Till recently, COVID-19 testing at the community or primary health centre-level in local bodies would take place only once or twice a week and symptomatic persons might have been required to wait to get a test done at a government facility nearby. Now, district health officials have issued an order to conduct testing daily at the panchayat-level.
Daily testing at the local level would begin in about a week, said Mathews Numpeli, district programme manager, National Health Mission.
Symptomatic people were required to report symptoms to the medical officer or health worker at the nearest government health centre, after which they would be given an appointment at a testing facility, said Dr. Numpeli. Walking into a government facility to get tested for COVID-19 on demand was neither allowed nor feasible since it could lead to a further spread of the disease, he added.
A doctor at the Ernakulam General Hospital said over 50 swabs were collected daily at the hospital — from symptomatic patients arriving at the casualty department and outpatient wing, patients being taken in for surgery and people identified as contacts of patients from Divisions 60 to 66 of the Kochi Corporation. The collection facility is manned by the hospital staff. Allowing people to walk in and get themselves tested at the hospital without prior intimation could prove to be unmanageable, the doctor said.
Getting symptomatic people tested had earlier been managed by the district’s COVID-19 control room. But in an attempt to decentralise and hasten the process, local bodies had been asked to inform residents of a local control room or health worker they could contact, said Dr. Numpeli.
Private facilities
People who suspect that they might have contracted the disease from a contact have resorted to private facilities to reassure themselves. After their acquaintance tested positive for SARS-CoV-2, a 39-year-old woman and her 47-year-old husband, residents of Pettah and both asymptomatic, got themselves tested at a private lab, where the woman tested positive. Ten days later, after a repeat test at a government facility, the man tested positive as well. “Since health officials might have asked us to wait 10 days before we get tested, we decided to get tested at a private lab to avoid that intervening period of anxiety,” said the man.
As per protocol, asymptomatic people are no longer tested even if they are high-risk primary contacts. If an asymptomatic person wanted a test done, they could choose a private lab, said District Medical Officer N.K. Kuttappan.
Walk-in kiosks
While the COVID-19 walk-in sample kiosk (WISK) was initially envisaged as a telephone booth-like facility where samples could easily be collected in case of a surge in caseload, problems of infection control could arise if they were set up in public places, said Nikhilesh Menon, nodal officer for COVID lab surveillance. The gloves and tunnel of the kiosk, that allows the health worker to collect the sample from behind a barrier, would have to be disinfected by a worker in PPE after each use. That, in addition to waste management, could be an issue in public spaces, he said.
Consequently, the kiosks have been placed in taluk hospitals, the two General Hospitals in the district, the Government Medical College Hospital, a few community health centres and first-line treatment centres, where they are being put to use to varying degrees.