New advisory says State Govts free to choose modalities as per their needs
The Indian Council of Medical Research (ICMR) has revised its Covid-19 testing strategy, allowing on-demand testing without a prescription across the country. However, it has given the flexibility to the States the right to modify the module accordingly.
“A totally new section has been added in the advisory on “Testing on Demand” which for all practical purposes does away with prescription by a registered medical practitioner though State Governments have the freedom to decide on simplified modalities,” the ICMR said in a statement here.
The ICMR also highlighted the frequency of Covid-19 testing. It stated that a single RT-PCR/TrueNat/
CBNAAT/ RAT positive test is to be considered confirmatory, without any repeat testing.
The on-demand testing facility can be availed by all individuals undertaking travel to countries/Indian States such as Himachal Pradesh and Uttarakhand mandating a negative Covid-19 test at the point of entry.
Tracking and contact tracing mechanisms should be ensured by the testing laboratories by notifying public health authorities.
The advisory came after the Delhi high court asked the State Government to re-think its policy to include asymptomatic patients for testing. The ICMR told the court it is just an advisory body and States were free to make changes as per their needs.
Rapid antigen testing (RAT) is the preferred strategy for screening in Covid-19 containment zones. People with influenza-like illnesses, all direct and high-risk contacts (family members, colleagues, those above 65, immune compromised, or have conditions such as diabetes, hypertension, or heart, kidney, and lung diseases), are required to be screened.
The new strategy lists situations where molecular testing such as reverse transcription-polymerase chain reaction (RT-PCR) should be preferred over the cheaper and faster but less accurate RAT. “Ideally, it is suggested that 100 per cent of people living in the containment zones should be tested by RAT particularly in cities where there has been a widespread transmission of the infection,” as per the ICMR?guidelines.
The guidelines also instructed the States that no emergency procedure should be delayed for the want of a test.
“Hospitals have been directed not to refuse admission to pregnant women citing lack of testing facility. All arrangements should be made to collect and transfer samples to a testing facility. Mothers, who test positive for the infection, have been advised to wear masks, wash hands frequently while handling babies, and cleaning breasts before feeding them,” as per the guidelines.
Also, all neonates with acute respiratory or sepsis-like illnesses or those with non-respiratory symptoms such as fever, lethargy, poor feeding, seizures, and diarrhea should be tested for Covid-19 using RT-PCR.
The strategy also suggests testing those with the atypical presentations for Covid-19 such as stroke, encephalitis, blood mixed sputum, pulmonary embolism, acute heart conditions, etc.
Further, the existing recommendations related to testing for COVID-19 have been extended, elaborated and divided into four parts -- routine surveillance in containment zones and screening at points of entry, routine surveillance in non-containment areas, hospital settings and testing on demand -- and choice of test (RT-PCR, TrueNat or CBNAAT and rapid antigen tests) in order of priority has been listed.
