Aug 21IssueOpinion

Effective diagnostics strategies for corona pandemic mitigation

With an array of ICMR-approved tests available in the market, it will be offer better
time efficiencies by reducing the turnaround time

The corona pandemic has globally disrupted lives and livelihood. We have already had two strong waves in  India, causing widespread agony, suffering, deaths, and mental trauma.

While lockdown, movement curbs, and social distancing/masks are effective in mitigating the risk of communicability and preventing the spread of the virus, a more effective strategy is required for testing and monitoring to counter the third wave.

India’s current testing strategy rests on rapid antibody tests and RT-PCR tests. Unfortunately, both these testing
strategies have limitations – the rapid antibody tests are stop-gap tests in nature. An RT-PCR test must follow
them in case of a negative result. But in an estimated 90 per cent of the cases, this SOP is not followed. As a result, these people continue to intermingle in markets, offices, and homes, and invariably the false-negative patients end up infecting others as well.

Although the RT-PCR test is the gold standard in COVID-19 testing, it is relatively expensive and out of reach
for much of the financially challenged populace. Also, RT-PCR requires high-end equipment, which is not available in rural and semi-urban India, making this form of testing unviable for most of the  rural population in the country.

There are far more effective techniques.With an array of ICMR-approved tests available in the market, it will be offer bettertime efficiencies by reducing the turnaround time available in the market and already approved by ICMR. The COVID-19 Ag Microlisa Elisa Antigen Test is one of the best known and viable alternatives. The
Elisa Antigen Test is ideal for contact tracing and is as reliable as the RTPCR tests, yet cost significantly less.
They don’t need extensive equipment or a high-cost workforce and can be deployed even in rural areas. Their
cost-effectiveness makes them a more preferred choice for the masses. The Elisa Antigen Tests are also more time efficient, and results are available at a fraction of time as needed for the RTPCR test.

The Elisa Antigen test can provide an impetus to India’s fight against COVID-19 by significantly bringing down the overall cost of testing. These tests also offer better time efficiencies by reducing the turnaround time between
testing and results to just two hours. India already has thousands of Elisa readers with laboratories across the
country to read the test results. Positive patients can be quickly isolated. This test will minimise uncertainty and confusion for the masses due to prolonged test results – to ascertain whether it is safe to interact or isolate and quarantine.

Another critical aspect of the corona pandemic mitigation strategy is the need for monitoring the effectiveness
of the vaccination and the development of antibodies within our citizens. The COVID-19 Neutralizing Antibody
Microlisa test is critical to India’s fight against the corona pandemic because it showcases how effective
the vaccination has been for creating neutralising antibodies against the SARS-CoV-2 virus.

Virus neutralisation is the gold standard for deciding antibody efficacy, and neutralising antibodies help form
an individual’s passive immunity. It provides short-term immunity to a healthy individual against disease.
Neutralizing antibody (NAb) is responsible for defending cells from pathogens, which cause disease (in this
case, SARS-CoV-2). NAb are produced naturally by the body as part of its immune response, and infections and
vaccinations against infections trigger their production.

Testing of antibodies is ideal for serosurveillance and seroprevalence.

Many countries are now testing for SARS-CoV-2 antibodies at the population level or in specific groups, such as
health workers, close contacts of known cases, or within households, and taking necessary corrective actions. These antibodies (in High Titer) determine if the individual has good humoral immunity, donate convalescent plasma, and if the vaccination is successful.

In addition, these antibodies help in segregating patients between mild, moderate, and severe categories. Hence
they act as an advanced diagnostic marker against the resurgence of COVID infections.

WHO supports these studies as they are critical for understanding the extent of and risk factors associated
with infection. Some of the countries that have implemented SARS-CoV-2 antibodies testing for monitoring the
development of herd immunity include – the US, the UK, Australia, China, Thailand, Germany, Sweden, Austria,
Switzerland, Finland, Brazil, Iceland, Spain, amongst others. This strategy should be immediately implemented in
India as well to counter the threat of the third wave.

The fight against the corona pandemic is a long and tedious one. These two are robust solutions for the diagnostic labs to fast-pace India’s comprehensive monitoring and detection process. We must wake up to the challenge and include these aspects mentioned above as an integral part of the country’s strategy to counter the pandemic. If we do, we will emerge through the crisis with far fewer losses, agony, and financial burden.

Healthcare innovations for post-pandemic world

Architects and healthcare professionals need to re-look at the design of healthcare facilities.

The COVID-19 pandemic has changed the definition of the normal for most of us. Hospitals around the world
have crumbled under the weight of the virus. The uncertainty has altered the way we live, travel, work and our
perceptions about health and safety. Technology has changed care, efficiency and improvement in healthcare, and it’s time that architects and healthcare professionals relook at the design of these healthcare facilities.
Today, healthcare practitioners and designers worldwide are working in tandem to bring about fundamental
changes in healthcare design and its implementation. At CDA, we believe that the probable future road map
of changes will revamp the medical service sector in the most accurate meaning of the word. As architects, we
refute the argument that the inevitable solution to a collapsing healthcare system is to build more infrastructure,
like metaphorical crutches holding up a dilapidated entity. Health futurists and researchers are now focused on
orienting the healthcare system towards a more digitally seamless care delivery model that attempts to retain the innate essence of care through technology.

Two possible stages anticipate major reorientation of the system’s antiques. The first one being, the hospital-centric model, which will employ tools like AI and Big Data to comprehend patterns out of the already existing profile of patients and use them for creating dynamic, iterative design layouts for hospitals. This model will look to inform itself from the ever-growing pool of healthcare statistics and data to develop digitally transformable floor plans within the hospital. This system will be aided by app-based scheduling and consultation for each patient, which will smartly manage the masses that would wait in endless queues. The dependence on care providers such as nurses can be eased with the help of advanced logistic support mechanisms to cut down on unnecessary displacement to provide for medicines, linens, testing samples, etc.

After boosting the efficiency of the healthcare system, the second stage will move a step further and reduce
the dependency on the hospital facility itself. The hospital building will dwindle in size, cut down on consultation,
diagnostic, and in-patient departments, and retain only intensive care units and critical care. A patient’s health will be monitored by smart infrastructure linked via the cloud to the hospital, which will provide remote healthcare
while in the comfort of one’s own home.

There will be a facility for virtual nursing and online interactions with the caregivers for enhanced support. The architecture of such ‘Smart Infrastructure’ would have to be completely cloud-collaborated, optimisable, and friendly to autonomous mobility such as drones, etc., allowing for interior access, movement, unloading,
and parking; suggests the paper. This will reduce healthcare costs and be a giant leap towards ensuring accessible care and medical service to all.

From a healthcare design standpoint, architects need to look beyond functionality. In a post-pandemic world,
healthcare designers need to set forth innovative solutions that seamlessly blend altruism with technology to
create a robust ecosystem, the benefit of which is bifold. These solutions will render high-quality medical care
to those in need and focus on patient safety, satisfaction, and comfort at present. Additionally, it will streamline
future care delivery by constantly collecting and analysing patient data through tech-enabled infrastructure. To
augment a seamless transition to digital and smart care delivery, healthcare designers should incorporate research in care delivery and equipment technology and analysis in the planning stages to result in flexible infrastructure.

As architects at CDA, we understand the criticality of designing adaptable, sustainable, and responsive hospitals,
focusing on patient care and experience. With a commitment to improving the healthcare scenario in India, we are optimistic that with architects working in partnership with doctors, researchers, policymakers and tech giants, an evolved healthcare ecosystem awaits.

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