Coronavirus in India: Kerala’s diverse COVID-19 testing strategy explained

The state has sent a total of over 22.45 lakh samples for testing.The state has sent a total of over 22.45 lakh samples for testing.

Coronavirus testing in Kerala: Kerala was the first state in the country where cases of coronavirus had emerged back in January, a month before the pandemic hit rest of India. Once the pandemic did return, Kerala was also the state where, for a substantial period, the most number of daily cases were reported and which had the highest caseload. However, by April, Kerala had managed to flatten the curve and curtail its cases.

A major role in this curbing of cases has been played by the various testing strategies that Kerala has announced from time to time. Let’s take a look at the various testing strategies that Kerala has adopted.

Coronavirus in India: Testing in Kerala

According to the COVID-19 dashboard of Kerala, as of Wednesday, the state has sent a total of over 22.45 lakh samples for testing, of which, the state has recorded a total of 1.17 lakh cases.

The state collects samples in the following cases:

  • The samples are collected from the symptomatic persons and this is categorised under routine samples.
  • Samples are also collected from “priority” groups, which include healthcare workers, persons who have high social exposure, and workers, and these samples are categorised as Sentinel surveillance.

The routine samples are tested using the RT-PCR tests, and so are the Sentinel surveillance and Expatriate surveillance samples. Priority samples are tested using CB-NAAT and True NAAT tests, while Rapid Antigen Card test is used for Point Of Care test and samples from cluster, coastal and tribal surveillance. Meanwhile, ICMR sero surveillance, cluster surveillance and airport surveillance sample test is done for screening, using Antibody Card or CLIA test.

Coronavirus in Kerala: Various testing norms in the state

Kerala has time and again taken several measures regarding the testing for coronavirus to ensure that the virus spread can be curtailed in the southern state. Here’s a look at a few of them.

  1. The state Health Ministry is using the standard RT-PCR test with a set of guidelines on how and when to use the rapid antibody test for detecting any false positives to complement the RT-PCR testing in the state.
  2. By April 24, the state had announced the setting up of Xpert-SARS-CoV testing facilities to augment the testing in Kerala, with the help of ICMR for cartridges, even as the state had effectively managed to contain the growth in cases by then.
  3. With Unlock, the Centre allowed people to return to their hometowns after over a month of lockdown. Quick testing of such passengers was possible individually. Hence, in order to effectively and quickly undertake the testing of the anticipated large number of passengers, the state announced the use of a pooled testing method. In this, the samples of various individuals are pooled together and tested for COVID-19 presence. That way, a large number of samples can be tested by a single test. If a pool of individuals tests negative, that indicates that all the individuals in that pool are COVID-19 negative. However, if a pool tests positive, then all the samples of all the individuals in that pool are tested separately to identify the individuals who have contracted the infection.
  4. When the ICMR-approved antibody tests were not available, Kerala came up with its own sentinel surveillance system that used RT-PCR tests to detect community transmission in the state, instead of waiting for the tests to become available. It was only when the tests were available that Kerala moved to the rapid antibody testing to detect the presence of community transmission.
  5. The rapid antigen tests were used for certain situations, like at the airport for the testing of the expatriates, testing in cluster containment zones and for sentinel surveillance.
  6. The state revised guidelines for coronavirus in prison. Back in May, the state had given some guidelines to ensure that the spread of the virus can be curtailed in the prison. A few days ago, Kerala took into account the fact that nearly 700 prisoners have tested positive for the virus in the state. The tests include standard checking of symptoms, along with certain innovations on behalf of the state. To check whether the prisoners’ sense of smell is fine, the state has said that coffee powder would be used and the prisoners would have to report in case there is any change in their perception of the smell. Apart from that, standard testing and isolation techniques would be applied to any symptomatic or suspected prisoners.
  7. The Travancore Devaswom Board, an autonomous temple board under the Government of Kerala that manages the Sabarimala Temple, is now also mulling over mandating of the antigen tests for devotees that are sure to visit the temple during the Mandala pilgrimage season scheduled to begin mid-November. Reports have stated that the board could be tying up with the health department to conduct the tests at the Nilakkal base camp that the devotees cross on their climb to the Sabarimala shrine.

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