The involvement of the private sector in screening and treating patients with suspected and confirmed cases of Covid-19, respectively, is expected to substantially help India in flattening the growing curve of active coronavirus cases.

Nilesh Shah, group president of Metropolis Healthcare—a Mumbai-based diagnostic chain—says that with the private sector now roped in, India’s healthcare system can reach a significantly larger section of the population by taking testing services to the doorstep.

In an interview with Fortune India, Shah said that though there is still a shortage of testing kits and personal protective equipment (PPE) for healthcare workers, the availability has improved compared to earlier. Edited excerpts:

Why did it take this long for the private sector to get involved in testing for Covid-19?

There was an early realisation that the private sector needs to be involved in the testing and treatment for coronavirus. It took a bit of time for the ICMR (Indian Council of Medical Research) to put the guidelines in place since ensuring high quality of testing is very important. A single false negative test can impact a lot of people, as was the case in South Korea. So the ICMR wanted to be completely sure that whatever testing kits the private labs use are of the highest quality and the labs they approve are good quality ones.

And then it also came to figuring out the commercial aspect as well. The government is very clear that the situation shouldn’t be misused as a money-making opportunity and the pricing of the tests (fixed at ₹4,500) should be such that it is just enough to cover costs.

There was also an issue of shortage of raw materials like PPE and testing kits. It took some time for all these pieces to come together. I don’t think there was any intentional delay on the part of the ICMR or the government. They have been swiftly reacting to the situation and have been very cooperative and supportive.

Nilesh Shah
Nilesh Shah
Image : Group president, Metropolis Healthcare

How did you overcome the shortage of materials needed for testing?

There were one or two international companies that had won approval for supplying the testing kits and PPE. But since international flights aren’t landing in India, that material isn’t coming. So we are relying entirely on Indian manufacturers. As far as the testing kits are concerned, they are all Indian. As far as the testing equipment is concerned, it is also imported as there are no Indian makers of these products. But there is some stock available in the country and we are able to manage the situation.

We had some machines that we have bee using as of March 26. Last night we received another five machines, which were installed overnight. We have ordered for 20 more, out of which seven are already in stock and should come in the next three-four days. A single machine can generate 200-300 tests a day. So machines aren’t that much of an issue. The bigger issue is of raw material—essentially the testing kits.

Could you quantify how the country’s capacity to test for Covid-19 would increase as the involvement of the private sector is ramped up?

South Korea could reach a capacity of 80,000 tests a day after the private sector got involved. From what I hear, we are now up to 10,000 tests a day. Currently we are dependent on only one Pune-based vendor (Mylab) for the testing kits. That company is now ramping up capacity and [have] said they will be able to make 50,000 kits a day by next week. So that should take up the country’s testing capacity to at least 50,000 tests a day.

There are quite a few other companies that have expressed their readiness to manufacture the kits. But they will have to go through a process of being approved by the ICMR to ensure that the kits are absolutely high quality, since we don’t want to end up with any false negative cases.

When the testing was being done only by the public sector, people had to walk in to the hospitals to get tested. Many didn’t want to do that for fear of contracting an infection, even if they didn’t have it. This would have also led to some amount of crowding at the hospitals. Now, we can test people who are in home quarantine and can also support patients who are admitted to private hospitals with Covid-19 symptoms.

What is Metropolis’ testing capacity at present?

We started testing around three days back and have done around 700 tests. By the end of the day today we will be at 800 tests. We have started collecting samples in Mumbai and Pune as of now and the tests are being done at our lab in Mumbai. But from Monday (March 30) we will start services in another 60-70 cities. We will also be conducting tests in Pune and Chennai in the next 15 days. We have the capacity there already but need to wait for regulatory approval. Right now we are collecting samples from people’s homes. Eventually, we will prepare around 700 of our collection centres to receive samples from people who walk in as well.

How are you training your staff to handle Covid-19 samples and test them?

We have trained our staff extensively. We have conducted online training modules and done a competency assessment of our staff. Only those that pass the assessment are put on the job. We have around 200 people working on coronavirus-related samples. We will shortly give them prophylactic treatment in the form of hydrochloroquine.

I can only say that the private sector is functioning as a single team and everyone is helping each other in sourcing materials, supporting in processes and compliances. Everyone is working with the single common goal of helping the country fight this crisis. We can make whatever is needed—high quality testing, doorstep services, pickup of samples from hospitals—a reality.

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