India can fight COVID-19, but only if the private sector is allowed to step in quickly – ThePrint

Posted: March 10, 2020 at 9:41 am

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Last week, the global number of confirmed cases of novel coronavirus or COVID-19 crossed 110,000 in over 100 countries, with a significant number of new cases emerging in South Korea, Iran and Europe. Concern over the extent of the pandemic has already affected both the worlds financial markets as well as the economy. Although India has been relatively less affected so far with only 43 confirmed cases as of 9 March it is too early in the international disease cycle to relax. China managed to contain the spread by enacting a cordon sanitaire around lakhs of people, using authoritarian measures that might be hard to implement elsewhere in the world. So, the global outbreak could get a lot worse, and if it does, we will certainly be affected.

That is why Indiaand the Narendra Modi governmentmust take a national approach tomanagethe risks of a COVID-19 epidemic in India. Such an approach would not only pull together all government departments and institutions, but also involve the private sector and civil society. (Disclosure: A member of my immediate family works for a private genetic testing firm.)

It is important to say this because thus far, the task of addressing theCOVID-19 has been delegated exclusively to the government. Almost all activities, from airlifting Indian nationals, screening arrivals at airports, testing samples, quarantining and treatment are carried out by the government. While this will be effective if the number of cases remainsinthe current order of magnitude, the governments facilities alone will not be sufficient if the number of cases rises 100timesor more.

The good news is that India has a private healthcare sector and R&D capability that can be used in the fight. The bad news is that were not letting them.

If weevenhave a fewlakh suspectedcases, the governments resources will fall short of what is required. The right time to think about the capacity required to handle such a massive crisis is now. The single most important thing for India to have a national response as opposed to a government response is to enable the private healthcare ecosystem to play an appropriate role to complement the governments efforts wherever possible.

Also read: Improve surveillance, screen pneumonia cases how experts want India to fight coronavirus

One of the most critical areas where private capability should be harnessed is in screening and testing. The greater our success in detectingCOVID-19 cases early, the greater our ability to contain the outbreak. Faster testing means fewer people in unnecessary quarantine, lower load on hospitals and faster contact tracing.

Currently, there are52governmentlaboratoriesin ICMRs Virus Research & Diagnostic Laboratories (VRDLs) that are equipped to carry outCOVID-19tests. Another 57 VRDL network labs are authorised to collect samples through state government health authorities. All of these operate under the aegis of the National Institute of Virology (NIV), Pune. As of6March, a total of 4058 samples from 3404 individuals have been tested by the network. The ICMR-NIV-VRDL network has the capacity to handle perhaps a 10X increase in the number of samples and is bound to have procured test kits to handle such a load.

Currently,private laboratories are not permitted to test forCOVID-19. In anticipation of a greater surge, theModigovernment must enable the most reliable private players to conduct suchtests as well. There are 53 private laboratories in India accredited by the College of American Pathologists (CAP) and hundreds more by the National Accreditation Board for Testing and Calibration Laboratories (NABL). Some of Indias best private laboratories can be carefully selected by the respective state governmentsbased on their technical capabilities, biosafety levels, quality standards and track records.

We can double the number of test facilities in a few precious weeks, and increase it even more over a longer period. Many private laboratories already offer commercial testing for other viral diseases, so with incremental effort,they can test forCOVID-19 too. This will also create incentives for private Indian companies with R&D capabilities to consider developing test kits for COVID-19,which currentlyhave to be imported from China and Europe. It is in Indias strategic interest to be able to develop probes, reagents and test kits for the current and future viral epidemics.

Also read: With centre-state political standoff, can coronavirus outbreak be effectively fought?

In addition to mandating standards and safety levels, ICMR must insist on compulsory and real-time reporting of samples and test results so that the government authorities have a single database to workwith. There should be no expectation of government funding or subsidy, just as there is no case forthegovernment to intervene in the pricing of these tests.

As the number of cases crossed 400 last week, the United States not only permitted private laboratories to performCOVID-19 tests, but alsochanged policyto enable laboratories to use tests they develop faster in order to achieve more rapid testing capacity in the United States. Canada has distinguished itself byanopen approach decentralising and opening up testing from the very outset. These are prudent and responsible responses to a feared escalation ofapublic health emergency. India with greater vulnerabilities and weaker public health systems should take a similar approach.

The author is the director of the Takshashila Institution, an independent centre for research and education in public policy. Views are personal

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