Ensuring healthcare in the time of a pandemic

No one can accurately predict duration of the COVID-19 pandemic and whether it will start receding in a few days or bounce back later. We have observed that the pandemic is affecting countries in multiple waves with possible different strains from UK, Brazil, or South Africa. Unfortunately, each new wave records higher number of infections than the last one. India is currently facing the second wave, conceivably because of the UK strain that is more infective but less virulent and recording one lakh plus cases every day since April 4. On the positive side, the vaccination drive against COVID-19 is picking up pace.

However, for a population of 130 crore, at about 30 lakh people vaccinated per day, we may take about one year to reach a 70 percent level herd immunity with 114 crore people vaccinated, considering the vaccine is about 80 percent efficacious. Till then, we cannot let our guard down and must practice COVID appropriate behavior.

COVID-19 forced everyone to do more with limited time and resources. It underscored the importance of pursuing opportunities to enhance efficiency while providing world-class care as we move into the new normal.

The pandemic exploded the need to scale-up testing as never attempted before. We at Dr Lal PathLabs, moved from testing a few hundred samples a day in one lab in Delhi, to 10,000 samples a day and have tested about 15 lakh samples so far in nine of our labs, all over India. RT-PCR Testing has again increased with the new surge in cases in about 2,500 labs in India, approximately half of which are private labs.

While effectively responding to the pandemic, two major barriers were overcome- adoption of digital technologies and partnerships between the government and private providers to deliver healthcare.

COVID-19 has again reinforced that health systems need to place a greater focus on shifting from reactive to proactive care. In a dramatic fashion, COVID-19 has shown that healthcare business models are highly sensitive to disruption when there are changes on supply side – like the sudden rise in demand for RT-PCR test kits, PPE and ventilators, or on demand side – like suspension of elective procedures and routine care due to the lockdown.

With the surge in number of cases again and uncertainties about the immediate future, private healthcare providers and governments, both central and state, must put their heads together to further improve healthcare delivery. This shall also encompass banking on technology to provide the key to unlock better planning, improved patient engagement, and cost-effective healthcare delivery.

For COVID-19 testing, we were able to bring down prices from ₹4500 to around ₹800. This was made possible because of significant reduction in prices of test kits and other consumables like PPE and bringing in more efficiencies as we constantly learnt from the pandemic.

Preparing for the future, amid intensifying pressure on labs to deliver high quality results, improve turnaround time, and reduce costs, automation has become an inherent part of operations.

Improvisation of current features for high-end labs to incorporate automation in pre-analytical and post-analytical phase of testing with re-run and reflex testing, closed tube sampling facilities, rapid STAT testing, integrated QC software for four level quality management along with bi-directional interfacing and modular systems with expandable test menu incorporating routine clinical biochemistry and immunoassays, shall become the order of the day.

Smaller labs, which are just upgrading to automation, shall also require fully automated analyzers but with open systems. Manufacturers need to overcome sensitivity of equipment to temperature and humidity and stringent water quality specifications, which are huge concerns for labs in tier III, IV cities and rural areas.

The government can also play a major role in bringing quality diagnostics to the masses by reducing customs duties and allowing private diagnostics players to use their CSR funds for performing essential diagnostics in public health settings like the 1.5 lakh Health & Wellness Centres (HWCs).

Ultimately, our main focus is to provide uninterrupted diagnostic tests for early diagnosis and treatment of diseases like TB, HIV-AIDS, cancer, cardiovascular disease, diabetes, strokes, and many others, in spite of the pandemic.