It’s dangerous to deny testing of asymptomatic Covid-19 patients

The whole point of the severe lockdown that started on March 25 was to use the period to expand the country’s health infrastructure as needed. Yet here we are more than two months on, with Covid-19 cases continuing to grow everyday while the specter of running out of hospital beds is looming large in metros like Delhi and Mumbai. The only way forward is to do more and more tests, and simultaneously ramp up bed capacity – including by converting more spaces like stadiums, schools and hotels into Covid care centers.

What is the absolutely wrong way of dealing with Covid? To slow down the testing to keep the official case count low, to browbeat hospitals to the same end, and make citizens run from pillar to post whether it comes to getting an RT-PCR test or a getting a Covid care bed.

In this context ICMR guidelines, which some state governments are using to discourage and indeed penalize testing of asymptomatic patients, have become a serious concern and urgently need revision. In India 28% of infected patients are estimated to be asymptomatic while global data suggests a third of patients are asymptomatic. Obviously patients spread the infection even when they are asymptomatic. With case count having crossed two lakh in the country, the need of the hour is smart surveillance rather than acting like an ostrich or inanely parroting that there is no community transmission. Case numbers will continue to grow in the immediate future. Increased testing will enable the health infrastructure to stay ahead of the virus curve, thus keeping the fatalities to a minimum.

In Delhi, some labs and hospitals have been asked to stop testing asymptomatic patients on the ground that they have not followed ICMR guidelines. The expert opinion of several doctors from even premier institutions like Sir Ganga Ram Hospital and Dr Ram Manohar Lohia Hospital is being shoved aside. Several highly respected doctors have publicly pointed to the critical need for a test to know whether a patient should be admitted in a designated covid ward/ICU or in a Covid free area, whether a cancer patient should be given chemotherapy, whether a patient has comorbidities that necessitate hospitalization even though she is asymptomatic etc. The Kejriwal government and others must listen to these experts. After two months of a stringent lockdown for ramping up healthcare capacity, it is inexcusable for officials and netas to insist that only symptomatic patients deserve testing or hospitalization – when the doctors say otherwise.

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