'High cost of RT-PCR machines a hurdle to ramping up tests'

New Delhi: Amid mounting pressure from experts and the Delhi High Court for the Delhi government to ramp up testing through RT-PCR for COVID-19, officials said on Thursday that the high cost of procuring RT-PCR machines might prove to be a hurdle in implementing the high court's suggestions.

The Delhi High Court on Wednesday suggested that the Delhi government increase the RT-PCR testing capacity to the maximum possible to detect COVID-19 infections, as Rapid Antigen Tests (RATs) were only 60 per cent accurate.

The high court asked an expert committee, set up by the Lieutenant Governor (LG), to convene a meeting on a priority basis to consider the extent to which capacity of testing by RT-PCR should be ramped up.

The bench also noted that in the week from September 8-15, the testing done through RT-PCR was less than one-fourth of the total number of tests and the rest was done by the RAT process. The RAT process is considered less accurate as compared to RT-PCR due to its high false-negative rate. An RT-PCR machine costs Rs 15-20 lakh, officials said.

A senior Delhi government official said, "We will need more RT-PCR machines to ramp up testing. These machines are quite expensive. It is not possible to make this kind of investment at this stage. The government can try, but it is already reeling under a shortage of funds."

Another official from the city's north district said they have already issued directions to the staff to conduct more RT-PCR tests.

The official said they are following all the guidelines with respect to conducting tests by testing all symptomatic patients, who test negative on rapid antigen, by retesting them using the RT-PCR method.

"We will ask the staffers to follow all the norms and we might start testing mildly symptomatic patients using the RT-PCR method," the official added.

At present, the sanctioned strength of conducting RT-PCR is 14,000 per day in Delhi.

The high court had also expressed concern over the continuous rise in COVID-19 cases, with nearly 4,500 new infections reported on Tuesday.

Nutan Mundeja, the head of the Directorate General of Health Services, said, "The court has ordered to do it. We will abide by its directions. We could ramp up the testing with the help of rapid antigen tests, as it is a point of care testing and the logistics is simpler."

Asked if RT-PCR machines being used for conducting other molecular tests can be diverted for COVID-19 testing, Mundeja said, "We have already diverted CB-NAAT machines meant for detecting tuberculosis. Every disease is equally important. And, other diseases are curable compared to COVID-19."

"If CB-NAAT is being used for tuberculosis diagnosis, ethically and professionally it should be used for TB rather than COVID-19 because TB is curable," she said. "We will examine it (ramping up RT-PCR testing) and see what best we can do," she said.

While CBNAAT and TrueNat machines test fewer samples in a cycle, the tests are faster than a traditional RT-PCR test and can be used by hospitals' emergency departments.

"We have been following the ICMR guidelines. RT-PCR tests are being conducted on those having symptoms. These tests are not prescribed for asymptomatic cases," Mundeja said.

with inputs from agencies