COVID-19 testing during the second wave of the pandemic

Latest Advisory from ICMR dt 04/05/2021

Context Recommendation to introduce Rapid Antigen Testing by ICMR

An unprecedented upsurge of COVID-19 cases and deaths is currently being witnessed across India. The overall nationwide test positivity rate is above 20%. Testing-tracking-tracing, isolation and home-based treatment of positive patients is the key measure to curb transmission of SARS-CoV-2, the causative agent of COVID-19. As on today, India has a total of 2506 molecular testing laboratories including RTPCR, TrueNat, CBNAAT and other platforms. The total daily National testing capacity is close to 15 lakh tests considering a three- shift operationalization of the existing laboratory network. At present, the laboratories are facing challenges to meet the expected testing target due to extraordinary case load and staff getting infected with COVID-19. In view of this situation, it is imperative to optimize the RTPCR testing and simultaneously increase the access and availability of testing to all citizens of the country.

Recommended measures to optimize RTPCR testing :

i. RTPCR test must not be repeated in any individual who has tested positive once either by RAT or RTPCR.
ii. No testing is required for COVID-19 recovered individuals at the time of hospital discharge
in accordance with the discharge policy of MoH&FW
iii. The need for RTPCR test in healthy individuals undertaking inter-state domestic travel may be completely removed to reduce the load on laboratories.
iv. Non-essential travel and interstate travel of symptomatic individuals (COVID-19 or flu like symptoms) should be essentially avoided to reduce the risk of infection.
v. All asymptomatic individuals undertaking essential travel must follow COVID appropriate behavior.
vi. Mobile testing laboratories are now available on GeM portal. States are encouraged to augment RTPCR testing through mobile systems.

Measures to improve access and availability of testing:

Rapid antigen tests (RATs) were recommended in India for COVID-19 testing in June 2020. However, the use of these tests is currently limited to containment zones and health care settings. RAT has a short turnaround time of 15-30 minutes and thus offers a huge advantage of quick detection of cases and opportunity to isolate and treat them early for curbing transmission. So far, ICMR has approved 36 RATs of which 10 are on GeM portal. To meet the overwhelming testing demand, it will be prudent to upscale testing using RATs.

Measures to ramp up testing through RAT

i. RAT may be allowed at all available Government and private healthcare facilities.
ii. Set up dedicated RAT booths in cities, towns and villages to offer testing to people.
iii. Testing booths may be set up at multiple locations including healthcare facilities, RWA, offices, schools, colleges, community centers and other available vacant spaces.
iv. These booths should be operational on a 24X7 basis to improve access and availability of testing.
v. Drive-through RAT testing facilities may be created at convenient locations as identified by local administration.
vi. Stringent measures must be instituted to avoid overcrowding at RAT testing facilities.

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