NATHEALTH has conducted a recent survey among 50 private laboratories across 13 Indian states to explore ways to enhance testing in private sector labs. Findings indicate that with the current testing scenario, while the public sector is running at nearly full capacity, the private sector is being utilized only at 25-30 %. 

The surveyed labs are currently working only single shifts, doing cumulative 5,000 tests per day with 17 labs doing less than 100 tests per day and 6 labs not doing any testing at all. A mere 30% utilization of private labs also indicate demand flow as a challenge to enhance testing. The current testing regime prioritizes demand flow to public labs with only excess demand flowing to private labs.

The current testing capacity in India stands at 150,000-170,000 tests per day with the public sector capacity at ~110,000 tests per day and private sector capacity at ~60,000 tests per day. Currently India is conducting 100,000 tests per day. A large portion of this is driven by public sector which conducts around 75,000 – 80,000 tests, while private sector conducts 15,000 – 20,000 tests per day. Private labs with support from central and state governments could quickly ramp up testing up to 4-6 times with double shifts.

Lab operators also mentioned significant on the ground operational issues. 56% of the survey respondents face logistics challenges which can be solved by sample flow between districts & states to ensure better utilization. 54% face difficulties with guidelines and procedures that may be solved by standardization of forms and simplified approval processes for sample collection. 24% face pricing and commercial solution for which lies in expedited payments to tide over immediate liquidity challenges and consolidated procurement of consumables/ kits.

The respondents to the survey highlighted that support is needed across Central and State Governments to ramp up testing. There is a potential to increase the testing capacity by 6 times through better utilization and 2-shift operations in private labs. Improving existing capacity utilization to 80% will increase testing to 14,000 tests per day assuming 1 shift operation. Additionally, increasing shifts to 2 will increase testing by 30,000 tests per day. We need to act now with cases expecting to peak further by mid-June 2020. 

The survey also indicates three key themes that require intervention to ramp up testing and reduce COVID19 infections:

Coordinated Operations support

• Consider consolidated procurement to manage costs
• Standardize one data entry format across Center / State
• Streamline sample collection approval
• Single window resolution of operational issues

Demand flow

• Demand flow currently directed predominantly to public labs. Consider private labs as active parts of the testing regime rather than just overflow capacity
• Resolve inter district/ inter-state logistics and testing to enhance utilization
• Explore private labs for antibody tests in future

Liquidity and standardized Pricing Guidelines

• On time payments for government directed testing to support cash-flow;
• Standardize NHA prices across states for testing for government directed tests