DIMAPUR, AUGUST 10: On May 19, 2020 the Indian Council of Medical Research (ICMR), under the Ministry of Health & Family Welfare, issued guidelines validating the usage of TrueNat for conducting COVID-19 confirmatory tests. Earlier on April 10, the ICMR had validated the use of TrueNat ~ a diagnostic machine commonly used for detecting Tuberculosis ~ for COVID-19 tests.
Almost 3 months have passed since ICMR’s directives and yet the data on usage of TrueNat in Nagaland’s battle against COVID-19 seems to be a mystery. The Health & Family Welfare Department has disclosed 29 TrueNat machines are in use all over the State, out of which 20 were procured by the Department. But repeated queries about how many machines are being used for confirmatory tests have remained unanswered.
Nagaland Page had reported on the viability of TrueNat machines as a less complicated and cheaper alternative to RT-PCR confirmatory tests conducted in the BSL-3 and BSL-2 labs at Kohima and Dimapur respectively. The Truenat tests also use real-time micro polymerase chain reaction (PCR) technology. According to ICMR, with the availability of customized cartridges, the TrueNat system is a comprehensive assay for screening and confirmation of COVID-19 cases. It has a quick turnaround time (30 -60 minutes) but only 1-4 samples can be tested at one run, limiting the maximum numbers that can be tested to 24-48 samples per day only. The viral lysis buffer that comes with the COVID-19 cartridges inactivates the virus and poses minimum bio-safety hazard. Safety is further augmented by the closed nature of these platforms and minimum sample handling. These features have facilitated use of these platforms at grass root level thereby increasing access to testing. TrueNat devices function in a wide range of environmental conditions with minimal user input, making them suitable for use in primary healthcare settings, the ICMR states on its official website.
Speaking to Nagaland Page over phone, Dr Jagadesh Mahanta, who holds the position of Distinguished Scientist Chair, ICMR, confirmed on the practicability of TrueNat testing especially in states like Nagaland where connectivity of remote areas is a problem. “RT-PCR and TrueNat tests are similar and both are efficient. What is crucial is the sampling time,” he informed.
Dr. Mahanta recently retired from the post of Director, Regional Medical Research Centre, Dibrugarh, which is under the ICMR. He also informed that if a hospital is already using the TrueNat for screening COVID-19 samples, it does not need any separate accreditation for running confirmation tests. The second test to validate, if a sample is positive or negative, just needs a different type of cartridge customized for COVID-19 confirmatory tests.
Nagaland Page had earlier raised the question as to why the Dimapur COVID Hospital is not carrying out confirmatory tests on TrueNat when all it needs is a separate set of cartridges.
The Nagaland H&FW Department, in its weekly bulletin on August 8, had revealed the different types of tests available for COVID-19, from which it could be well established the TrueNat testing, to confirm whether a sample is positive, is reliable and also a viable alternative to RT-PCR tests. But the Department is apparently reluctant to reveal how many districts are conducting the COVID-19 confirmatory tests on TrueNat. When Nagaland Page contacted Dr Nyanthung Kikon, state Nodal Officer for IDSP, for the second time in 3 days with the same query, he failed to provide any data, and once again asked this Scribe to call up each district.
Is this an oblique way of the Nagaland Government to explain and validate setting up of the Bio-Safety Labs at Kohima and Dimapur, which cost quite a pretty penny, when the much lesser expensive TrueNat could have served the public as efficiently and effectively with the right chips (customized cartridges) during this pandemic? The question, as always, is: who has the Bio-Safety Labs at Kohima and Dimapur served ~ seeing that hundreds across the state are still waiting for their COVID test confirmatory results?