Varanasi/Lucknow: Saurabh Kumar Singh, 28, a Varanasi-based lab technician under the National Health Mission, is nervous. He has just recovered from Covid-19 and is now set to get back to work. On the day he got sick, 6 April, he collected 50 home samples from the city. This, when, according to Singh, people were reluctant to get tested.
“But now my colleagues tell me every day that they (people) want to desperately get tested,” he said, adding that many of his colleagues around the state had tested positive for Covid-19.
Another technician who works with SRL, a chain of private labs, said he is exhausted. “Some of the patients are critical. Many of them got into this condition within hours of handing over their samples. Their reports come back after many days of waiting.”
In the one-week period from 21 to 27 April, Uttar Pradesh, one of the 10 worst Covid-hit states, recorded an average of 34,813 cases daily, according to data sourced from the Covid19India.org dashboard. Its positivity rate in the period was 16.7 per cent on average.
According to the state government, it is conducting 2.25 lakh-2.35 lakh tests every day, but Uttar Pradesh’s testing/million rate lags below the national average.
Furthermore, the situation in its two of the districts with the highest number of active cases — Varanasi, which hosts PM Modi’s Lok Sabha constituency, and Lucknow, home to the state capital — betrays utter chaos.
There is a rush to be tested and the state infrastructure appears to be struggling to keep up. It can take days to get tested, and another few days for the results to come back.
The positivity rate in Varanasi on 27 April was over 40 per cent, as compared to the national average of 21 per cent. It was above 30 per cent for all but one day (25 per cent on 23 April) in the preceding week, surpassing 50 per cent on 25 April.
Lucknow, meanwhile, hasn’t released any testing numbers at all since 12 April, with the authorities attributing this to a Covid outbreak in the chief medical officer’s (CMO’s) office.
In both Varanasi and Lucknow, some private labs have alleged that they have been asked to go slow on testing, while also claiming a shortage of kits.
Speaking to ThePrint, Varanasi CMO Dr S.S. Kannojiya denied allegations that private labs were told to slow down testing but acknowledged that they are struggling to keep up with the demand for tests.
ThePrint reached Lucknow CMO Dr Sanjay Bhatnagar for a comment but the calls went unanswered. The staff of Lucknow District Magistrate Abhishek Prakash said he was busy in a meeting and wouldn’t be able to talk.
On 28 April, UP Cabinet minister and government spokesperson Sidharth Nath Singh told ThePrint that efforts are under way to boost testing in the state.
“There is inadequate resource in rural areas but we are ramping up our testing infrastructure. We have already placed orders for 40 RT-PCR machines. They will come by 10 May,” he said.
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Situation in Varanasi
In an interview to ThePrint last week, UP Health Minister Jai Pratap Singh had said the state is, on an average, conducting anywhere between 2,25,000 and 2,35,000 tests every day, of which 45 per cent are RT-PCR.
According to the health department data accessed by ThePrint, RT-PCR tests — considered more accurate than the quicker rapid antigen tests (RAT) — formed over 60 per cent of the total tests performed between 21 and 27 April.
While 3,241 RT-PCR tests were conducted on 20 April, there were 4,516 such tests on 21 April, 3,782 on 22 April, 3,690 on 23 April, 3,860 on 24 April, 2,323 on 25 April, 3,067 on 26 April, and 2,817 on 27 April. Meanwhile, 2,202 RATs were conducted on 21 April, 1,711 on 22 April, 2,162 on 23 April, 1,803 on 24 April, 1,493 on 25 April, 1,522 on 26 April, and 1,479 on 27 April.
The number of cases detected on these dates were 1,637 on 20 April, 2,562 on 21 April, 1,815 on 22 April, 1,485 on 23 April, 2,796 on 24 April, 2,057 on 25 April, 1,840 on 26 April, and 1,752 on 27 April.
The government testing labs in the district include facilities at Banaras Hindu University (BHU), ESIC, SSPG, along with community healthcare centres and primary healthcare centres in rural blocks. Apart from this, the administration has installed testing booths at railway stations and the airport, among other places.
Private facilities in the district include labs such as Heritage, Meridian Hospital, Oncquest, Apex, SRL and Lal Path. Of these, only Lal Path Labs has been allowed to collect samples from home. In the 11-day period between 17 and 27 April, none of the private labs except Lal Path Labs and SRL conducted any Covid test, according to district health data accessed by ThePrint. Even SRL collected 108 samples from home on only one day, 24 April.
