Sukraraj Tropical and Infectious Disease Hospital in Teku, Kathmandu, stopped conducting rapid diagnostic tests on Covid-19 suspects on Tuesday, as it ran out of test kits.

The hospital has directed doctors at the out-patient departments to recommend polymerase chain reaction (lab) tests only for those that have a history of travelling to the disease-hit areas or reported close contact with the infected.

"Everyday over 40 people, including those that have returned home after travelling abroad, or stayed in judicial custody, used to seek Covid-19 tests at our hospital," Dr Sagar Rajbhandari, director, told the Post. "But due to lack of rapid diagnostic test kits, we are performing polymerase chain reaction tests, that too only on a few."

Polymerase chain reaction (PCR) tests are more expensive than rapid tests, and take a longer time to process. While rapid tests look for antibodies in the blood, PCR tests look for virus genes in patients’ nasal or throat swabs.

Like Sukraraj hospital, several hospitals across the country have run out of rapid diagnostic and some even lack reagents for the PCR tests. The situation is such that even people from Covid-19 hotspots are being deprived of testing.

"We had decided to test at least one member of every family of hot spots, " Krishna Prasad Khatiwada, a health worker at Triyuga Municipality, Udayapur, told the Post over the Phone. "But due to lack of rapid diagnostic test kits, we haven’t been able to perform tests."

Of the 75,000 rapid diagnostic test kits the government procured recently, over 52,000 have already been used up.

The Department of Health Services had signed a contract to procure 100,000 rapid diagnostic test kits through a fast track process, but the contractor has not been able to deliver those test kits on time.

The Ministry of Health had also assigned the Nepal Army to procure medical equipment, including 28,000 polymerase chain reaction test kits through a fast track process about a month ago, after a contract signed with Omni Business Corporate International, a private firm, was scrapped.

But the army too has failed to deliver those items on time.

Mahendra Prasad Shrestha, director general at the Department of Health Services, concedes that the ministry doesn’t have enough rapid diagnostic kits. "We have already performed over 52,000 tests,"Shrestha told the Post. "The remaining tests are distributed throughout the country."

Similarly, laboratories capable of conducting polymerase chain reaction tests are also running out of kits. The labs might have test kits sufficient for the next five days, according to Shrestha.

"Due to the May Day holidays in China, both the army and our other contractors have not been able to bring in the medical equipment including reagents," Shrestha told the Post.

"The cargo is ready in China. Once the flights resume, we will bring it here."

Shrestha claimed that no one needing a test has been denied so far. "We have been performing polymerase chain reaction tests on those referred by doctors," added Shrestha.

Multiple officials the Post talked to said that they were encouraged to perform polymerase chain reaction tests only on those who have returned from the disease-hit areas and have symptoms as the test is costly compared to rapid tests.

When asked why the army and private contractors failed to deliver the medical equipment on time, Shrestha said that the Health Ministry and Foreign Affairs Ministry are involved in the deal being pursued by the army.

"The army is just a medium. The Ministry of Foreign Affairs and I myself are involved in the process of buying equipment through the government to government process."he added.

Shrestha said that authorities in China are testing medical equipment being sold by private companies to check for conformity with safety standards.

Meanwhile, seven more people have tested positive for Covid-19 in the country, pushing the tally to 82. According to the ministry, all new cases are from Nepalgunj, Banke, and the cases have been detected through contact tracing of other cases. "All 23 cases are interlinked with the first cases in Nepalgunj, " Dr Sameer Adhikari, deputy spokesperson for the ministry, told the Post.