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Transportation has been the most important means of spread of covid-19 across the globe

Transportation has been the most important means of spread of covid-19 across the globe

Advanced Lab provides full range of routine and special tests at highly economical rates.

Interview with Prof. Dr. Rafiq Khanani — Managing Director, Advanced Laboratories Private Limited

Dr. Rafiq Khanani is a pioneer in the development of clinical diagnostic services in Pakistan. He is a Founding Director of Dow Diagnostic Reference and Research Laboratories, Dow Institute of Hematology and Blood Transfusion, Dow Radiology Institute, Institute of Biological and Biomedical Sciences, and Citilab Diagnostic Centre.

Advanced Laboratory Diagnostic Centre is a refreshed commitment by the founder of Citi Diagnostic Centre Professor Rafiq Khanani and his team. Citilab Diagnostic Center was founded in 1986. Over the years, Advanced Laboratories has evolved into an established name in PCR, ECLI and HPL-C Technology, trusted by patients, physicians, renowned labs, healthcare centre and NGOs. He is currently a Managing Director of Advanced Laboratories Private Limited.

PAGE: How do you look at COVID-19?

Dr. Rafiq Khanani: COVID-19 spread across the globe during the last ten months started from Wuhan city of China in November-December 2019. It was considered a problem of Hubei province of China and world did not pay much heed to it till hundreds of miles away, unnervingly it entered every nation, bypassing the so called ‘fool proof’ security barriers, immigration laws and health screening. As most of the nations under estimated the potential of this virus appropriate control measures were not instituted although scientist fraternity not only was expecting such an epidemic and global measures in place to identify it at the earliest point, not much was done due to different political priorities of the governments.

The earliest symptomatic case was traced back to December 1, 2019. China reported first COVID-19 death on January 11, 2020. Wuhan, a city of 11 million people, was placed under quarantine orders on January 23 but it was too late to contain the virus, which silently harbored in thousands of seemingly healthy individuals. On January 30th World Health Organization declared it as Global Public Health Emergency after receiving reports of 9000 COVID-19 cases from 18 countries outside China. Virus continued its journey in the bodies of healthy and sick persons to anchor in every nook and corner of the world. Realizing the potential of spread globally World Health Organization (WHO) on March 11, 2020 declared COVID-19 as global pandemic.

Diamond Princess Cruise ship was the first to make headlines as 10 people on board had tested positive for the novel coronavirus on February 4, 2020. The cruise from the Port of Yokohama on 20 January 2020 for a round-trip tour of Southeast Asia during the Lunar New Year period with 2,666 passengers and 1,045 crew members onboard, out of that 705 tested positive and 17 died in due course.

PAGE: What could have been most important cause of spread?

Dr. Rafiq Khanani: Transportation has been the most important means of spread of COVID-19 across the globe. First case in Pakistan was reported on February 26, 2020 and first death on March 20, 2020. Total number of laboratory proven cases in Pakistan was 318,000 and deaths directly attributed to COVID-19 were 6,560, till this filing. A close look at the epidemic curve in Pakistan shows that one day maximum of 6,825 new infections were reported on June 14, 2020, highest number of 153 deaths were reported on June 20th. On August 3 only 331 cases (80% reduction) reported and only 6 deaths (96% reduction) on August 02. Since then, the epidemic curve has flattened with occasional small surges and troughs. Such a significant reduction in only six weeks was a great sigh of relief.

PAGE: Has there been any unique behavior in Pakistan?

Dr. Rafiq Khanani: Recent studies show that gene deletions in the SARS CoV-2 genome in persons with COVID-19 are responsible for attenuated (low) virulence and transmission. Viruses that infected the first generation of host during March 2020 were brought in by persons coming from countries with infection. When these viruses started circulating locally for the first 20-25 generations, up to the month of June 2020 were able to maintain their original makeup. Virulence and transmissibility reduction became noticeable in the last week of June 2020, which can only be explained by gene deletions most important of which are ∆382 and others hitherto unidentified deletions most probably in ORF6 or 8. Pakistan has relaxed the rules of testing and quarantine for inbound passengers, which may bring highly aggressive viruses circulating in Europe, America and other countries. Life cannot go on without transportation industry, but we must learn to live with COVID-19 and adapt ourselves to the new norms of travel not only to contain COVID-19 but also to prevent impending threats of new, hitherto, unknown pathogens.

PAGE: What role is being played by Advanced Laboratories?

Dr. Rafiq Khanani: Advanced Laboratories is a progressive development of Citilab, which was formed in 1987 by a group of pathologists and radiologists. Citilab was a pioneer in starting innovative technology in laboratory diagnosis of HIV and Hepatitis in Pakistan by automatic ELISA technique in 1987. Citilab started Molecular Pathology Labs in 2008 especially for Hepatitis B, C and HIV. As soon as COVID PCR was available in Pakistan during the last week of March 2020, Advanced Lab also started performing these tests after approval from the Sindh Health Care Commission. Advanced Lab has performed over 30,000 COVID PCR tests. Laboratory regularly participate in External Quality Control program of American Proficiency Institute and inter laboratory quality control programs. Clients have repeated tests with other contemporary labs and have found Advanced Lab reports up to the satisfaction of doctors. Laboratory provides full range of routine and special tests at highly economical rates.

PAGE: What is the biggest asset of Advanced Lab?

Dr. Rafiq Khanani: Biggest asset of Advanced Lab is qualified, experienced and dedicated team of professionals. However, best quality equipment and consumable chemicals and kits are also as important. Advanced Lab also has the most up to date software to satisfy the requirements of various industries including air travel industry, which require dedicated portals and security. Advanced Lab is serving several airlines and Gerry’s Travel passengers. Smaller cities generally do not have high quality labs. Advanced Lab as well as other labs have collection units, which serve most of the purpose.

In COVID-19 Advanced Lab has been at the forefront of client-oriented services. We provided home sampling for infected individuals to prevent further spread, drive through collection of samples, training of technicians to properly collect the samples, fast reporting of results, additional tests required for monitoring of patients and prognosis, additional tests for Antigens, IgG and IgM antibodies, COVID-19 antigen tests etc. We also continuously communicated our results to the government for public health and epidemic monitoring purpose. Advanced Lab is also taking part in several national and international research projects on corona virus including genetic analysis.

PAGE: Do Pakistanis follow SOPs?

Dr. Rafiq Khanani: As far as SOPs are concerned there is very poor compliance. COVID-19 in Pakistan has entered into endemic phase with reduced pathogenicity and transmissibility but if new viruses are introduced it may lead to new waves of highly lethal infections. Government should impose strict regulation for incoming passengers to prevent re introduction of highly virulent viruses.

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