Prioritise rapid test

When countries are shifting to at-home rapid antigen tests for detecting the coronavirus to keep pace with the Omicron's blistering speed of transmission, the government has stuck to its policy of keeping the self-administered kit available at only healthcare points.

At present, the rapid antigen test kits can be found in 545 public and 100 private healthcare points across the country, according to the Directorate General of Health Services (DGHS).

Also called lateral flow tests, the tests require rubbing a shallow swab inside one's nostrils and throat and then exposing the swab to a few drops of a liquid reagent, which looks for protein antigens that live on the coronavirus's surface.

In about 15 minutes, one can find out whether they have been infected with the coronavirus or not. The tests are excellent at flagging people who have high viral loads -- and who are thus most likely to be actively transmitting the virus to others.

Coupled with their rapid results, the self-swab kits have become a vital tool in fast diagnosing infection with the Omicron variant -- which causes mild symptoms among vaccinated people that is not too dissimilar from the common flu -- and compelling people to isolate immediately.

Easy availability of such kits in Bangladesh, which is going through a third wave of Covid-19 cases, can help slow the spread of the virus, according to experts.

While the polymerase chain reaction remains the gold standard for detecting the virus, due to the inconvenience and costs involved in getting the test, many tend to avoid getting one and pose the risk of spreading the virus.

In public hospitals, the RT-PCR test costs Tk 100, while it costs Tk 3,000 in private healthcare providers. For at-home sample collection by private operators, it costs Tk 3,700, while it costs Tk 300 by public institutes.

The antigen test costs Tk 700 in private hospitals and Tk 100 in public healthcare points.

Only three types of people can be tested as per the guideline provided by the Institute of Epidemiology, Disease Control and Research (IEDCR): people showing Covid-19 symptoms in the previous 1-7 days, those who came close to a metre of a Covid-19 patient and stayed for at least 15 minutes, and healthcare staffers treating Covid-19 patients.

Data from the DGHS indicates that the antigen test has not been expanded so much: on average, 2,721 tests were conducted in a day in the past seven days.

"If the government really wants to curb the Omicron, the antigen testing kits must be made available everywhere at free of cost," Ridwanur Rahman, an infectious disease specialist, told The Daily Star yesterday.

While the official tally of Omicron cases in Bangladesh stands at 55, the ongoing surge in Covid-19 cases, particularly in Dhaka, is said to be driven by the heavily mutated variant.

In the 24 hours to 8 am yesterday, 9,500 cases were recorded -- the highest since August 12 last year -- and up from 8,407 cases the previous day.

Many countries in Europe and America and neighbouring India are offering lateral flow test kits, Rahman said.

Britain has used the tests to fight outbreaks since 2020, even before Omicron, and makes them freely available, while the US recently said that it planned to make 500 million tests available for free and that Americans could request that tests be sent to their homes.

"When the infection rate rises, choosing rapid antigen testing method is ideal -- maybe 80 percent of the tests will come out to be positive and they can be isolated immediately," Tahmina Shirin, director of the IEDCR, told The Daily Star yesterday.

Asked why people's access to rapid kits at home is barred by the guideline, she said: "The guideline was adopted based on the situation at that time. But, it is the ministry higher-ups who can decide on updating it now."

After months of bureaucratic exercises, the health services division of the health ministry on September 17, 2020 had approved the antigen rapid testing at public healthcare centres.

Later on Jul 18 last year, the government initially approved 78 private healthcare organisations across the country to use rapid antigen test kits.

As of yesterday, the Directorate General of Drug Administration has given emergency use authorisation to 23 foreign brands inside the country as their kits met the criteria of 90 percent sensitivity and 95 percent specificity.

The retail price range per kit has been approved from Tk 220 to 550, according to the officials.

The local suppliers are allowed to supply kits to only the government's Central Medicine Store Depot and the approved private laboratories.

However, this newspaper has learnt that the rapid antigen kit of a brand is available for mass people in the market, which is illegal.

Contacted, ABM Khurshid Alam, the director-general of the DGHS, told The Daily Star: "If there are many other countries where the home-based rapid test is available, we will also consider it. But we have no plan right now."