(This article is based on a case study by Prof Sarang Deo and MIHM analysts Aman Kabra and Hemanshu Das)

The Covid-19 infection is spreading at an unparalleled pace. In India, as on May 1, 45 persons were being tested per million population, a significantly low rate as against the world median of 397 tests per million. This remains oblivious of the fact that several labs have been onboarded for Covid-19 testing. We attempt to obtain more insights into this situation by providing approximate estimates of the actual testing capacity of approved labs and its utilization across different states in India, and attempt to answer the question, “Is the projected testing capacity in the near future adequate to handle the increase in required testing volume?”

While the testing volume increased by about 150% in the last week of April, the laboratory tests capacity increased by less than 10%. This connotes to a substantial increase in capacity utilization. Apart from this, heterogeneity in the utilization of capacity can be seen across states. The capacity utilization for Telangana and Kerala stood at 12% and 19%, respectively, thus indicating the availability of substantial spare capacity. Meanwhile, Madhya Pradesh, Karnataka and Tamil Nadu utilised almost 100% their capacity. This clearly points to a looming testing scare if the lab capacity in these states is not augmented soon.

Indian Council of Medical Research targets at upscaling the nationwide testing capacity to 100,000 tests per day by May-end. Our study indicates that we may have a national testing capacity of ~105,000 by May 31. However, only time will tell if this would be adequate enough to meet the testing needs of India required across different states.

Based on our results, we found that the testing capacity needs to be scaled up significantly across the states having a high utilization currently. Maharashtra, for instance, would need to add more than 450% of its testing capacity. Similarly, a state with less number of reported cases like Haryana will need to add more than 600% capacity. Interestingly, Kerala looks equipped to handle its projected testing volume with the current capacity because the number of Covid-19 cases being reported from the state is on a decline.

Some of the findings of our study include: (a) In most of the states, the existing rate onboarding of labs is not sufficient to meet the required testing volume. Therefore, ICMR would need to increase the rate of onboarding of labs. (b) Despite the efforts, it is likely that each state may not become self-sufficient for testing the people. The government may engage with the private sector to enable sample transfers and utilize the surplus capacity of the adjoining states. (c) The surplus HIV and TB-testing capacities may be utilised for COVID-19 testing as they require the same underlying technology for testing. (d) Pooled testing i.e. aggregating multiple samples into one before being tested can decrease the test-kits consumption substantially. However, this will require training of lab personnel for pooled testing. (e) An aggregated sample collection model, akin to the e-commerce return pickups, can reduce the need for ambulances by 4 and thus reduce the burden on resources.

The complete study can be accessed on Medium here.

The Times of India reported this story on May 21. The report can be read online here.