Twelve private healthcare laboratories have so far been authorised by the Indian Council of Medical Research (ICMR) to test for COVID-19, and it is expected that the list will be expanded. However, the laboratories’ resources have been stretched to the limit with increasing number of test requests.
Some of these labs say that they have been overwhelmed by the number of requests for home collection of samples, given constraints of both staff and testing kits, and concerns over safety.
Thyrocare, Metropolis (both Mumbai), Dr Lal PathLabs (Delhi), SRL Diagnostics (Gurugram, Mumbai), Apollo Hospitals (Chennai), Strand Life Science (Gurugram), CMC (Vellore), Unipath Speciality (Gujarat), Neuberg (Bengaluru), and Sir HN Reliance Foundation (Mumbai) are among those on the ICMR list, where one can test for COVID-19.
But there is a condition for testing.
It can be undertaken only if the patient has a prescription from a doctor who certifies that the patient meets the criteria for testing. All major labs have said that this rule will be enforced and that no testing will be undertaken without a prescription.
While private testing will help assess factors such as community spread of COVID-19, the diagnostic firms are facing challenges. Two of the most common challenges are logistics and safety of staff.
Thyrocare’s A Velumani said staff attendance at office is down to 20. Thyrocare has, in fact, had to close down its wellness testing in order to concentrate resources on COVID-19 testing.
Then there is the safety issue as well. A Mumbai-based lab said that out of the 20-25 technicians specifically trained for swab collections (the type of test needed for COVID-19), only a handful have agreed to undertake home collection of samples, and that too at a steep 50 percent revenue share basis.
Similarly, in the same lab around 8-10 versus a normal capacity of over 20 staff have agreed to test COVID-19 samples, but only with a 50 percent hike in salary. Despite protective gear and required safety protocols in place, the rest of the staff don’t believe COVID-19 testing is worth the risk, says an industry official.
That is not the case everywhere though. The head of another lab said that 90 percent of their network of over 150 labs are open with skeletal staff on a rotation basis.
Metropolis’ Almira Shah told CNBC-TV18 that her lab is exploring options such as opening COVID-19 dedicated centres for potential patients and also a possible drive-through system where the swab can be collected from the potential patient while in the car thereby minimising contact. Besides safety, the other key challenge is logistics.
Dr Lal PathLabs CEO OP Manchanda agreed that safety of employees due to potential exposure via home collections is a major challenge.
Manchanda points out there are challenges to keep operations running mainly due to the difficulty in commute, with major cities under lockdown. Shah, in fact, pointed to a graver example of how some private lab staff were roughed up by cops in Mumbai on their way to work, despite identity indicating they are a part of essential services, which have been exempted from curfew.
The other issues being faced by private labs include pricing as well as procurement of kits. Currently, heads of companies manufacturing kits point out that there is a global shortage of supplies due to high demand for COVID-19 tests.
While the numbers vary from company to company, the head of a diagnostic company said that about 200-300 kits are available with private labs on an average. They however expect it increase in the coming days as more testing kits get approved by the National Institute of Virology, Pune.
Pricing on the other hand is just break even at Rs 4,500 that the government has capped for COVID-19 testing. However, industry heads are quick to point out that it is a public health challenge and pricing is not the priority.
But, in a scenario where preventive wellness testing is almost nil with normal business down sharply, they cannot afford to provide tests for free. Shah in fact says they would encourage donations from companies and high-net-worth individual (HNIs) to provide free COVID-19 testing for patients who cannot afford it.
The next few days however will be crucial for the private diagnostic industry to determine the current situation. Questions on the volume of tests one can undertake, the challenges technicians face in home collections and the rate of procurement of test kits are just few of the imponderables.