Experts note the risks in India

NEW DELHI – On New Year’s Eve the Indian government wrote to the states encouraging them to promote the use of home tests on COVID-19, especially for people experiencing symptoms to avoid stressing local health systems.

During last year’s surge caused by the delta, an explosion in cases overcrowded hospitals and test labs. But last month, when new infections caused by the omicron variant rose sharply, the number of people checking themselves at home across India.

In the first 20 days of January, about 200,000 people shared their test results with the Health Agency of India – 66 times more than in the whole of 2021. The strategy seems to have worked. Those who tested positive for rapid, albeit less accurate, tests were ordered to isolate themselves at home, allowing hospital beds to remain accessible to the most vulnerable.

But experts say the figure is probably only a fraction of the actual number of tests used. Despite rules requiring people to share their results with the authorities, many do not. This means that the already ambiguous testing data in the country are even less accurate, and future clusters may go unnoticed.


This is a problem that some Indian states are already noting. In the state of Maharashtra, state health officer Dr. Pradip Vyas recently asked all users to report their results. And because tests do not distinguish between omicron and the more deadly version of the delta, which also continues to spread in India, he warned that there are still vulnerable people who need hospital care.

“Suddenly there may be a strain on our healthcare infrastructure,” he wrote in a letter to authorities last month.

Since January, pharmacists in the state have begun keeping records of those who buy home tests. But this is not the case in most Indian cities.

“If I had to guess, perhaps only 20% of people who use home tests report this,” said Srinat Reddy, president of the Public Health Foundation of India, adding that ideally every result should be reported. test so authorities can track the virus. .

“If you don’t report it, your sample won’t be sent for genomic analysis, and then you can skip tracking clusters and variants,” he said.


In an interview with , several people in the New Delhi capital admitted that they gave a positive result through home tests, but did not share their results with the authorities.

As the highly contagious version of omicron is still spreading across Asia, more and more countries are making a difficult trade-off between accuracy and speed, deploying agile home tests to make sure patients are not flooding hospitals.

This was announced in South Korea on Wednesday free rapid coronavirus test kits will be available in kindergartens, primary schools and senior welfare centers starting next week after an unprecedented wave of omicron infections. Recently, authorities have begun to move away from a strategy of predominantly PCR testing to rapid tests, even though some experts have warned that the latter do not reliably detect early omicron infections. People can buy tests at home in pharmacies and stores or pass tests for free in health departments and stations, where each with a positive result is then PCR tested.


Indian officials are hoping for a centralized database where people download test results via a mobile app. MyLab, the first company approved for the home test on COVID-19, produces 500,000 tests a day. Sales were up tenfold from the previous quarter, said Saurab Gupta, head of strategy at MyLab. India has so far approved eight home tests priced from $ 2 to $ 33.

Despite the greater use of home tests, experts say they are not as accurate as laboratory PCR tests, and are more likely to report false negatives.

Parul Saxena, a housewife in New Delhi, passed a home test last month that failed. But when her body continued to ache and fever, she went for a PCR test, which confirmed what she was feeling all the time – that she was positive for COVID-19.

The Indian Ministry of Health did not respond to questions sent by email.

Another problem is that home tests are inherently harder to set up – which needs to be done as the virus progresses. While the accuracy of both home and lab tests affects the development of the virus, rapid tests may not reveal a new option, said Vinita Ball, who studies the immune system at the Indian Institute of Science Education and Research.


After last year’s catastrophic surge in the delta and a sharp rise in the number of omicron infections starting in 2022, cases in India have stabilized and many cities have reopened restaurants, schools and jobs. India recorded 30,757 new cases and 541 deaths on Thursday, up from a high of 300,000 last month. Experts warn that in India, as elsewhere, there were likely to be no cases even before the advent of home testing.

But some say it is not necessary to report all positive cases to the authorities. Officials can continue to study the spread of the virus through reliable random sampling, said Dr. Jacob John, who studies viruses at the Christian Medical College in Velor, southern India.

Reddy, a health expert, questioned the importance of counting cases at this stage of the pandemic in India.

“Now this will not be a top priority – it is important to make sure that when people are very ill, they have enough medical facilities,” he said.


Ashley St. John, an associate professor at Duke-NUS Medical School in Singapore, agreed that other factors are more important.

“I think our concern that we have very accurate data on positive cases has diminished with the increase in vaccinations,” she said. “We know that many vaccinated people can get a positive result even without developing symptoms or a serious illness. In addition, we have moved on to the recognition that the virus is endemic and cannot be traced in everyone. “


Kim Tong Hyun from Seoul, South Korea, contributed to this report.


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