In a significant change in testing protocol in the country, the Indian Council of Medical Research has recommended stopping mandatory testing of all COVID-19 patients during contact tracing and only testing those who are at ‘high risk’. The ICMR advisory recommended that the contacts of confirmed COVID-19 cases do not need to get tested unless identified as "high risk" based on age or comorbidities, according to a new government advisory.
The Indian Council of Medical Research Advisory on Purposive Testing Strategy for COVID-19 said that individuals undertaking inter-state domestic travels also do not need to get tested. It said testing can be undertaken either through RT-PCR, TrueNat, CBNAAT, CRISPR, RT-LAMP, Rapid Molecular Testing Systems or through Rapid Antigen Test (RAT). However, it is pertinent to note that the advisory is generic in nature and may be modified as per the discretion of the state health authorities for specific public health reasons.
A positive point-of-care test (home or self-test/RAT) and molecular test is to be considered confirmatory, without any repeat testing, the advisory said. It also added that symptomatic individuals, testing negative on home/self-test or RAT should undertake RT-PCR test.
The ICMR guidelines said that the following groups of people need not get tested for the coronavirus:
> Asymptomatic individuals in community settings
> Contacts of confirmed cases of COVID-19 unless identified as high risk based on age or comorbidities
> Patients who stand discharged as per home isolation guidelines
> Patients being discharged from a COVID-19 facility as per the revised discharge policy
> Individuals undertaking inter-state domestic travel
The ICMR said that the new advisory is aimed at early detection of symptomatic cases and early detection of infections in senior citizens and individuals with co-morbidities (diabetes, hypertension, chronic lung or kidney disease, malignancy, obesity etc) for quick care.
The guidelines also state that genome sequencing is not required to be undertaken for treatment, as it is done for surveillance purposes. “Therefore, genome sequencing is to be performed only in a subset of positive samples as per recommendations of INSACOG (Indian SARS-CoV-2 Genomic Surveillance Consortium),” it said.