India has been quick to build capabilities in select areas of diagnostics to help with COVID-19 management. (PTI photo)

By Dr Shravan Subramanyam,

In the past month, I have read some interesting comparisons of epidemics of the past centuries with the current COVID-19 pandemic. The world was not the same a century ago, but some of the practices like ‘social distancing’ – though the word in itself was not coined back then – still hold good several decades or maybe even a century later, notwithstanding all the medical advancements that are being challenged by newer forms of viruses and their ever-evolving manifestations on the human body. If ever there was a time to test all the sophistication that the world had garnered in medical technology, this is the time. However, in India, it is beyond a test of the robustness and resilience of our medical infrastructure and resources. It is a test of our ability to scale up to global technologies to help Indian healthcare manage the lives and livelihoods of 1.3B people.

Protecting lives cannot be delinked from protecting livelihoods in a pandemic situation, given that the past three decades have established that people and product movement are the foundations of economic growth and sustenance. The need of the hour is to take the best the world can offer and employ them to save and enhance the lives and livelihood of people in every country.

India has been quick to build capabilities in select areas of diagnostics to help with COVID-19 management. Within weeks of the global pandemic announcement, we brought in the world’s best of RT-PCR technology for COVID-19 diagnosis. These tests are helping diagnose for the SARS CoV-2 virus when it is active and the infected person is displaying symptoms, thus enabling timely and quality medical intervention. These test results are helping the healthcare establishment put in place precautionary measures to prevent the person from further spreading the virus.

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The next step for an effective testing program is antibody testing, which measures immune response to the novel Corona virus. This, in turn can help plan pandemic management efforts in the future. On this count, bringing in the world’s best CLIA (chemiluminescence immunoassays) technology is paramount as it provides scale, accuracy and efficiency in testing, with high throughput automated instruments. This is now a globally used technology for SARS CoV-2 antibody screening. UK is making such antibody screening tests act of making antibody tests available to its healthcare staff, eligible patients and care residents in England giving them the confidence to be available to fight the COVID-19 situation.

Talking of livelihood and looking closer home, Singapore has commissioned antibody testing for 300,000 migrant workers as part of planning initiatives towards planning for pandemic management. Malaysia is touted to be winning its war rather effectively against COVID-19, with its testing programs. Both these countries with a large expat population are instilling confidence in their people to ensure livelihoods are saved by saving lives.

If such antibody testing are going to be the basis for sero-prevalence studies that feed into our strategy, plans and investment for COVID-19 in the future, it is important that the tests are run on automated platforms that provide for volume testing across India and at the same cost provide us cost and people efficiency, considering the time of healthcare staff including lab colleagues is at a premium in current times. CLIA-based antibody testing provides all these benefits and bring in the advantage of test result accuracy.

Diagnostic solutions are an important tool to decide the clinical intervention required for the person, and facilitates epidemiological studies that are required to plan living in the post COVID-19 world. Here, we are talking of protecting lives and livelihoods because they no longer are de-linked, and India requires no less than the world’s best.

Now that we’ve established the ‘value of diagnostics’ as being equivalent to the ‘power of knowing’ to base our clinical decisions and healthcare planning on, what comes next? The need is to build skills, size and structure to make Indian Healthcare robust to manage not just routine needs of a 1.3B people but also allow scaling up to meet extraordinary situations like in the current COVID-19 pandemic.

The 3S role of building the future healthcare of India is already a Government focus in its economic and industrial planning across sectors. In as far as the first ‘S’ goes, skill-building in healthcare especially on the latest diagnostic technologies is integral to making Indian healthcare make economic sense. India’s contribution to world healthcare in the nursing and medical talent space is indisputable. With our inherent strengths in technology skills, building a talent pool for advanced medical technologies is key to protecting the lives of people and enhancing livelihoods for the young.

The second ‘S’, size, is known to most of us as capacity. This is the access question that almost every healthcare organization in the Government and private sector have been working towards finding an answer to. In a country that spans several thousand miles any direction you measure it, building scale and capacity is an important factor that would test the efficacy of our future healthcare system.

The third ‘S’ is all about structure or infrastructure. Dedicated infrastructure for specialized testing and healthcare intervention and others for routine care could be possibly be a way to optimize spending and use of such infrastructure. For example, a molecular centre of excellence in specific pockets could serve the need for advanced infectious disease testing for their respective neighbourhood districts. In the COVID-19 kind of pandemic situation, they become ready infrastructure for scale-up to newer tests.

While almost every single business entity is planning its lockdown and post-COVID 19 strategy, I am keen to see the various parts of the Indian healthcare system in the Government and private sector come together to establish such systems that can protect our people’s lives and simultaneously trigger economic progress. In uncertain times like the one we find ourselves in, this could be our ticket to recovery.

(The author is Treasurer of NATHealth and Managing Director, Roche Diagnostics India. Views expressed in this are personal.)