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Red Parliamentary Panel Flags Rapid Antigen Tests: A Look at What Makes Test Method Controversial

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While experts say rapid antigen tests can help countries with outbreaks, India’s practice of combining data from rapid tests and RT-PCR tests risks creating an incomplete picture of its levels of infection.

Standing Parliamentary Committee on Family Health and Welfare in its latest report on Covida-19 has said he is concerned about the use of less reliable diagnostic tests which increase the chances of false negatives.

The chairman of the Standing Parliamentary Committee on Health, Ram Gopal Yadav, presented the report entitled, ‘Pandemic Outbreak’ Covida-19 and its Management ‘to the chairman of Rajya Sabha M Venkaiah Naidu.

This is the first report by any parliamentary committee on the governments it deals with Covida-19 pandemic.

The report said the government should evaluate the authenticity of the Rapid Antigen Test versus RT-PCR and other diagnostic tests to highlight the true picture of on-site testing capacity.

She has strongly recommended that test facilities be increased for more accurate tests.

The report also noted, the testing structure is limited to larger districts and cities, and the lack of testing equipment in rural areas has also resulted in underestimated case reporting.

What is the purpose of the rapid antigen detection test? Covida-19 ?

It is a test on inhaled nasal samples that detects antigens (foreign substances that trigger an immune response in the body) found in or within the SARS-CoV-2 virus.

Above Indian Express, the test is a precautionary test, performed outside the conventional laboratory environment and used to quickly obtain a diagnostic result.

Above IndiaShpenzo, Antigen testing is faster and cheaper than the gold standard of testing, RT-PCR technology. Also very accurately reveals the positive cases of Covida-19 . But its downside is that it gives a considerable number of false negatives when a person test can come as negative when they can actually be positive for viral disease.

What is the difference between an RT-PCR test and a rapid antigen test?

As mentioned by the Indian Medical Research Council (ICMR), the RT-PCR test takes a minimum of 2-5 hours including the time taken to transport the sample. These specifications limit the widespread use of the RT-PCR test and also impede the rapid growth of testing capacity in various control areas and hospital settings, Declared ICMR advisory.

In a reliable rapid antigen detection test, the maximum time for interpreting a positive or negative test is 30 minutes.

Red parliamentary panel flags rapid antigen tests A look at what makes the testing method controversial

A laboratory staff wearing personal protective equipment (PPE) puts their hand on the samples collected for Covida-19 coronavirus testing. AFP

What is the government’s position on this?

According to guidelines issued by the ICMR, those tested negative Covida-19 by rapid antigen test should definitely be tested sequentially by RT-PCR to rule out infection, whereas a positive test should be considered a true positive and there is no need for reconfirmation by RT-PCR test.

In a circular on June 23, 2020, about “newer additional strategies for Covida-19 testing, the government has stated that antigen testing can help “field level for early detection of infection and rapid content” and can provide a “rapid diagnosis of SARS-CoV-2 in field environments”.

The government then said that this technology should be used both in the field (outside the laboratory) and in hospitals and together with the RT-PCR test technology.

To date, antigen tests produced by at least three companies have been approved by ICMR for use in India. It has allowed the use of antigen detection kits developed by the South Korean company SD Biosensor, which is commercially called Standard Q Covida-19 Bag for detecting ag.

So what is the matter with this testing method?

ICMR has conducted a two-page independent evaluation of the SD Biosensor kit, at ICMR and AIIMS.

The results found that the kit had very high specification, or the ability to detect true negatives, ranging between 99.3 percent and 100 percent in both countries. The sensitivity of the test, or its ability to detect positive truths, ranged between 50.6 percent and 84 percent, depending on the patient’s viral load. The higher the ability to detect true negatives, the more reliable any positive result is.

This means that when it returns a positive result, it is 99.3 percent to 100 percent accurate, but when it returns a negative result, it can only be 50.6 percent to 84 percent accurate.

This means that the use of rapid tests can allow some infected people to return freely to the community, spreading the virus to even more people.

Red parliamentary panel flags rapid antigen tests A look at what makes the testing method controversial

A health care worker performs a rapid antigen test Covida-19 during a mass review for coronavirus . AFP

For example, in Philippines, a high number of false negatives in tests performed on returned workers meant that infections were planted in new locations when they were allowed to go home, causing a harsh resurgence of cases.

While experts say rapid antigen tests could help countries with out-of-control outbreaks quickly discover where hotspots are, India’s practice of combining data from rapid and traditional RT-PCR tests risks creating a picture. not complete its levels of infection, after this article in press.

Mixing these two data points may give the impression that a country is testing extensively and that the number of positive cases is declining or that the increase in case numbers is slowing down, but in fact this may not be the case.

However, others also point out that even the gold standard RT-PCR can lose infections, only to a lesser extent than RAT.

Dr. K. Srinath Reddy, President of the Public Health Foundation of India (PHFI) and Member of India Covida-19 i said task force press that even the RT-PCR test can miss 30-40 percent of cases if the swab is taken too early in infection or the collection technique is not perfect.

Wires argumenton sethe retest method also makes the ICMR strategy uneconomical, given that the cost of each rapid antigen test is captured at Rs 450. CS Bedi, a medical adviser to SD Biosensor, told the website that the price of the kit could be higher than Rs 450. for non-governmental buyers.

Although antigen testing is useful to detect new positive cases of Covida-19 , the fact that many of its results can be false negatives, directly affects the fight against Covida-19 .

With data from agencies

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