Giri contributed reporting.

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 territories around 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
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.