Sunil Bansal, a resident of Varanasi, was first tested for Covid-19 on May 17.
His sample returned a positive report on May 28, 11 days later. Since then, he has been in an isolation facility in the Pandeypur area of the city. Another sample of his was taken on June 5, when he was deemed cured. “It’s five days now, but the report hasn’t come. I can’t leave the centre until the report comes,” said Bansal, a pharmacist who was on railway station duty when he tested positive.
The number — there are only 33 laboratories testing for Covid — and concentration (most are in the big cities) of testing facilities in Uttar Pradesh is making people wait for days to know their status.
Experts say this is worrying; they point to another cause for concern — UP has currently tested only 1,740 people per million residents, lower than the national average of 3,797 and far below other states. Maharashtra has done 4,730 tests per million for instance; Tamil Nadu, 8,206; and Rajasthan, 6,860.
To be sure, the state does average of 12,500 tests per day but this is well short of what is needed, the experts said. Uttar Pradesh has a population of 224 million, according to Census of India projections.
State surveillance officer Dr Vikasendu Agrawal said, “UP’s per case testing ratio is better than several other states. The state has reported 11,610 cases till now.”
Bansal’s sample, like all other samples from Varanasi, are tested at Banaras Hindu University (BHU). The same lab also tests samples from Sonbhadra, Mirzapur, Jaunpur, Bhadohi, Ghazipur, Mau, Azamgarh and Ballia districts, which collectively have a population of about 25 million people. The lab can test a maximum of 330 samples in a day.
“Delay in the test report is a double blow. First, an infected person may be moving around. Second, a cured patient’s stay may get prolonged in an isolation centre,” said Sunil Yadav, president of the government pharmacist federation, Uttar Pradesh.
The situation at BRD Medical College in Gorakhpur is similar.
“We test samples for seven districts in Gorakhpur and Basti and have a capacity of about 1,000 tests per day,” said Dr Ganesh Kumar, principal of the college.
The Meerut testing centre, at Lala Lajpat Rai Medical College, tests samples from the adjoining districts of Baghpat, Saharanpur, Shamli, Muzaffarnagar, Bulandshahr, Ghaziabad, Noida, Bijnor and Hapur.
Out of the total 34,000 samples tested this far in the Meerut lab, 16,132 were from Meerut and 17,868 of other districts. On paper, the average time taken for testing samples is 68 hours, a little short of three days.
The lab at Jawaharlal Nehru Medical College (JNMC), Aligarh Muslim University, caters to the districts of Kasganj, Hathras, Etah, Mathura, Badaun and Aligarh.This lab has thus far conducted more than 16,000 tests.
In Agra, a hotspot of the coronavirus disease, the labs are at Sarojini Naidu Medical College and Jalma Institute for Leprosy & Other Mycobacterial Diseases. There are also three private labs. Cases from nearby districts too reach Agra.
Lucknow has seven government labs and the reporting time is between 24 and 36 hours for coronavirus samples. King George’s Medical University lab receives samples from districts also such as Barabanki, Gonda, Bahraich, Hardoi, Sitapur, Unnao, Ayodhya, Farrukhabad, Sambhal, Shahjahanpur, Kannauj and Hathras.
KGMU’s microbiology lab tests around 1200 samples each day.
Despite the delays, the state is better off now than it was a few months back, according to a state health department officer who added that in February, UP sent samples to National Institute of Virology (NIV), Pune and National Centre for Disease Control, Delhi.
It was only later that testing started at labs in KGMU, Lucknow and JLNMC, AMU, Aligarh . From mid- March, testing also started at medical colleges in Meerut, Agra, Prayagraj and Gorakhpur. Now, 22 government laboratories and 11 private laboratories are testing samples in the state. Still, the daily pendency of samples was 9,000, the officer added, asking not to be named.
Seven of Uttar Pradesh’s 22 government labs are in Lucknow. They collectively conduct over 2,000 tests a day.
There are two labs each in Agra and Gorakhpur. The other districts with a lab are: Prayagraj, Jhansi, Aligarh, Noida, Meerut, Saifai (Etawah), Bareilly, Kanpur, Greater Noida, and Varanasi. Eleven other private labs were also allowed to test samples.
“Uneven distribution of labs is a threat as we will fail to know the spread in districts where the lab facility is poor. But as people from there will migrate for work, the infection will spread to other places,” said Dr PK Gupta, former president of the Indian Medical Association (IMA), Lucknow.
Principal secretary, health and medical welfare, Amit Mohan Prasad said the state government is increasing the testing capacity. Testing of samples started in four more hospitals on Wednesday, he added.
“ The state government has decided to set up virology laboratories in all the 75 district hospitals and work on this has started,” he said.
Surveillance officer Agrawal added: “TrueNat Machines have been installed in all 75 districts and will be used for testing samples of suspected coronavirus patients.” These are portable battery operated machines originally meant for the detection of tuberculosis.
UP reported the first coronavirus case on March 2 and till now about four lakh (400,000) samples have been tested till now.
Given the size of the state (UP’s land area is 243,290 square kilometres, if it were a country it would be the 78th largest in terms of land area), it takes time for samples from some districts to reach hospitals.
“One person carrying samples from Azamgarh to Varanasi will take over three hours to reach. And if all samples of the district are to be collected, the delay in samples reaching the lab could be 12 hours, which means the test report can take over 48 hours to reach the patient/doctor,” added Dr Gupta.
“Having one lab for five or seven districts is practically unworkable. Ideally, there should be one lab in each district or at least one lab between two districts,” he added.
UP will have to get innovative with its testing, Dr Gupta said, suggesting antibody tests. “It’s a simple test and can tell the spread of virus authentically.”
Dr RB Singh, former additional director (administration) in the state health department, said, “Uttar Pradesh at present is not aware of where it stands in terms of coronavirus cases. In fact, only aggressive testing can tell this status. Hence, it should be increased swiftly so that we know the accurate number of cases.”