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Why India has not started using rapid test kits and the efficacy of HCQ & BCG vaccine

In episode 445 of #CutTheClutter, Shekhar Gupta draws from an interview with Dr Raman R. Gangakhedkar, head of epidemiology at ICMR, and examines various issues related to Covid-19.

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New Delhi: Dr Raman R. Gangakhedkar, head of epidemiology at Indian Council of Medical Research, recently gave an interview to ThePrint’s National and Strategic Affairs Editor Jyoti Malhotra and addressed various issues on Covid-19.

The first question he addressed was on rapid test kits, which India hasn’t started using yet. He says these are first generation ELISA tests and are based on detecting antibodies. ELISA tests are used for HIV & Hepatitis B. Rapid antibody kits test for both IgG (Immunoglobulin G) & IgM (Immunoglobulin M) antibodies. However, Dr Gangakhedkar explained that since an IgM antibody is larger is size, it overshadows the IgG antibody. This makes it difficult to find IgG. He said this creates problems in diagnosis and even the US FDA doesn’t recommended rapid tests for diagnosis.

He then came to the question of whether India is testing enough or not. He said no country can test everybody and India has done well on testing. He explained that India has tested more than 2.5 lakh samples for Covid-19 while the US has tested 16 lakh. The Covid-19 has hit the US far more than India and the US economy is much bigger than the Indian economy.


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


Does hydroxychloroquine really work? 

Hydroxychloroquine is perhaps the most political drug in the world. US President Donald Trump had recently called Prime Minister of India Narendra Modi over India’s ban on hydroxychloroquine’s export, which Modi then partially lifted on 6 April.

Dr Gangakhedkar explained that no drug can kill a virus directly and hydroxychloroquine is certainly not doing that. According to him, it is possible that hydroxychloroquine could work as an immunomodulator and that is why it seems to be helping in some cases. Immunomodulators modify the immune system in such a way that the body is able to fight a virus.

Gangakhedkar said that based on evidence — medical personnel and suspected cases of Covid-19 are given hydroxychloroquine as a prophylactic. This will in some way be a trial of the drug.


Also read: Inform public not to use HCQ and azithromycin without prescription, Modi govt tells states


What explains the BCG vaccination effect? 

A correlation between BCG vaccination program of a country and Covid-19 infections of that country has been reported. It seems like BCG is helping against Covid-19. Dr Ganghakhedkar argued that although the correlation is strong, it cannot be taken as a causation. This means some other factor may be present, which is linked to BCG vaccination program and Covid-19 infections. He said countries with BCG vaccination program may have less people travelling overseas.

He also argued that India has done well in dealing with the pandemic and it may be because of the lessons that we have learnt so far from China and other countries. Social distancing, contact tracing, isolation and travel restrictions are what India has learnt from other countries.

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1 COMMENT

  1. Wonderful article .. Thanks.. Hav eshared it in India today and Times of India comments section
    rapid antibody tests are not teh be all and end all .

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