Covid-19 testing in Herat; infection rate seems higher than official report

A finding by Kabul Now suggests that infection rate of coronavirus in western Herat province seems low for major health facilities in the city have pitfalls in assessment of Covid-19 testing.

Herat was the first city which reported the first positive case of coronavirus in Afghanistan; official record, however, shows a decline in positive cases of Covid-19 disease as compared to the capital Kabul. According to figures issued by the Ministry of Public Health (MoPH), out of 84 new cases of coronavirus reported in 15 provinces over the past 24 hours, only three people tested positive for the pandemic disease in the western Herat province.

Speaking at a press conference on Wednesday, April 22, in Kabul, the MoPH spokesperson, Wahidullah Mayar said that the remaining 81 cases were reported in Kabul (28), Kandahar (22), Nimroz (5), Helmand (4), Zabul (2), Ghazni (2), Kapisa (4), Nangarhar (6), Kunar (3), Parwan (1), Bamyan (1), Laghman (1), Paktika (1), and Farah (1) provinces.

According to official record, the total confirmed cases of covid-19, which is widely disputed, raises to 1,176 cases. Surpassing Herat province, Kabul has now the highest number of infected patients (413) followed by Herat (334), and the southern province of Kandahar (130).

According to Mayar, a total of 166 patients have recovered from the disease and 40 others have lost their lives across the country.

The dramatic decline in Herat province seems dubious and far from reality since the province is adjacent to Iran, facing a huge influx of refugees who return from Iran after outbreak of the coronavirus in Iran.

Sources from Herat’s health sector, who spoke on condition of anonymity, told Kabul Now that China-made testing kits are not responsive. They say VTM tubes, used by health facilities, do not work as proper as requited.

Sources claim that the actual number positive cases of coronavirus in Herat is higher than the number officially announced.  

“If VTMs do not have the required quality, there would be problems in the virus growth. These tubes have the required quality for the virus growth,” said Feroz Frotan, who is in charge of Herat’s laboratories association. He, however, added that it may cause problem if the quality of the VTM is not checked.

Lack of required medical materials for testing Covid-19 is another matter of concern in Herat. Most Covid-19 diagnostic laboratories do not have required medical materials to test cases of the pandemic virus.   

“When a laboratory fails to test a Covid-19 case it could be disastrous for the patient would freely make movements in the community,” said Mahdi Hadid, a member of Herat provincial council.

Spokesperson for Herat’s public health department, however, assures that all tests for coronavirus are taken with accuracy and are processed through PCR diagnostic panel. According to him, the VTM tubes, supplied by the World Health Organization (WHO), work properly.

The MoPH spokesperson, Wahidullah Mayar, also assures about accuracy of PCR tests, explaining that tests have 99 percent accuracy and some results, which were double-checked in Netherland, showed the same results as were tested in Afghanistan.

Lack of nasal swabs

At times when positive cases of coronavirus was reported high, samples were taken and tested from patients’ nose and mouth. But, Herat’s Covid-19 diagnostic lab has ran out of nasal swabs since five days ago while experts believe that taking nasal specimen to diagnose the coronavirus is more helpful than specimen taken from the patients’ mouth.

On the other hand, sources told Kabul Now that all people who have died of suspicious coronavirus are not tested either for coronavirus due to lack of sufficient facilities. According to Herat’s health authorities, seven people—so far have died of the coronavirus—have raised speculation in the city.

According to Ghulam Hazrat Mushfiq, Herat’s Mayor, the patients who pass away as the result of covid-19 disease are buried in a special way.

Forced tests by strongmen

Some strongmen force doctors to test them and their relatives.  The source, however, said that 99 percent of the order based tests have been negative.

Meanwhile, spokesperson for Herat’s health department, said that the process of taking samples from suspicious patients was stopped in “Polyclinic” of the province. “We prioritize those to take test for coronavirus who show special symptoms or are under treatment in our centers,” he added.

One PCR machine for western Afghanistan

According to Herat’s health authorities, there are four PCR machines in the province but just one machine is currently operational. One of the reasons behind delay in results of the tests is lack of required equipment in the lab.  

Based on the account of spokesman for Herat’s health department, they have already talked to WHO for supplying the required equipment to make the remaining three PCR machines operational. He added that if all four machines become operational, the testing capacity will boost up by 500 cases on daily basis.

This comes while samples taken in Farah, Badghis, and Ghor provinces are also tested in Herat province. Feroz Frotan, head of Herat’s laboratories association says that test centers in Herat are understaffed.