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These labs on wheels rush to people to speed up coronavirus testing

The Mobile Infection Testing and Reporting (MITR) Lab developed by IISc and ShanMukha Innovations
If you ever get stuck at a traffic signal in Bengaluru suburbs and see a fellow commuter wearing personal protective equipment and driving a white and blue van, don’t mistake it to be just any other emergency vehicle. Chances are that it is one of the Mobile Infection Testing and Reporting (MITR) Labs on its way to perform Covid-19 testing. 

The mobile lab is India’s first and only Indian Council of Medical Research (ICMR)-approved biosafety level (BSL-2+)-compliant mobile diagnostic lab for end-to-end RT-PCR (reverse transcription polymerase chain reaction, a laboratory test technique) based Covid-19 testing.

These mobile labs have been developed by the Indian Institute of Science (IISc) in collaboration with ShanMukha Innovations, a company incubated by Society for Innovation and Development-IISc.

The mobile labs enable a significant reduction in turnaround times from 2-10 days to 4-12 hours for the confirmatory test of Covid-19. Adhering to the World Health Organization (WHO) and ICMR guidelines for sample handling, MITR Labs provide the highest levels of safety for health workers. MITR Labs adds a critical element to India’s response to the Covid-19 challenge. The aim is to do rapid deployment of MITR Labs to emerging hotspots and containment zones to provide an effective solution for controlling the spread of infection.

“By taking the lab to the samples, the delays in transporting samples and then awaiting processing in an existing lab can be significantly reduced thereby providing authorities with a critical time in control and preventive measures,” said Arun B, Director, Shanmukha innovations, SID, IISc.  

Supported by various organisations including Tata Motors and SBI Foundation, the first set of MITR labs are successfully tested with the biosafety level (BSL-3) central lab operational at IISc. The first batch of MITR Labs, are ready for deployment.

The mobile labs have the capacity to process 6,000 samples per month with the potential to go up to 9.000 samples per month with additional equipment and workflow optimisation. 

“With completely safe, standards-compliant mobile labs, MIRT Labs can be taken to remote areas and enable end-to-end testing with the same quality as a central lab in a large city,” said Arun.

But how do these mobile labs conduct the tests? Three vehicles are used. The process starts with identification of people who need to be tested. Based on inputs on hotspots, contact tracing and other factors decided by the State health department, first the sample collection van is taken to the location where samples are to be collected.

Maintaining social distancing, the sample is collected in the booth attached to the collection van using approved protocol and swab kits. The swab samples are aliquoted and then inactivated inside a BSL-2 cabinet inside the sample collection van.

Swab specimens are then transferred to the second van, a sample processing vehicle using the pass box present in both the vans. Inside the sample processing van, RNA (ribonucleic acid) extraction and isolation steps are performed within a BSL-2 cabinet. 

RNA samples are then transferred via the pass box to the sample testing van. Template addition and RT-PCR assay are run in the sample testing van. 

After the batch of 80 samples are processed in the RT-PCR instrument, results are analyzed and are uploaded to the ICMR portal with the help of the laptop and 4G network connectivity available inside the sample testing van. Results are then communicated to the patients as per the ICMR guidelines.

MITR Labs are fully equipped and functional molecular diagnostic laboratories. The design of the lab is to adhere to the highest safety standards including choice of materials (stainless steel 304), air circulation, isolation and filtering (high efficiency particulate air filters).

The other gadgets one can see include centrifuges, vortex mixers, BSL-2 cabinets, PCR cabinet, RT-PCR instrument and deep freezers. Some other tech devices placed in the three vans include back-up power generators, webcam and Global Positioning System (GPS) and 4G connectivity.

There is an imminent need to deploy multiple such labs across the country. India which has already overtaken Russia to become the third worst-hit nation by the Covid-19 pandemic, crossed a tally of 14 lakh infections this week. The total confirmed cases of the coronavirus in India are 1,435,453, according to data by Johns Hopkins University. As of Tuesday morning, 32,771 people had died.

ShanMukha Innovations has started engaging with various state governments across the country for additional units. They are also actively working with partners to scale up the solution across the country.

Besides Arun, the other team members behind this innovation include Dr. Sai Siva Gorthi, founder ShanMukha Innovations and associate professor at IISc and Dr. Deepak Saini, who is also an associate professor at the institute. The other members include Rajesh Srinivasan, a PhD scholar at IISc, Sujith Vijayan, product design lead and Yatish Dasari, who handles operations. The team is geared up to produce additional units of MITR Labs through its network of vehicle, fabrication and equipment suppliers. 

As the state health departments are the primary beneficiaries of this solution, Arun said his team need their active engagement to specify the number of such labs required in each state. This includes operational support for the same to ensure effective use of the solution in addressing the testing challenges. 

“The Central government can provide support to the states in implementing this solution at the regional level,” said Arun. “Private sector CSR teams and NGOs can partner with the government to scale this further through their resources for both MITR Labs and their operations.”
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