Lapses in TrueNat labs protocol, say health officials

[ Tongam Rina ]
ITANAGAR, Jul 19: From zero in March to nine ICMR-approved testing labs and two on the way for Covid-19, Arunachal has come a long way.
While the RT-PCR lab has been set up at the TRIHMS, TrueNat labs have been set up in the intermediate reference lab, Naharlagun, the Bakin Pertin General Hospital & Training Centre, and the district hospitals in Tawang, Roing, Bomdila, Changlang, Namsai, Khonsa and Longding.
Most of the labs are functional, but not in adherence with the required ICMR guidelines, and some do not even meet the basic minimum specifications of a lab, say health officials who have raised questions about the safety standards of the TrueNat labs with regard to bio-medical waste management and human resources.
The districts were provided with TrueNat machines (Quatrro and Duo) along with A-II Type (BSC-4F) bio-safety cabinets but no funds were placed for waste disposal management, logistics, or training of human resources.
“All the logistic issues and training of HR has already been taken into account by you,” reads a message from the health department.
The labs were approved after recommendation by an eight-member committee set up by the health department on 1 June, the department says.
The members had been asked to visit the labs to verify the facilities. But the approval was asked for even before the committee could visit the labs for assessment and give their final recommendations as the state was in a hurry to get the approval from the ICMR, notwithstanding the fact that not all were ready on the ground.
Some of the labs have no trained technicians to run them while others are still arranging autoclaves. Most do not have freezers as recommended by the ICMR. Two sets of freezers were recommended in the ICMR guideline.
The freezer is required if the collection of samples is more than what the TrueNat machine can test. Most of the machines acquired by the state can test only upto 30 samples a day.
While the health department says that all requisite care has been taken and approval given as per the guidelines of the ICMR and as per the committee set up by the state government, some labs, when reached on the phone, said that they do not have the minimum facilities, including cold storage and incinerator.
Most of the bio-medical wastes are burnt in the open or buried in pits, according to health department officials.
“Some of the pits are open. We are not able to burn them because of the rain,” a health official of a district said.
“We were given a sketch with space specifications. Accordingly, three rooms were prepared. We were not given any other guidelines,” said another health department official of a district.
Though the focus is now on the antigen tests, the question remains whether these labs were set up in a hurry without basic requirements of a lab during the pandemic. Most of the hospitals and waste disposal pits – some open – are in the midst of residential areas.
Meanwhile, an incinerator was received on 17 July for the Itanagar capital region, which will be set up soon. Anything that needs to be rectified will be done, health officials say.
Even though the state needs testing facilities, questions remain how these labs got the ICMR certification when they don’t have basic minimum facilities.