RAT investigation: the truth of the corona crisis in Delhi?

Since the meeting with Union Home Minister Amit Shah on June 14 with Delhi Chief Minister Arvind Kejriwal and Lieutenant Governor Anil Baijal, there seems to be something unusual with the Covid-19 investigation strategy and infection data in Delhi. The number of investigations in the national capital increased by 27 percent that day and for the first time, more than 7,000 investigations were conducted in a single day. The next day, the city with a population of 1.9 million increased the number of investigations and reported more than 13,000 investigations.

It is the Delhi government that has allowed the use of rapid antigen testing (RAT) for coronaviruses in so-called containment zones for the first time in the country. The kit, used for sample collection, was producing a South Korean company in Haryana outside the city. Each kit contains a Covid-19 antigen detection device, a viral extraction tube with a viral lysis buffer, and a sterile swab. According to Delhi government data, now 40 percent of all tests being conducted in the city are RAT.

Shah's meeting with Kejriwal and the introduction of RAT on a large scale have shown a resounding presence here despite the increasing cases of coronavirus in Delhi. Of the total investigations in the city, the positive rate of Covid 19 i.e. the positive rate of investigation decreased from 37 percent on June 13 to 12.8 percent on June 30. However, the number of daily investigations in Delhi has increased almost three times to more than 20,000. It seems that during this period the number of coronaviruses reported daily in the city has increased by just one-third. In the midst of all this, on June 22, the Delhi High Court asked the Kejriwal government to extend the RAT investigation further. Delhi now plans to conduct a RAT check-in all parts of the National Capital Region in July.

Even though the rate of positive cases in Delhi has declined sharply, but it is still much higher and it was one and a half times the national average on 30th June. Although earlier the rate of positive cases was higher here than in Maharashtra (Mumbai and Pune together more cases are coming daily), but now it seems that in Delhi, per capita investigation is now less positive. is. However, it should be noted that the Maharashtra government did not allow RAT till June 23, through which to report in half an hour to seriously ill patients, pregnant women, or people who already have another disease. May go. Under the RAT it is seen whether the tested person has antigen in the respiratory system and within 30 minutes of the test, it is confirmed whether they are infected with Covid-19 or not. However, the World Health Organization (WHO) has said that in such a rapid screening process, antigens can be detected only when the virus is active ie at the initial stage or if the infection is high. The WHO categorically stated in April that 'such an investigation is possible to detect half or more of Covid-19 infected patients and depends on the group of patients examined'. This means that RAT cannot detect the virus in many cases, even if the person examined is infected and can infect hundreds of others. Even the Indian Council of Medical Research (ICMR) considers reverse transcription-polymerase chain reaction (RT-PCR) to be the best standard for COVID-19 testing. It had earlier said that those whose reports are coming negative in the RAT investigation must be investigated by RT-PCR.

However, RAT investigation is important for India's population as the report is found quickly and the cost is also low. Dr. Sabina Khan of Delhi-based Hamdard Institute of Medical Sciences says, "Our country has a large population and requires skilled technicians for RT-PCR and specialized laboratories for molecular testing." We have previously conducted rapid screening for human immunodeficiency virus (HIV). I see no harm in doing the same for the Covid-19. '

A senior Health Ministry official says, 'You have to think like a policymaker, not just an epidemiologist. If you compare it to RT-PCR then the rapid testing requirement will be slightly less visible. But you cannot do RT-PCR in densely populated areas of India. This investigation will prove to be very expensive in the entire country and we cannot afford it. If our objective is to investigate more people, then the logistics of RT-PCR is also very cumbersome. In such a situation, rapid testing is the only way left. Dr. Jayashree Bhattacharya, former Principal of Vardhman Mahaveer Medical College at Safdarjung Hospital in Delhi, says, “We do rapid tests of people with pregnancy and heart disease. Students have to take exams, people have to go back to work. Rapid tests may give more inaccurate negative reports, but it saves time and money to check for fast-spreading infections in a more populous country.

Business Standard tried to contact Delhi Health Minister Satyendar Jain over the phone but he could not be contacted.

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