Test and treat

Most Covid-19 epicentre states have shown signs of retreat or plateauing of the second wave of coronavirus pandemic. However, the Northeastern states are showing a clear spike in Covid-19 cases. These figures have shown a big leap especially in Assam where assembly elections and Bihu celebrations were held. Political interests certainly proved costly in terms of human lives lost and thousands suffering. Meghalaya used to have low record of new cases in a day till end of 2020. However, cases continued to rise. What the government of Meghalaya eventually did was to launch a series of compulsory testing. Today Meghalaya ranks among the second highest after Assam in terms of new covid cases in a day. On May 21, for instance, Meghalaya recorded a single day spike of over 800 new covid cases and the numbers are rising. Assam with over 6000 new cases on the same day, leads the entire region. Manipur with over 606 new cases; Sikkim with 317 new cases; Mizoram with 284 new cases and Arunachal Pradesh with 394 new cases on the same day – are indicative of the need for more wider testing. Nagaland recorded 309 new cases on the same day while Tripura surprisingly recorded only a little over 400 for a hugely densely populated state. As per the studies, nationally for every one case recorded as positive, five have been missed. Reports said these are clearly indicative of either faulty swab sample collection by ill trained staff or wrong timing of testing swab samples. In states where testing is almost compulsory the numbers have shown increase. This can be seen in states like Meghalaya, Mizoram, Assam, Manipur etc. To achieve faster result ICMR has insisted that covid tests should not be on RT-PCR tests solely but instead on Rapid Antigen Tests (RAT), which will help in surveillance and in breaking the chain of transmission.Antigen tests detect viral proteins in patients at the peak of the infection. They are not considered to be as accurate as the RT-PCR tests. When using antigen tests, a significant number of people infected with the virus show up as negative, which could result in the authorities missing many infections. RT-PCR tests detect the presence of viral RNA and is rated to be very accurate as it is able to detect a COVID infection even before the person becomes infectious, which helps to prevent virus transmission to other people. RAT is not per se inaccurate provided the latest technology is adopted. ICMR’s own tests show just 50-60% accuracy, which means 40 to 50 of every 100 infections are being missed. This is because India continues to use the older model instead of adopting to newer antigen technologies which are faster and accurate.Western countries, especially the US, have adopted new generation antigen technologies like Abbot’s rapid Panbio antigen tests. A nasal swab is inserted into a small, portable device, and a visual result is provided within about 15 minutes, similar to a home pregnancy test. Installation of more COVID beds is only one solution whereas the main challenge is to test more so that infected persons who were untested , do not suddenly appear in hospitals when it becomes too late.More people are dying of low oxygen saturation that suddenly overwhelm especially the young.