COVID-19: UP’s Health System Paralysed After Test Results Take 4-5 Days

Amid a steep rise in COVID-19 cases in the state capital Lucknow and other parts of Uttar Pradesh, the majority of testing is being done by only two prestigious medical institutes — King George Medical University (KGMU) and Sanjay Gandhi Post Graduate Institute of Medical Sciences (SGPGI) in Lucknow, aside from a few private labs. As a result, the system now finds itself under strain with tests taking four to five days to return results.

Many private pathology facilities in the city are either denying facilities saying their testing capacity is either 'full' or that they had been banned by the state government from conducting COVID-19 tests due to 'discrepancy' in their reports. Even government-supported testing labs are said to be overwhelmed and are providing test results in three to four days.

While there has been no official word on barring private pathology labs from conducting tests, many people have reported an inability to get any tests done. Most people in the city who experienced symptoms of COVID-19 had to struggle all day to find a lab to get themselves tested.

In one such case, Rajeev Shukla, a doctor, and his son Alok, had to struggle all day to find a lab. "On Sunday morning, my son and I experienced COVID-19 symptoms and made several calls to the Integrated Covid Command and Control Centre for help but our calls remained unanswered. We also tried at least a dozen private pathology labs, but all refused saying they had been banned by the government from conducting COVID-19 tests. A private lab in Aliganj said that they were already stretched beyond capacity and that we would have to wait for at least three to four days to get tested," Shukla told Newsclick.

He added that the private labs who have conducting tests, asking for Rs 1,900 per person for sample collection. Both RT-PCR and antigen tests now cost much more that what the government had stipulated. The state government has had to remind labs of the rates they would charge for testing.

Neeraj Mishra, former Resident Doctors' Welfare Association (RDWA) KGMU president, said that the state government had restricted "all national-level private pathology labs from conducting COVID-19 tests following complaints from over half a dozen districts that reports were inaccurate. As per the government, the reports by private testing labs were not up to the mark. Apart from KGMU and SGPGI, only two private labs – one in Aliganj and the other in Gomti Nagar are conducting coronavirus testing. Dr. Lal PathLabs and PathKind Labs used to test earlier but they have been prohibited from conducting tests," Mishra told Newsclick, adding that testing was one of the major aspects of controlling the spread of COVID-19.

Accusing the state government of an "irresponsible" attitude towards patients. "Why is symptom severity not a criteria for emergency support by the authorities? Oxygen saturation levels are falling and patients are feeling the effects of the virus but they are asked for RT-PCR reports which will come in a minimum of four to five days if the patient is lucky enough. How will this approach improve the mortality rate?" Mishra asked.

He added that given the scenario that exists at the moment, "they should consider everyone (COVID-19) positive and allow triage according to symptom severity. Testing seems to be delaying treatment," he said.

"There is a delay in COVID testing in the state. We are conducting RT-PCR tests on those who are symptomatic and came in contact with such patients several times. Generally, it takes between 24 and 36 hours to get RT-PCR reports but due to the burden, the process is taking four to five days. Besides, all private labs have still not received permission to conduct tests," a doctor deputed at KGMU told Newsclick on the condition of anonymity.

Echoing similar sentiments, Dr. C.S. Verma, president of the public health outfit, Jan Swasthya Abhiyan (JSA), Uttar Pradesh, said that the labs are facing acute shortage of manpower for sample collection and tests due to the huge surge in cases. "Earlier, private testing labs were giving out negative reports after taking a hefty amount from patients. Now, however, the government should take the control of private labs and use their testing labs. The government will have to trust private hospitals and private hospitals will have to play an important role as it is a crucial time," he said.

"We are facing an acute shortage of health infrastructure because the government did not come up with any solid roadmap to fight the pandemic in a year. We have a shortage of ambulances, testing labs, para medical staff, dedicated hospitals and shortage of medicine. Unless and until the government does not abide by WHO guidelines which say that six per cent of the GDP shall be spent on health infrastructure, a number which is one per cent as of now, the root cause will not be addressed," Verma told Newsclick.

The Allahabad HC has also warned of a "complete collapse of the public health system."

Meanwhile, Uttar Pradesh's law minister Brijesh Pathak's letter, exposing the poor condition of hospitals in the state capital and a lackadaisical attitude of the administration and hospital authorities, is making the rounds on social media. It also questioned Chief Minister Yogi Adityanath claims that the state was doing its best against the virus.

Pathak has written to the additional chief secretary (medical and health) and the principal secretary (medical education) about how even he is unable to do anything for the health system in these tough times.

"I received hundreds of calls in a week asking for help but due to lack of resources at hospitals we are unable to help them out," he alleged, adding that there was no response by the Health Officer's office and went on to underline that beds should be increased in hospitals to attend to patients. He added that hospitals should ramp up testing as well.

Narrating an ordeal of his friend, author and Padma Awardee Yogesh Parveen, who recently passed away due to alleged medical negligence, the minister said in his letter that he had spoken to the chief medical officer (CMO) and requested him to provide an ambulance and medical facilities for the 80-year-old. However, despite waiting for several hours, the ambulance did not arrive and Parveen passed away.

Pathak drew attention to the many other shortcomings in the state's health system. These include no response on the CMO's helpline numbers, four-to-seven days' time for getting COVID-19 test results and a two-day waiting time for admission to a hospital and the paucity of testing kits.

"At present, the status of health services in Lucknow is a matter of grave concern and if matters continue thus, a lockdown might be inevitable," the letter read.

Uttar Pradesh is witnessing a fresh wave of pandemic. The state recorded as many as 18,021 new COVID-19 cases on Tuesday, the highest single-day spike in UP this year. A total of 85 people lost their lives too, the highest single-day toll this month.

In a bid to effectively control the rise in COVID-19 cases, the state government had imposed a night curfew in Lucknow last week.

(This article was first published by Newsclick)