ICMR issues new advisory on who needs to undergo Covid test

Jan. 10: The Indian Council of Medical Research (ICMR) on Monday has released fresh advisory for testing COVID-19 samples.

Scope: This advisory on COVID-19 testing strategy is for:

• Early detection of symptomatic cases for quick isolation and care.
• Early detection of infections in elderly (>60yr) and individuals with co-morbidities (diabetes, hypertension, chronic lung or kidney disease, malignancy, obesity etc) for quick care.

Spectrum of Tests available for COVID-19:

• Point-of-Care Tests: Home or Self-Test / Rapid Antigen Test (RAT)
• Molecular Tests: RT-PCR, TrueNat, CBNAAT, CRISPR, RT-LAMP, Rapid Molecular Testing Systems, Newer SARS-CoV-2 Omicron or variant detection rRTPCR assays”

Who may be tested:

A. In community settings:

1. Symptomatic (cough, fever, sore throat, loss of taste and/or smell, breathlessness and/or other respiratory symptoms) individuals.

2. At-risk contacts of laboratory confirmed cases. [At-risk contacts are elderly (>60yr) and individuals with co-morbidity such as diabetes, hypertension, chronic lung or kidney disease, malignancy, obesity etc].

3. Individuals undertaking international travel (as per country-specific requirements).

4.  International travelers arriving at Indian airports/seaports/ports of entries as per laid down guidelines.

B. In Hospital Settings:

5. Testing may be undertaken as per discretion of the treating doctor with the following considerations:

• 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 ore hospitalized for delivery should not be tested unless warranted or symptoms develop.
• Admitted patients may not be tested more than once a week.

People who need not be tested:

1. Asymptomatic individuals in community settings

2. Contacts of confirmed cases of COVID-19 unless identified as high risk based on age or co-morbidities

3. Patients who stand discharged as per home isolation guidelines

4. Patients being discharged from a COVID-19 facility as per revised discharge policy

5. Individuals undertaking inter-state domestic travel

Genome Sequencing is done for surveillance purposes and is not required to be undertaken for treatment 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). 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.

However, ICMR in its latest guideline for Covid test also stated that its advisory is generic in nature and may be notified as per discretion of the state health authorities for specific public health and epidemiological reasons.