ET Q&A:
Five months after the Covid-19 pandemic stormed the world, testing strategy continues to be one of the most controversial clinical decisions for countries across the world.
Most countries are facing shortage of molecular testing kits and this is leading to inequitable testing and clinical results. Geneva-based Foundation for Innovative New Diagnostics (FIND), which is part of the WHO collaboration on improving access to Covid-19 diagnostics, believes “targeted testing” is the best strategy in the current situation, its chief access officer Sergio Carmona and India head Sanjay Sarin told Divya Rajagopal in an interview.
There is a tremendous emphasis on ‘test, test, test’. Is this the policy countries should follow?
Carmona: The ‘test, test, test’ policy has a few caveats. We know that demand for tests is high, and hence it is critical to go for targeted testing. It is perhaps a compromise of the best clinical practice, but testing and use of diagnostics are the best possible ways to help healthcare providers change the course of clinical care. So, those who are showing clinical symptoms and are critically ill should be prioritised. In some countries testing has been so scarce that it has been reserved only for healthcare workers and first line responders. The other thing is, molecular tests are not cheap and also have a value in time.What do you think about India’s strategy?Sarin: As of now the government of India continues to focus on testing more and more people as their guidance continues to expand on this. There is also a strong realisation that there are gaps in demand and supply. Despite the fact that there are more Indian companies now supplying the kits, the dependence on imports continues. More than 90% of test kits in India are imported.Can testing give confidence to employees and commuters. What is your view?
Carmona: Testing is good if it educates people. So, it has enormous value for healthcare workers who need to get to work. But testing without symptoms or history of being exposed is also wasteful. So, yes, there is the controversial idea of “immunity passports” where you test to safeguard the travel industry. But if you have a good diagnostic test that gives you assurance that you had been exposed and you are negative, it could have important consequences to the economy.
There is a tremendous emphasis on ‘test, test, test’. Is this the policy countries should follow?
Carmona: The ‘test, test, test’ policy has a few caveats. We know that demand for tests is high, and hence it is critical to go for targeted testing. It is perhaps a compromise of the best clinical practice, but testing and use of diagnostics are the best possible ways to help healthcare providers change the course of clinical care. So, those who are showing clinical symptoms and are critically ill should be prioritised. In some countries testing has been so scarce that it has been reserved only for healthcare workers and first line responders. The other thing is, molecular tests are not cheap and also have a value in time.What do you think about India’s strategy?Sarin: As of now the government of India continues to focus on testing more and more people as their guidance continues to expand on this. There is also a strong realisation that there are gaps in demand and supply. Despite the fact that there are more Indian companies now supplying the kits, the dependence on imports continues. More than 90% of test kits in India are imported.Can testing give confidence to employees and commuters. What is your view?
Carmona: Testing is good if it educates people. So, it has enormous value for healthcare workers who need to get to work. But testing without symptoms or history of being exposed is also wasteful. So, yes, there is the controversial idea of “immunity passports” where you test to safeguard the travel industry. But if you have a good diagnostic test that gives you assurance that you had been exposed and you are negative, it could have important consequences to the economy.
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