• Nivedita Gupta, Varsha Potdar, Ira Praharaj, Sidhartha Giri, Gajanan Sapkal, Pragya Yadav, Manohar Lal Choudhary, Lalit Dar, A P Sugunan, Harmanmeet Kaur, Ashok Munivenkatappa, Jayanthi Shastri, Krishnasamy Kaveri, Shanta Dutta, Bharti Malhotra, Amita Jain, Kammilli Nagamani, G B Shantala, Sharmila Raut, M M Vegad, Ajanta Sharma, Aashish Choudhary, Megha Brijwal, Anukumar Balakrishnan, Jayaswamy Manjunatha, Manish Pathak, Sivasubramanian Srinivasan, Hasina Banu, Himanshu Sharma, Parul Jain, Pakalpati Sunita, R Ambica, Babita Fageria, Disha Patel, Gitika Rajbongshi, Neetu Vijay, Jitendra Narayan, Neeraj Aggarwal, Anu Nagar, Raman R Gangakhedkar, and Priya Abraham.
• Division of Epidemiology & Communicable Diseases, Indian Council of Medical Research, New Delhi, India.
• Indian J Med Res. 2020 Feb 1; 151 (2 & 3): 216-225.

Background & ObjectivesAn outbreak of respiratory illness of unknown aetiology was reported from Hubei province of Wuhan, People's Republic of China, in December 2019. The outbreak was attributed to a novel coronavirus (CoV), named as severe acute respiratory syndrome (SARS)-CoV-2 and the disease as COVID-19. Within one month, cases were reported from 25 countries. In view of the novel viral strain with reported high morbidity, establishing early countrywide diagnosis to detect imported cases became critical. Here we describe the role of a countrywide network of VRDLs in early diagnosis of COVID-19.MethodsThe Indian Council of Medical Research (ICMR)-National Institute of Virology (NIV), Pune, established screening as well as confirmatory assays for SARS-CoV-2. A total of 13 VRDLs were provided with the E gene screening real-time reverse transcription-polymerase chain reaction (rRT-PCR) assay. VRDLs were selected on the basis of their presence near an international airport/seaport and their past performance. The case definition for testing included all individuals with travel history to Wuhan and symptomatic individuals with travel history to other parts of China. This was later expanded to include symptomatic individuals returning from Singapore, Japan, Hong Kong, Thailand and South Korea.ResultsWithin a week of standardization of the test at NIV, all VRDLs could initiate testing for SARS-CoV-2. Till February 29, 2020, a total of 2,913 samples were tested. This included both 654 individuals quarantined in the two camps and others fitting within the case definition. The quarantined individuals were tested twice - at days 0 and 14. All tested negative on both occasions. Only three individuals belonging to different districts in Kerala were found to be positive.Interpretation & ConclusionsSudden emergence of SARS-CoV-2 and its potential to cause a pandemic posed an unsurmountable challenge to the public health system of India. However, concerted efforts of various arms of the Government of India resulted in a well-coordinated action at each level. India has successfully demonstrated its ability to establish quick diagnosis of SARS-CoV-2 at NIV, Pune, and the testing VRDLs.

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