Of the 30 centres Dr Lal has in the city, only seven are authorised to collect samples from home.
An official associated with the lab told ThePrint on the condition of anonymity that there “is a shortage of testing kits and furthermore, we are discouraged by the administration from conducting more tests”.
“So, we cannot conduct Covid tests aggressively as of now,” the official said.
Officials in the state health department acknowledged a shortage of testing kits. “Right now, we have a shortage of testing kits and maximum lab technicians are Covid positive. We don’t have enough resources too,” an official said, requesting anonymity.
However, Varanasi CMO Dr S.S. Kannojiya denied the allegation that the administration has discouraged private labs. “We have a shortage of testing facilities, but we are working to bolster our capacity,” he said.
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Struggle in Lucknow as well
Home sample collection for Covid appears to be rare in Lucknow too.
In mid-April, the district administration released a list of 24 private labs in Lucknow where testing can be done. ThePrint tried to contact all the labs. Sixteen did not pick up the call. Eight picked up, but said they cannot send anyone to collect samples from home.
Vinay Mishra, a manager at Park Diagnostic Centre, a private facility, said, “We are conducting RT-PCR tests in our labs but not sending staff to anyone’s house for testing. The reason behind this is that we do not want our staff to get infected in any way. We have a staff of 15 members. Some of their family members are already suffering from coronavirus, so we cannot take a risk and send them to the field.”
Noor Alam, executive manager at New Lucknow Diagnostic Centre, said they sent staff for home collection earlier but are “doing it less now because we need staff at our labs”.
“We have limited resources, so working according to it,” he added.
Both labs said they conduct between 80 and 150 tests a day.
An executive at a lab based in Lucknow said private facilities had stopped tests in the second and third weeks of April on the order of the administration.
“Maybe they will not accept this in the media but that’s true. Now, after the pressure of public & social media, they have ordered private labs to restart testing but private labs do not have so much capacity and kits to do more tests,” the executive added.
At the three government-supported pathology labs — KGMU, SGPGIMS and RMLIMS — reports are taking 3-5 days to come. A source in the health department said: “The three government-supported labs together conduct over 25,000 RT-PCR tests per day but since the number of samples collected daily is over 30,000, there is a huge backlog which causes delay.”
The impact of this on the ground is residents left struggling to get tested.
Babita Singh, a resident of the Para area of Lucknow, said she faced a hard time getting tested after she developed fever and body pain.
“I searched for a Covid testing service for home (collection) but did not get any response. After this, I went to Ram Manohar Lohia Hospital where tests were going on, but there was a huge queue for testing, so I returned home,” she added.
“Visuals of these queues are scarier. After two days, somehow, I managed to get a test done in a private hospital but it took 48 hours to give the RT-PCR result.”
Government rules stipulate that RT-PCR results be ideally given within 24 hours, and latest within 48 hours.
Asha Tiwari, a resident of Sarojini Nagar who tested Covid positive along with her family, said “government hospitals are taking 48-72 hrs to give RT-PCR test results”.
“One more risk we faced is that there were long queues at the government hospital in Lucknow that we visited, but at that time, there were no private labs conducting tests in our area,” she added. “So we use one source, who helped us get tested in a government hospital.”
Lucknow last released test figures on 12 April (29,492), when the district reported 3,874 cases. It recorded 3,759 cases on 28 April, 4,435 on 27 April, and 4,615 on 26 April.
‘Testing should increase’
Testing is key to checking the spread of Covid-19 as it helps identify and isolate infected individuals. The mantra of “test, track, treat” was part of PM Modi’s message to chief ministers in an interaction on 8 April.
In September 2020, the US government’s National Institutes of Health wrote, “Since it is recognized that nearly half of all SARS-CoV-2 infections are transmitted by people who are not showing any symptoms, identifying infected individuals while they are presymptomatic, as well as those who are asymptomatic, will play a major role in stopping the pandemic.”
Dr A.K. Shukla, former CMO in the UP government, said a daily testing rate of 80-100 samples for private labs is very less. “Testing should increase not only in data but in reality also. Ground reports are very much necessary. Private labs should increase testing. 80-100 samples are very less.”
Inputs from Moushumi Das Gupta
(Edited by Sunanda Ranjan)
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Lethargic attitude is the root of this situation.