SAI's COVID-19 SOP under spotlight as five hockey players test positive

Manpreet Singh was one of five Indian hockey players to test positive for Covid-19. Ian MacNicol/Getty images

Even as five members of the Indian hockey team were revealed to have tested positive for the Covid-19 virus on Thursday, the reason for their testing negative on tests conducted earlier, appears to be the fact that the standard operating procedure (SOP), laid down by the Sports Authority of India, was not implemented properly.

The initial negative tests results for the hockey players were likely a result of being tested by Rapid Antigen kits rather than the more comprehensive RT-PCR (Real-Time-Polymerase Chain Reaction) tests that the SAI guidelines for the resumption of training camps had mandated.

Referring to athletes who had traveled outside SAI facilities during the nationwide lockdown to curb the spread of the coronavirus, the SOP document, that was published in May, and which had been approved by the Sports ministry stated that "all the athletes and staff, including administrative staff joining the training facilities afresh, shall be tested for COVID-19 (RT-PCR test) to prevent any chance of infection to the personnel who have been staying in an infection free environment at the training facilities...."

Members of the Indian hockey team had returned to the national hockey camp at the SAI South Centre in Bengaluru following a month-long break. They had earlier been stranded at the centre for over two months (till June) when a national lockdown was imposed to contain the virus. However, the members of the Indian hockey team, who had arrived in Bangalore, were subject to the Rapid Antigen test.

In contrast to the RT-PCR test, that takes a minimum of five hours to give out the results, the maximum duration for interpreting a positive or negative test is 30 minutes in the reliable rapid antigen detection test,. However, the antigen test, while delivering quick results, is less accurate, with a sensitivity rate of 50.5% to 84%, depending on the viral load of the patient. Data from two major civic laboratories in Mumbai shows that up to 65% of symptomatic patients who tested negative for the Covid-19 virus on antigen tests were subsequently confirmed with positive results on RT-PCR tests.

It is learned that the Karnataka government, not SAI, conducted the Rapid Antigen Tests on the athletes at the SAI Bangalore campus. Despite the reduced sensitivity of the test, the Karnataka government has been increasing the use of the rapid antigen test as they look to ramp up testing for the virus. Of the 42,458 tests done on August 3, 29,488 (69%) were rapid antigen tests, while 12,970 (30%) tests were performed using RT-PCR kits.

An official order issued by the health and family welfare department reads: "All symptomatic persons testing negative through rapid antigen testing should undergo confirmatory tests through RT-PCR.

As such, the players were subsequently tested via the RT- PCR kit on Thursday, after one player subsequently showed symptoms of the virus. It was subsequently surmised that the players had picked up the virus while traveling to Bengaluru. However, the same test could have been carried out at the start itself since private testing (after furnishing a prescription from an authorized physician) is permitted in Karnataka.

The members of the national cycling camp who arrived at New Delhi's IG stadium at the start of the month, having traveled from various parts of the country, were tested through the RT-PCR kit, which showed that none of the players had the coronavirus. "We were thinking of doing the tests on our own, but the Sports Authority of India suggested that they would get it done for us. They will also be conducting regular tests on the cyclists over the duration of the camp," said Onkar Singh, the general secretary of the Cycling Federation of India (CFI).

But while the CFI is going ahead with its plans for the national camp, other federations are noticeably jittery, especially after the positive cases amongst the men's hockey team.

"The incident came as a shock to us. We feel that it is not possible to conduct a camp. While there's no doubt the players can be kept safely at a camp, there's no way to be sure they will not pick up the virus if they are travelling to the camp from their homes across India," said Rajiv Bhatia, secretary of the National Rifle Association of India, which indefinitely postponed their own national camp that was expected to begin on August 1.