Unwillingness to undergo RT-PCR test a challenge, says BMC as TPR shoots up | Mumbai news

Mumbai: With the city continuing to test fewer Covid-19 samples, Brihanmumbai Municipal Corporation (BMC) said that the biggest challenge they are facing is the unwillingness of symptomatic patients to undergo RT PCR tests and overreliance on home testing kits.

Amid a surge in Covid-19 cases, BMC commissioner Iqbal Singh Chahal had earlier instructed ward officers to ramp up testing from 8,000 to 30,000. However, the city has been seeing less than 18,000 tests a day.

In the last 24 hours, the city reported over 2,000 cases, making it the highest single-day spike since the peak of the third wave. While the state added 5,218 new cases, Mumbai logged 2,479 cases on June 23.

On January 23, Mumbai had logged 2,550 Covid-19 cases and 13 fatalities. In the present surge, the city saw 2,366 cases on June 16 with a TPR of 15.11%.

The BMC, however, said that because of a technical snag in the ICMR portal, Covid-19 positive cases were added in the new cases of June 23. The city reported one death of a 42-year-old female with kidney disease. The doubling rate has improved and stood at 390 days.

On June 22, the city saw 8,131 tests with a test positivity rate of 20.20%.

Explaining the reasons behind the drop in testing numbers in Mumbai, Chahal told HT that the state Covid-19 task force asked him to stop asymptomatic testing.

“I have been told by the Covid-19 task force that we should stop testing asymptomatic people. People too are reluctant to test themselves as the line of treatment for both Covid-19 positive and negative patients has been the same so far i.e paracetamol. With hospitalisation percentage being below 2% and deaths being low, citizens are not coming forward for testing,” he said.

As per revised Indian Council of Medical Research (ICMR) guidelines on Covid-19 testing dated January 10, 2022, at the community level, people with cough, fever, sore throat, loss of taste/smell, or other respiratory symptoms should be tested along with their high-risk contacts. It said high-risk contacts are senior citizens and people with comorbidities like diabetes, hypertension, chronic lung or kidney diseases, cancer, obesity etc. The ICMR guideline said asymptomatic contacts of Covid-19 positive patients with no comorbidities are not required to undergo testing.

BMC medical officers said the approach towards Covid-19 testing has changed with rules related to Covid-19 being relaxed. “For example, we earlier did mandatory testing of international passengers. We used to test in crowded places like malls. We no longer do such testing. At the ward levels, we are trying to create awareness among people to do the test if they have symptoms and continue home isolation if the symptoms are not severe. We can no longer force anyone for the test like before,” said a BMC medical officer.

She said while the tests are down as compared to the first three waves, the focus is now on ensuring patients with influenza-like illness (ILI) and severe acute respiratory infections (SARI) symptoms get tested.

“We have asked all private practitioners, hospitals, our dispensaries and hospitals to do RT PCR for people coming with fever, cough, cold and breathlessness,” the medical officer said.

Private laboratories too are seeing a lesser demand for RT PCR. Dr Nilesh Shah, president of Metropolis Healthcare Ltd said while they are seeing a positivity rate of 35-36% in the last few days, the present demand for RT PCR is the same as it was when the cases were low in March-April.

“We aren’t seeing much demand. We are assuming that with home testing kits available, people are preferring it more than RT PCR as they can evade reporting positive results to BMC and avoid home isolation. Also earlier, asymptomatic people too got tested out of fear. It does not happen anymore. There is an overall drop in volumes,” he said.

State Covid-19 task force member Dr Rahul Pandit, however, said that the city’s high test positivity rate (TPR) because of low testing should not be of concern and BMC should concentrate on smart testing.

“At this stage, we need smart testing where only symptomatic patients and their high-risk contacts should be tested. We do not need to test the contacts around the symptomatic patients with no symptoms. As long as genome sequencing is happening and we know the variants and sub-variants in circulation and the disease is milder to asymptomatic, we should not worry about high TPR,” he said.

Dr Vasant Nagvekar, infectious disease expert and state Covid task force member said genomic sequencing holds more gravity epidemiologically. “Many people are doing rapid antigen tests at home. That’s why the number of tests is less. Since the symptomatic patients are lesser than the third wave, we do not have to worry. To understand the strain of the virus, we have to continue the genomic sequencing,” he said.

Dr Subhash Salunkhe, epidemiologist and member of the National task force, said people and government authorities have become lethargic. “The hospitalisation and infection rates are going up and we all should take these developments seriously. We cannot drop our guards saying the disease is mild. People are not following Covid-19 appropriate behaviour. They are not tested even if they have symptoms. These are warning signs that we might be in trouble in the coming days,” he said.

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