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India will use rapid antibody tests in Covid clusters even after WHO advised against it




A doctor wearing personal protective equipment (PPE) places a saliva swab into a test tube for analysis during coronavirus symptom tests (Representational Image) | Photographer: Krisztian Bocsi | Bloomberg
A doctor wearing personal protective equipment (PPE) places a saliva swab into a test tube for analysis during coronavirus symptom tests (Representational Image) | Photographer: Krisztian Bocsi | Bloomberg

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New Delhi: India will go ahead with its decision to use imported antibody rapid diagnostic kits for testing in Covid-19 clusters after they arrive over the next couple of days even as the World Health Organisation (WHO) recommended against the usage of these tests outside research settings.

Speaking at a press meet Saturday, Indian Council of Medical Research (ICMR) chief epidemiologist Raman Gangakhedkar said India will do rapid testing to detect exposure in hotspots and will follow it up with real time-polymerase chain reaction (RT-PCR) tests.

The move came three days after the WHO published a scientific brief that said current evidence suggests rapid testing kits – whether based on antibody or antigen detection – were to be used only in research settings. “They should not be used in any other setting, including for clinical decision-making, until evidence supporting use for specific indications is available.”

Rapid antibody tests are prick based tests that provide quick results and don’t need to be conducted in laboratories. These tests can detect the presence of coronavirus antibodies in the body. However, since the antibodies appear only 7-10 days after a patient gets infected, the tests can detect exposure to the virus but cannot be used for diagnosis, according to the WHO.

The ICMR had approved the use of rapid antibody tests on 4 April in areas reporting Covid-19 clusters, large migration and evacuees. Following this, lists of kits validated by the ICMR and Drug Controller General of India were released.

ThePrint reached ICMR Director General Balram Bhargava for a comment but there was no response until the time of publishing this report.

Also read: What is rapid antibody test that India has cleared for Covid-19 and how it will help

Why India want to use these tests

Speaking to the press Saturday, Gangakhedkar said India aims to use the rapid diagnostic tests in hotspots to understand how many people have been infected, and to compare day wise trends.

“This can help us to understand how effective the containment measures were,” said Gangakhedkar.

Secondly, healthcare workers will be tested to understand if they are infected. “If there is a healthcare worker who tests positive and is RT-PCR negative and then the person is immune to the virus… Be assured that he or she will not spread it to others,” said the ICMR epidemiologist.

He added that rapid antibody tests are first-generation, which means they are new and will get as effective as other diagnostic tests with time.

An official working on Covid-19 crisis in Kerala told ThePrint on condition of anonymity that the state plans to use rapid diagnostic tests for surveillance but not screening. However, a Rajasthan who didn’t wish to be named said these tests will be used as they are approved by ICMR and will help isolate positive cases quickly.

Also read: Antibody test or RT-PCR. Both needed to fight Covid-19. Don’t rake up controversies

Poor results in UK, Spain and Czech Republic

The WHO brief on 8 April said antibody tests kits detect the presence of the virus only in the second week of the infection so can’t be used as confirmatory tests. Also, since the tests can cross-react with other pathogens, including other human coronaviruses, they often give false-positive results.

The brief added that there is no evidence to support the use of the rapid diagnostic tests to predict immunity of the person to the virus.

The United Kingdom government had intended to use rapid diagnostic tests to know the spread of the disease and detect how many have immunity to the virus and can safely go back to work. However, a validation study by the University of Oxford involved multiple rapid diagnostic tests and found that none of them performed well, giving many false positives and negatives.

Since then, the UK has cancelled its order of rapid testing kits and has tried recovering its costs. Similar rapid diagnostic tests failures have been reported in Spain, the Czech Republic and Slovakia.

Also read: Scientists dissect the genetic architecture of SARS-CoV-2, to understand how it replicates

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Andhra doctor, suspended for alleging PPE shortage, now beaten by cops for ‘creating nuisance’




doctor with a stethoscope
A doctor with a stethoscope (Representative image) | Pixabay

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Bengaluru: A doctor with a government hospital in Andhra Pradesh, who was suspended for questioning the shortage of PPE kits, was admitted to a mental health facility Sunday, a day after he was allegedly manhandled by the police and arrested for creating nuisance in Visakhapatnam.

Dr Sudhakar Rao, a government civil surgeon, was beaten, his hands tied behind his back and dragged by police officers Sunday. During the incident, Sudhakar allegedly verbally abused the Jagan Mohan Reddy government in an inebriated state. Videos of the incident have since been widely shared online.

“The police control room received a call about a person creating nuisance on Beach Road Hospital in Visakhapatnam. The Fourth Town police was rushed there and found that the person was the suspended doctor, Sudhakar.

“When the police tried to control him, he snatched the mobile phone of an officer and threw it away. He is suffering from mental disorder and he was drunk. He was sent for a medical examination,” Vishakapatnam Police Commissioner R.K. Meena told the media Sunday.

Sudhakar was admitted to a mental hospital Sunday after doctors at the King George Hospital in Vishakapatnam said he suffered from anxiety.

“Since the doctor is in anxiety and talking irrelevant things, I have referred him to a mental care hospital in Visakhapatnam,” said Dr Radha Rani, medical superintendent, King George Hospital.

A statement released by the hospital said: “Dr Sudhakar was brought to the KGH casualty ward at 6.30 pm. From the smell, it was found that he was in a drunk condition. Under the influence of alcohol, he did not cooperate with anybody there and kept abusing all. Still, his pulse, BP were checked. Pulse was 98, BP 140/100. Blood samples were sent to forensic lab to ascertain alcohol content in his blood.”

Also read: 6 toilets for 20 houses, inadequate testing: Why Mumbai’s Worli chawls are a Covid hotspot

‘Treatment towards Sudhakar was inhuman’

Sudhakar, who spent more than 10 years at the Narsipatnam Government Hospital in Andhra Pradesh, was suspended from his duties in March after he openly criticised the Reddy government for failing to provide PPE kits and N95 masks to doctors treating Covid-19 patients.

He had alleged that the state government was giving N95 masks and PPE kits meant for doctors to politicians and the police.

A video of Sudhakar criticising the government was also shared widely. In the clip, he can be heard saying: “We are putting our lives at risk here. We are asked to use the same mask for 15 days and a fresh mask will be provided only twice a month.”

Speaking to ThePrint, Dr P. Gangadhar Rao, member of the National COVID Committee of the Indian Medical Association, said the manner in which Sudhakar was manhandled by the police was “inhuman” and “violated” human rights.

“We strongly condemn the way he was taken into custody. He was not carrying a weapon, he was alone, the number of policemen outnumbered him. Why treat him like that? We also saw a video where a policeman beats him with a lathi,” said Dr Gangadhar.

He added that Rao was one of the most experienced anaesthetists the Andhra Pradesh government had.

“Our next step of action is to get Sudhakar to write an unconditional apology for having used filthy language, abusing the chief minister and the government. We will then take our appeal to the CM seeking that he be reinstated,” Gangadhar said.

Also read: Face shields, gowns, masks — the new attire for cabin crew post lockdown

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