July 4, 2020
Molecular Solutions Care Health is a diagnostics and research organisation in the health sector. They started with the purpose of making advanced molecular testing available to anyone in need.
Molecular Solutions has been doing rapid testing of COVID-19 as part of the CovidActionCollab. CAC Volunteer Vartika spoke to Ms. Varsha Sridhar, Founder, Molecular Solutions to understand their COVID-19 response so far. Molecular Solutions has been engaged with the Collab since the very beginning (from around the start of the first lockdown). They have offered to help with anything related to COVID-19 community testing.
What have been your key actions and initiatives around the COVID-19 response?
Molecular Solutions has been a strong advocate of the Point of Care (POC) Testing at Primary Healthcare Centres (PHC) for a long time. In the past, we have approached multiple state governments and large foundations for this purpose. Molecular Solutions has now set up the first Point of Care diagnostic lab at a PHC in Karnataka for COVID testing. This community testing centre was a proposal for 18 months. We are finally making it a reality now, with the support of CAC.
Molecular Solutions has also started a sewage testing facility. Multiple studies across the world have shown that SARS CoV2 RNA can be found in sewage samples from a community, prior to a localised outbreak in that area. Thus, sewage testing for SARS-COV2 RNA can be used as an early marker for local outbreaks. Through the CAC, we have formed a team of water experts, engineers, sewage treatment experts, public health researchers and molecular biologists. We have also obtained BBMP permission to collect sewage and test for SARS Cov2 RNA.
A trial run was conducted in a drain in Sheshadripuram, Bengaluru and the sample had detectable levels of beta coronavirus RNA, which is not specific for SARS CoV2 RNA. We are currently in the process of determining whether the beta coronavirus RNA is specific to SARS CoV2 or not.
Interestingly, Sheshadripuram in Bangalore had no positive cases (until the day of sewage collection). Four days after we found the coronavirus positive sewage, the first few cases in Sheshadripuram were reported.
Our next steps are to perform this testing in containment zones, hotspots as well as multiple low prevalence communities in the city. Our ultimate aim is to develop an easy protocol for sewage testing for surveillance which can be given to the local governments for their use.
About Point of Care Diagnostics
Primary Healthcare Centres (PHCs) are the building blocks of our healthcare system in India. They are state-owned rural health care facilities- usually single-physician clinics with facilities for minor surgeries too. Health has very limited budget allocation (1.15% of GDP) in our country. By extension, PHCs are also poorly funded as well. As of 2019, there are 30,000+ PHCs in India. Because of lack of adequate resources, these PHCs either do not provide adequate care to patients or provide a very high number of referrals to hospitals.
A Point of Care (POC) diagnostic device is used to obtain diagnostic results while with the patient or close to the patient. They are used in clinics and hospitals. POC diagnostic devices are known to give quick feedback on many sorts of medical tests.
POC diagnostic devices (RT-PCR machine – Truvenat) are helping a great deal in rapid response against COVID-19. These Made-in-India devices are being used to test the suspected patients and deliver the results in two hours. Moreover, a highly trained technician is not necessarily needed for the testing as the testing is automated. Deployment of these devices at more PHCs will greatly reduce the time and effort needed for testing.
What are your biggest learnings/challenges?
When we decided to work on community testing from COVID 19, we didn’t anticipate the magnitude of challenges ahead of us. One of the major challenges that we faced was procurement of rapid testing kits. It was a tedious process.
Also, every step of the testing process requires authorisation from a different government body. Getting authorisation has not been an easy task, given that authorities are now busier than ever. We have not been able to conduct free community testing yet because of pending approval from BBMP (Bruhat Bengaluru Mahanagara Palike). We are only conducting paid testing for now.
Any stories/insights emerged from the field or from your work?
With POC testing we have been able to considerably shorten the turnaround time for results. It has saved a lot of time and money for the suspected patients. This matters a lot to those belonging to lower economic strata of society and is already facing economic issues. It has also helped save institutional capacity and bandwidth.
How did you leverage the COVID Action Collaborative? How do you plan on doing so in the future?
CAC has catalysed the setting up of the ICMR laboratory and that has opened up many other opportunities for us. It also helped us curate a team of experts for sewage testing.
CAC helped us reach out to the interns, which in turn enabled us to significantly expand our testing capacity. We were initially facing a shortage of human resources (both technical and general), which was deterring our COVID response. Through the CAC, we recruited five interns. They are helping in setting up the testing laboratory, sample collection and reporting to ICMR. With these extra hands, we are now also helping YRG Care, Chennai.
Finally, we are collaborating with CAC members, Karuna Trusts and PCMH Restore Health, to co-develop solutions, including sewage testing. This would not have been possible without the CAC.
About the Author:
Vartika Shukla is a financial inclusion, fintech and women economic empowerment consultant. She has more than eleven years of experience of working with banks, mobile network operators, agent network managers and microfinance institutions across Asia and Africa.
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