Covid cases turn serious as wait for test reports delays treatment

KOLKATA: The prolonged delay in RT-PCR reports that physicians and hospitals demand before they start treating Covid patients is compromising their condition, leading to late hospitalisation, extended treatment and exacerbating the bed crisis, say doctors.
While patients were reporting to hospitals within four-five days of Covid symptoms that allowed early intervention and prevented the worsening of condition in the first wave, they are doing so after 10-14 days now, when their condition is so compromised that they are in respiratory distress. This is primarily happening due to delay in Covid testing. RT-PCR test is currently mandatory for hospitalization of Covid and non-Covid patients.
Responding to the situation, the health department issued a circular on Thursday evening, asking hospitals to admit emergency patients to dedicated beds for patients with serious acute respiratory infection (SARI) and then undertake a rapid antigen test to check if the patient has Covid. “No patient can be referred without stabilizing and arranging bed in the hospital referred,” the circular stated.
While private diagnostic laboratories said they were stretched beyond capacity, government laboratories like NICED have spare capacity that lies unused. “We can run tests on 4,000 samples in a day. But currently, we are testing less than the capacity,” said NICED director Shanta Dutta. The high throughput COBAS 6800 is testing about 1,200 samples daily on an average, or under a third of the capacity.
Capacities at other government labs are also not being optimally used. SSKM, RG Kar and School of Tropical Medicine are capable of testing around 2,000 samples each but are currently running 1,000 to 1,400 tests daily.
Private labs like Dr Lal-Path Lab and Suraksha Diagnostics, on the other hand, are pushing their capacity to the limit. While the former is doing 3,000-4,500 tests daily, the latter is testing 1,500-2,000 samples daily.
Sodepur resident Vipul Kumar Singh, who could get a booking for swab collection at a private diagnostic centre on Sunday after trying since Friday, was yet to get a report on Thursday, nine days after the onset of fever and almost a week after he was advised to undergo a Covid test. With no let up in his fever, he is desperate for treatment but hospitals refused to admit him without a Covid confirmation report.
There have been instances of deaths of patients waiting for Covid report. “The delay in testing and getting the report is turning mild cases serious and serious cases severe. This is leading to hospitalisation of many patients who could have been treated at home with early intervention. Also, by the time they are landing in hospital, they require critical care and are taking longer to recuperate. This is accentuating the bed crisis,” said a doctor attached with a government Covid facility.
Internal medicine specialist Arindam Biswas said there was no point waiting for the RT-PCR report if the symptoms indicated Covid and doctors needed to start medications to prevent the condition from deteriorating. “Another way is a CT scan as this imaging can find suggestive signs of the infection. Waiting for a Covid report with strong symptoms can be suicidal,” said Biswas.