Can Self-Administered Rapid Antigen Tests (RATs) Help Rural India? An Evaluation of the CoviSelf Kit as a Response to the 2019-2022 COVID-19 Pandemic

Abstract

This paper evaluates India's first officially approved self-administered rapid antigen test kit against COVID-19, a device called CoviSelf. The context is rural India. Rapid antigen tests (RATs) are currently popular in situations where vaccination rates are low, where sections of the community remain unvaccinated, where the COVID-19 pandemic continues to grow and where easy or timely access to RTPCR (reverse transcription-polymerase chain reaction) testing is not an option. Given that rural residents make up 66% of the Indian population, our evaluation focuses on the question of whether this self-administered RAT could help protect villagers and contain the Indian pandemic. CoviSelf has two components: the test and IT (information technology) parts. Using discourse analysis, a qualitative methodology, we evaluate the practicality of the kit on the basis of data in its instructional leaflet, reports about India's 'digital divide' and our published research on the constraints of daily life in Indian villages. This paper does not provide a scientific assessment of the effectiveness of CoviSelf in detecting infection. As social scientists, our contribution sits within the field of qualitative studies of medical and health problems. Self-administered RATs are cheap, quick and reasonably reliable. Hence, point-of-care testing at the doorsteps of villagers has much potential, but realising the benefits of innovative, diagnostic medical technologies requires a realistic understanding of the conditions in Indian villages and designing devices that work in rural situations. This paper forms part of a larger project regarding the COVID-19 pandemic in rural India. A follow-up study based on fieldwork is planned for 2022-2023.

Keywords: COVID-19; CoWIN; CoviSelf; Indian pandemic; Indian villagers; digital divide; discourse analysis; poverty; qualitative medical/health research strategies; rapid antigen tests (RATs); rural India.

Figure 1

The components of the self-administered CoviSelf RAT kit. (Showing in clockwise order from the bottom left-hand side: the plastic bag for disposing of used items, the CoviSelf package, the instruction leaflet and, in the centre, the sterile nasal swab, the test card and the pre-filled extraction tube.) Source: Ms Anusha Kesarkar-Gavankar, photograph of 18 November 2021.

Figure 2

The CoviSelf test card. (From the far left: the QR code, the control point C, the test point T and the sample well for receiving the nasal mixture). Source: Ms Anusha Kesarkar-Gavankar, photograph of 18 November 2021.