Impact of COVID-19 on IVD in 2022-23

COVID-19, which struck India in 2020, has been a revelation for the medical diagnostic industry, thanks to the able guidance by ICMR and quick steps taken by the Government of India. The number of laboratories in the country for RT-PCR testing rose from 14 in February 2020 to more than 1596 in August 2020. This meteoric rise in the diagnostic capability of labs, training of staff, and the integration and use of digitization in reporting, tracing, and follow-up of patients/contacts has changed the perspective of average labs about own capability and sustainability.

The confidence gained by diagnostic industry to rise to such challenges in future will now impact the short-term plans and hence purchase decisions. For instance, the lab and the blood bank at Apollo BGS Hospital, Mysore, in a span of one year, acquired molecular lab and apheresis capability. In ordinary circumstances, these steps may have taken 3 to 4 years in a Tier-II city like Mysore. Role of the lab in the critically ill was always given due importance in Apollo, but now it gained cutting-edge technology, thanks to the support from the management in response to the call of the nation.

In-vitro diagnostics in Tier-II cities has often been relegated to outsourcing high-technology lab tests to metros. COVID-19 changed the scene where Tier-II city labs have been forced to acquire technology and sustain it. Antibiotic resistance in microbiology has now reached epidemic proportions in India. As a result of these developments, we now plan to increase the scope of molecular testing and automation in microbiology with organism identification and antibiotic sensitivity. We must also add molecular rapid testing for specific syndromes like respiratory-tract infection and meningitis, where bacterial, viral, and fungal pathogens are tested in the same panel.

These would be the expected steps for any lab, but we need to improve point-of-care (POC) testing to be able to take the lab to the patient. Aging population prefers and needs to be tested at home.

The dependence on the central lab for the hub-and-spoke model, where all samples are transported to the main lab, may be too slow today and hence rapid testing with investment in apps and software to share the information with doctors and patients is the order of the day.

Sample transport with the help of pneumatic chutes to the lab from wards and ICUs saves time and even money in the long run, where carrying samples has some built-in delay. We should be aiming to acquire the system shortly. Bar codes are already part of most labs, but sample sorting and intra-lab transport with the help of these will further shorten the TAT for high-throughput labs like hematology and biochemistry.

Auto-verification software should be the aim of labs that wish to reduce delays related to manual verification of reports; these software are now easily available in India and are found to increase speed by about 50 percent.

In transfusion medicine, we would consider a sterile docking device and automated component separation to improve quality and infection control.

The story so far was here and now, what is available and needs to be acquired.

But there are more ways for the utilization of lab results in patient care, like use of artificial intelligence and algorithms in the care of critically ill patients This technology is in a nascent stage, but it is our duty to explore the utilization. Lab, radiology, clinical parameters, and POC results are integrated into the patient-monitoring system and generate alarms and suggestions for the care teams to act upon. It is a very exciting realm of patient care, as at least some decisions in investigation and treatment will be helped by the AI-based decision-support system.

On the whole, the pandemic has thrown up challenges for healthcare, to which at least in our country we have risen to and changed our conservative approach. Diagnostics has now got due attention and investment from the management and as a pathologist, I am not complaining.