ICMR issues new guidelines for COVID-19 tests

New Delhi: The Indian Council of Medical Research issued an advisory on 10th January titled, "Purposive Testing Strategy for COVID-19 in India", where it laid down guidelines on who may or may not get tested for Covid-19 amidst the rising cases in India presently. 

Under community settings, symptomatic individuals; at-risk contacts, i.e elderly and individuals with co-morbidity such as diabetes, hypertension, chronic lung or kidney disease, malignancy, obesity etc, of laboratory confirmed cases;  individuals undertaking international travel, and international travelers arriving at Indian airports/seaports/ports of entries are required to get tested for Covid-19.

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For those under hospital settings, the ICMR stated some guidelines that could be followed after considering the advice from the treating doctor. It stated:

• No emergency procedure (including surgeries and deliveries) should be delayed for lack of a test.
• Patients should not be referred to other facilities for lack of a testing facility. All arrangements should be made to collect and transfer samples to testing facilities, mapped to the health facility.
• Asymptomatic patients undergoing surgical / non-surgical invasive procedures including pregnant women in/near labour who are hospitalized for delivery should not be tested unless warranted or symptoms develop
• Admitted patients may not be tested more than once a week.

However, the people who are not required to get tested are:

• 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 revised discharge policy
• Individuals undertaking inter-state domestic travel

It stated that testing could be undertaken either through rRT-PCR, TrueNat, CBNAAT, CRISPR, RT-LAMP, Rapid Molecular Testing Systems or through Rapid Antigen Test (RAT). However, it noted that a home or self-test / rapid antigen testing and molecular test (which are rRT-PCR, TrueNat, CBNAAT, CRISPR, RT-LAMP, Rapid Molecular Testing Systems, Newer SARS-CoV-2 Omicron or variant detection rRTPCR assays) could be confirmatory which would require any repeat testing. And symptomatic individuals testing negative are required to undertake RTPCR test as detailed in the algorithm. 

It also directed all the RTPCR and RAT tests to be uploaded on the ICMR portal. It further states that the vaccination status of those testing for Covid-19 though any method should be entered into the Sample Referral Form (SRF) in the RTPCR app. 

It states, "genome sequencing is to be performed only in a subset of positive samples as per recommendations of INSACOG", reasoning that the sequencing is conducted for surveillance purposes. 

Citing quicker detection of newer variants, it notes, "The newer SARS-CoV-2 Omicron or variant detection rRTPCR assays are recommended to be used in areas with limited genomic surveillance capacity for quick detection of emergence of newer variants in such areas."

The guidelines issued by the ICMR could be accessed here.