Testing a challenge in remote rural areas
Sixty-one-year-old Velumani A is working round-the-clock with his staff to facilitate clinical testing, the demand for which is likely to increase due to the Covid-19 outbreak.
But people are refusing testing, he says, because of the stigma attached to being infected with the virus.
Thyrocare’s phlebotomists (people trained to draw blood from a patient) arrived at a plus five-star hotel in Mumbai on March 25 to pick up throat and nose swabs of up to 2,000 quarantined international passengers, but most refused to be tested, Velumani, Founder and Managing Director of Thyrocare, told BusinessLine.
“On March 25, when news channels flashed the lab’s WhatsApp numbers for testing inquiries, our customer service representatives were flooded with 60 WhatsApp messages per second. I asked them to pass the screen shots on to executives, who called back at least 3,000 persons in one day and counselled them on the need for testing,” he said.
Rural population in lockdown
Thyrocare is currently testing in Mumbai, and Municipal Corporation of Greater Mumbai (MCGM) had asked the lab to collect samples from close to 2,000 persons who are currently quarantined in five-star hotels around the city airport. “Because all hotels are out of business, the civic body is asking them to accommodate international passengers who have just arrived. Even after they finish a fortnight of quarantine, where will they go, they cannot travel because of lockdown restrictions,” he said.
MCGM is not paying for testing samples, though, said Velumani. The Central government has capped testing at ₹4,500 per sample.
Most refused to be tested as an ambulance and persons wearing hazmat (hazardous material) suits would attract neighbours’ attention. “We could ultimately collect nasal and throat swabs from only three international passengers on the first day,” he added.
Most labs are concentrated in metropolitan cities. His foremost worry is that as private labs commence testing, the rural population under the current 21-day lockdown is out of reach.
“Before putting a plan in place on how to test in remote rural areas, the government announced a lockdown. Migrant workers from Mumbai, Bengaluru, Delhi and so on have gone to far-flung villages of Uttar Pradesh, Bihar and Odisha only last week. Some of them will act as asymptomatic carriers of the virus and aid in spreading it,” said Velumani.
Velumani said that Thyrocare has personal protective equipment (PPE) to last for only the next four days as transport movements have been restricted. “PPE requirement is growing by ten times the number infected in the country. While supply is little, demand is high, and a PPE package that costs ₹400 is now three times the price at ₹1,200. Our supply comes from Bengaluru, and vendors are now asking for payments in advance. We are struggling with logistics,” he said.
Also, because the company has always followed a business model of picking up samples from doorstep, Thyrocare’s phlebotomists are present in 4,000 to 5,000 talukas or blocks across India. But, Velumani says, the challenge lies in training them for throat swab collection. Also, it is unethical to collect blood samples and throat swabs in the same collection centre. So infrastructure will need to be ramped up to make separate collection facilities.
“The ratio of blood to throat swab collection up till now was 1000:1. Throat swabs are only collected in case of respiratory disorders in hospital set-ups. We have never seen a condition as infectious as Covid-19 before. So, my technicians are very scared to pick up samples without adequate PPE. We trained 25 technicians in a day and are scaling it up everyday,” he said.
Thyrocare was in the black in the latest quarter, and Velumani says that all corporates will have to weather the Covid-19 storm for the upcoming eight quarters. “With up to 40 per cent profit, we are placed luxuriously at the moment, let us see what the future holds,” he said.
What patients must do
Before making a bee line for the lab, patients, if they develop mild symptoms, must quarantine themselves at home, and if their symptoms get severe must admit themselves and be put on ventilator to overcome the issue. He warned against in-house doctors of some private labs recommending Covid-19 tests to unsuspecting people to make money.