Amid the unprecedented India lockdown, a staggering 85 per cent of India's 100,000 pathological laboratories, an important component of the public health services, have downed shutters, industry players said.
Of this 100,000 path-labs, roughly 80 per cent, are run by technicians with a diploma in Medical Lab Technology qualifications in Tier III or IV places, around 3,000 run by MD (Pathology), some 1,500 by institutions, diagnostic chains or major hospitals and the rest by MBBS doctors, mostly in Tier I and II centres.
Nearly 85% of labs closed
"Since lockdown, almost 85 per cent of the path-labs remain closed for various reasons. Primarily, the lab staff cannot commute to work, patients are scared because of Covid-19, hospitals have slashed all their routine surgeries/procedures, OPDs cater to only emergency problems, besides the prohibitive costs to keep labs running without patients," Transasia Managing Director Suresh Vazirani told IANS.
The result is only bare minimum lab facilities are available for cancer patients, pregnant women or critical cases, with skeletal staff of 10-15 per cent, said Association of Practising Pathologists of India (APPI) Committee member Dr. Vipul Patel.
Owner of Bhide Laboratory Services, Charni Road, Dr. Milind Bhide said that a majority of his technicians live in the suburbs and nobody can travel due to the lockdown.
"The skeletal public transport is only for government servants, lab technicians are not permitted. We tried options like sending vehicles for pickup-drops, but it was not practical, so even I had to temporarily close it down," Bhide told IANS.
Lab technicians: Most vulnerable group
Vazirani, who is one of India's leading lab equipment and reagents manufacturer, said that all regular and periodic necessary tests for hypertension, diabetes, bilirubin (jaundice), malaria, urinary tract infection, and diarrhea are closed.
"Even many medicines are not easily available, so many just pop paracetamol for temporary relief. But in the absence of proper tests, diagnosis, medicines and treatment, there could be long-term repercussions on peoples' health," said a concerned Vazirani.
Bhide said there is another serious issue for the private lab technicians -- roughly estimated to be around one million in the country -- who are not covered under the Rs 50 lakh insurance scheme announced by the Centre last week, at the height of the Covid-19 pandemic.
"Path-lab technicians are also at the risk of the pandemic, their families worry over the nature of the work as nobody knows what kind of patient we are dealing with (routine or a possible Covid-19 infectee). Plus, there is shortage of safety equipment for most of the smaller labs," Bhide said.
Lockdown hit supplies of medical raw materials
Patel urged the government to consider extending the Rs 50-lakh insurance cover to all the Path-lab technicians, staff and medicos as they render very critical services to the overall public health system.
Patel added that the emergency services currently available are only in the labs managed by doctors who have upgraded their safety standards, while the others have no resources or access to enhance their safety norms suited for a pandemic like Covid-19.
"However, at a meeting today, the APPI committee reviewed their preparedness after the lockdown is lifted and there is a flood of patients, the regular and the fresh ones, the safety procedures and other aspects," Patel said.
Vazirani, Patel and Bhide point out how the total lockdown has hit supplies of medical raw materials like chemicals or even alcohol as the wholesale markets (like Mumbai's Dava Bazaar) are shut, further hampering the work of path-labs.
Other industry players said that with most surgeries postponed and out-patient-departments shut in most hospitals, even the work of other diagnostics systems like x-rays, ultrasound, sonography, CT-Scan, MRIs, etc has been badly hit.
Of the 100,000 path-labs in the country, only a small percentage adhere to the recognized quality systems or accreditation by the National Accreditation Board for Laboratories (NABL), which is another matter of concern, according to experts.