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. 2020;151(2 & 3):216-225.
doi: 10.4103/ijmr.IJMR_594_20.

Laboratory preparedness for SARS-CoV-2 testing in India: Harnessing a network of Virus Research & Diagnostic Laboratories

Nivedita Gupta  1 , Varsha Potdar  2 , Ira Praharaj  1 , Sidhartha Giri  1 , Gajanan Sapkal  3 , Pragya Yadav  3 , Manohar Lal Choudhary  2 , Lalit Dar  4 , A P Sugunan  5 , Harmanmeet Kaur  6 , Ashok Munivenkatappa  7 , Jayanthi Shastri  8 , Krishnasamy Kaveri  9 , Shanta Dutta  10 , Bharti Malhotra  11 , Amita Jain  12 , Kammilli Nagamani  13 , G B Shantala  14 , Sharmila Raut  15 , M M Vegad  16 , Ajanta Sharma  17 , Aashish Choudhary  4 , Megha Brijwal  4 , Anukumar Balakrishnan  5 , Jayaswamy Manjunatha  7 , Manish Pathak  8 , Sivasubramanian Srinivasan  9 , Hasina Banu  10 , Himanshu Sharma  11 , Parul Jain  12 , Pakalpati Sunita  13 , R Ambica  14 , Babita Fageria  15 , Disha Patel  16 , Gitika Rajbongshi  17 , Neetu Vijay  6 , Jitendra Narayan  6 , Neeraj Aggarwal  1 , Anu Nagar  6 , Raman R Gangakhedkar  1 , Priya Abraham  18
Affiliations

Laboratory preparedness for SARS-CoV-2 testing in India: Harnessing a network of Virus Research & Diagnostic Laboratories

Nivedita Gupta et al. Indian J Med Res. 2020.

Abstract

Background & objectives: An outbreak of respiratory illness of unknown aetiology was reported from Hubei province of Wuhan, People's Republic of China, in December 2019. The outbreak was attributed to a novel coronavirus (CoV), named as severe acute respiratory syndrome (SARS)-CoV-2 and the disease as COVID-19. Within one month, cases were reported from 25 countries. In view of the novel viral strain with reported high morbidity, establishing early countrywide diagnosis to detect imported cases became critical. Here we describe the role of a countrywide network of VRDLs in early diagnosis of COVID-19.

Methods: The Indian Council of Medical Research (ICMR)-National Institute of Virology (NIV), Pune, established screening as well as confirmatory assays for SARS-CoV-2. A total of 13 VRDLs were provided with the E gene screening real-time reverse transcription-polymerase chain reaction (rRT-PCR) assay. VRDLs were selected on the basis of their presence near an international airport/seaport and their past performance. The case definition for testing included all individuals with travel history to Wuhan and symptomatic individuals with travel history to other parts of China. This was later expanded to include symptomatic individuals returning from Singapore, Japan, Hong Kong, Thailand and South Korea.

Results: Within a week of standardization of the test at NIV, all VRDLs could initiate testing for SARS-CoV-2. Till February 29, 2020, a total of 2,913 samples were tested. This included both 654 individuals quarantined in the two camps and others fitting within the case definition. The quarantined individuals were tested twice - at days 0 and 14. All tested negative on both occasions. Only three individuals belonging to different districts in Kerala were found to be positive.

Interpretation & conclusions: Sudden emergence of SARS-CoV-2 and its potential to cause a pandemic posed an unsurmountable challenge to the public health system of India. However, concerted efforts of various arms of the Government of India resulted in a well-coordinated action at each level. India has successfully demonstrated its ability to establish quick diagnosis of SARS-CoV-2 at NIV, Pune, and the testing VRDLs.

Keywords: Virus Research and Diagnostic Laboratory; diagnosis; preparedness; quality control; quarantine; severe acute respiratory syndrome-CoV-2; COVID-19.

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Conflict of interest statement

None

Figures

Fig. 1
Fig. 1
Virus Research and Diagnostic Laboratory Network of 106 laboratories in India. Source: Map outline reproduced with permission from Survey of India, Department of Science & Technology.
Fig. 2
Fig. 2
Process from sample collection in the field, transportation, testing and reporting of results. NCDC, National Centre for Disease Control; MoH&FW, Ministry of Health & Family Welfare; IDSP, Integrated Disease Surveillance Programme; DHR, Department of Health Research; ICMR, Indian Council of Medical Research; VRDLs, Virus Research and Diagnostic Laboratories; ICMR-NIV, ICMR-National Institute of Virology.
Fig. 3
Fig. 3
Testing laboratories for severe acute respiratory syndrome coronavirus 2. Source: Map outline reproduced with permission from Survey of India, Department of Science & Technology.
Fig. 4
Fig. 4
Organization of laboratories for severe acute respiratory syndrome coronavirus 2 diagnosis in India and their respective roles.
Fig. 5
Fig. 5
The incremental decline in number of samples referred to the National Institute of Virology after testing at the Virus Research and Diagnostic Laboratories was established.
See this image and copyright information in PMC

Comment in

  • Pandemic SARS-CoV-2 laboratory preparedness in India: An opportunity beyond diagnostics.
    Dwibedi B. Dwibedi B. Indian J Med Res. 2020 May;151(5):495-496. doi: 10.4103/ijmr.IJMR_1548_20. Indian J Med Res. 2020. PMID: 32611920 Free PMC article. No abstract available.
  • Authors' response.
    Gupta N, Potdar V, Praharaj I, Giri S, Sapkal G, Yadav P, Choudhary ML, Dar L, Sugunan AP, Kaur H, Munivenkatappa A, Shastri J, Kaveri K, Dutta S, Malhotra B, Jain A, Nagamani K, Shantala GB, Raut S, Vegad MM, Sharma A, Choudhary A, Brijwa M, Balakrishnan A, Manjunatha J, Pathak M, Srinivasan S, Banu H, Sharma H, Jain P, Sunita P, Ambica R, Fageria B, Patel D, Rajbongshi G, Vijay N, Narayan J, Aggarwal N, Nagar A, Gangakhedkar RR, Abraham P. Gupta N, et al. Indian J Med Res. 2020 May;151(5):496. doi: 10.4103/0971-5916.286255. Indian J Med Res. 2020. PMID: 32611921 Free PMC article. No abstract available.

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