COVID-19 | Govt now prefers rapid antigen tests to RT-PCR to contain virus in rural areas

The spread of coronavirus to rural areas has forced the government to radically change its testing strategy, preferring Rapid Antigen Tests (RATs) to the existing practice of RT-PCR tests it has so far insisted on.

RT-PCR tests were so far the ‘gold standard’ for the government to control the spread of the virus. By the end of June, nearly 60 percent of all tests done would be the RATs.

ICMR chief Balram Bhargava on Thursday said India would do 45 lakh tests daily by the end of June in which RATs would account for 27 lakh tests (60 percent) and RT-PCR Tests would account for 18 lakh tests (40 percent).

The spread of coronavirus to rural areas, where RT-PCR testing labs are not available, is the main reason prompting this strategy change. The feedback from the states is that they have started doing RT-PCR tests through mobile vans in rural areas but the reports take 2-3 days to come as the samples have to be shifted to RT-PCR labs situation in bigger towns.

However, RATs can be done in rural areas by a door-to-door exercise and throw up results in an instant, thereby helping in the quick start of the treatment.

On April 8, Prime Minister Narendra Modi had impressed upon chief ministers that at least 70 percent of the tests conducted in the country should be RT-PCR tests. The Centre considers that a more reliable test.

As on May 14, out of a capacity of about 19 lakh daily tests in the country, 12 lakh tests are being done through the RT-PCR mechanism, translating to over 60 percent and RAT’s account for 7 lakh tests. But the government is now changing this strategy while ramping up its testing capacity in the second wave.

The change in the strategy will start reflecting by the end of this month itself with the daily capacity of tests being increased to 25 lakh with the RATs accounting for nearly half the tests at 12 lakh.

The government has also approved home-testing RAT kits of multiple companies that are soon to hit the pharmacy stores and cost just Rs 250– this is also expected to significantly ramp up the RAT testing numbers from June in the urban areas. Up to 4 crore kits from Mylab Discovery solutions, could be available in June.

In the past, the government did not depend much on RAT given their low reliability and has in fact been insisting on the RT-PCR test if a symptomatic person tested negative during the RAT. Uttar Pradesh, for example, has increased its testing capacity in a big way this month through RAT and is now doing the highest number of tests in the country at nearly 2.91 lakh tests daily.

The positivity rate in UP has been sharply falling in May and daily cases reported from the state have dropped from a high of about 38,000 on April 24 to just 6,725 cases on May 20. In Bihar too, there has been high reliance on RAT out of the 1.4 lakh tests done daily in the state. Here too, the daily number of cases has almost halved from 13,900 on May 5 to 6,551 on May 20.