What can you do before test kits ramp up?
#2 : What can District Magistrates do before COVID19 tests ramp up?
Greetings from the India chapter of endcoronavirus.org! We’re assisting Indian administrators in understanding and acting on the COVID-19 situation. Drop us an email on india@endcoronavirus.org to sign up for the Outbreak Control Playbook.
1st April, 2020 : Testing Shortage & Ways Out for Administrators
From what has been happening in other countries, we know that at least 1.2% of India’s total population needs to be tested at least once (requiring 1.5 Cr tests) for us to stand a fighting chance against COVID-19. We also need to perform at least three tests on possible vectors (such as healthcare workers, police forces, and other essential service providers), requiring another 7 crore tests.
Even if we perform 1 Lakh tests a day and implement isolation and quarantine strategies perfectly, it will take us at least another 2.5 years of testing to meet these targets!
You may be aware that this isn't our current testing capacity; it’s not even close. So far, India has only done ~50,000 tests in all.
Now, the availability of test kits is threatened.
Recent developments around the world suggest that we may not be able to acquire or manufacture the much-needed test kits for some time. As the demand for testing grows beyond our national capacity, the availability of timely and accurate results will also be threatened. To prepare you for this in advance, We present you with a few probable scenarios and ways to tackle problems
• There is a backlog for testing and it is no longer possible to turn around results within 24 to 48 hours. This will require the identification and approval of more government and private testing laboratories along with labs at academic and research institutions.
• The demand for laboratory reagents exceeds the capacity for supply. A thorough centralized inventory management system that is capable of identifying reagent shortages and reallocating reagents to approved labs may help us solve this issue.
• Laboratory staff is exhausted and working hours need to be reduced. Training of more lab technicians for carrying out tests and automation of some basic sample processing steps might help in the reduction of fatigue of laboratory staff.
• The number of incoming samples exceeds the capacity for safe pretesting storage. Sample storage can be done at the collection centers and transferred to labs in time for processing. The logistics industry already has multiple Just-in-time algorithms for achieving this.
• Critical staff become infected or are otherwise unable to perform their duties (e.g. being in quarantine). PPEs and effective training are a must. Creating negative pressure environments at sample collection and processing rooms will also help in avoiding infection risk to the lab technicians.
• Laboratory instruments can no longer be serviced or properly maintained. A centralized inventory management system can also help here.
If you are a senior official who can help resolve any of the above-mentioned challenges, this should be your first priority
Our strategy for District Magistrates in India : COVID-19 is a war only Districts can fight.
Measures to take before testing ramps up
There are multiple modes of testing for COVID-19; however the recommended method or gold standard as per WHO is RT-PCR (real-time polymerase chain reaction) method which can currently be done only at certain ICMR approved govt labs or ICMR approved private testing labs.
During a supply shortage of testing, well-informed decisions on where and who to test may help districts better ration the tests.
We have collated as well as devised ad-hoc guidelines for districts to work with based on the level of threat faced (Red / Yellow / Green Zones).
Link : Bridging the Gap: Measures To Contain Outbreak Before Tests Ramp Up
Email us on india@endcoronavirus.org to know your zone.
Email us at india@endcoronavirus.org to sign your district up for the Outbreak Control Playbook.
EndCoronavirus.org (non-profit) is the world’s largest organization to fight COVID-19, with 2000+ scientists, doctors, engineers & analysts, from NECSI / Harvard / MIT / IIT / IIM, monitoring the spread & control of COVID-19 since January. We have published the most effective set of guidelines for governments to fight the pandemic. Our efforts were critical in the US in banning flights from China in Jan & other early outbreak control measures.
Our mission is to end the outbreak in India.
Yaneer Bar-Yam is the president of the New England Complex Systems Institute. Yaneer is an MIT-trained physicist and complexity scientist who studies pandemics. He has warned about global pandemics due to increasing travel for 15 years. He recommended community-based monitoring of symptoms to stop Ebola in West Africa in 2014, and it worked.
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