Nepal

Shortage of kits to transport virus samples

Shortage of kits to transport virus samples

By Sabitri Dhakal

Rapid diagnostic test (RDT) kits are pictured on the 22nd day of the government imposed lockdown in Lalitpur, on Tuesday, April 14, 2020. Photo: Skanda Gautam/THT

Kathmandu, April 19 Hospitals and laboratories are facing shortage of kits to safely transport specimens collected from suspected COVID-19 patients. The nasal and throat swabs collected from suspected coronavirus patients across the country are transported in kits known as viral transport media. The swabs are being tested in 15 different laboratories across the country to confirm COVID-19. Test results are then cross-verified at National Public Health Laboratory, Teku, before making them public. But many hospitals that collect the specimens from suspected coronavirus patients are facing a shortage of viral transport media. “We only have seven VTM left,” said Madan Kumar Upadhyaya, medical superintendent at Narayani Sub-regional Hospital, which is treating four COVID-19 patients in its isolation ward. The hospital collects more than 20 specimens per day and sends them to laboratories in Kathmandu and Hetauda. Bharatpur Hospital is facing the same problem. “We have about 40 VTM left with us. If there is a rise in the number of cases, it will be difficult to transport the samples to labs,” said Shree Ram Tiwari, chief medical superintendent of the hospital. Province Public Health Laboratory, Janakpurdham, which is also facing shortage of VTM, had asked for 1,000 such kits. “But we are yet to receive them,” said Ram Binay Sah, officiating director of the laboratory, which has already collected 317 samples of suspected COVID-19 patients but has only 40 VTM left in its stock. Laboratories across the country are testing over 190 samples per day using the polymerase chain reaction method in which nasal and throat swabs are tested. So far, 8,050 tests have been performed using this method. The World Health Organisation strongly recommends the use of VTM whenever specimens cannot be taken to labs promptly, because these kits allow storage of samples at a temperature of 2-8 degrees Celsius. “Collection of samples without a VTM is improper. VTM has chemicals in it to preserve the virus and prevents bacterial and fungal growth. The chemicals in the VTM also help preserve the RNA (genes) of the virus. We can’t take samples to labs without VTM,” said Shravan Kumar Mishra, virologist at National Public Health Laboratory. NPHL had added 10,000 VTM to its stock in late March. “At that time, we had about 2,000 additional VTM. We gave them to provinces as per their demand,” said NPHL Director Runa Jha. Nepal has detected 31 COVID cases so far; four patients have recovered. Health experts have been demanding that the number of PCR tests be increased for early detection and isolation of COVID-19 patients for which adequate number of VTM is needed. “The process of procuring additional 15,000 VTM is under way. It will take eight to 10 days to bring the kits,” said Bhogendra Dotel, director Logistics Management Division under the Department of Health Services. A version of this article appears in e-paper on April 20, 2020, of The Himalayan Times.