Contacts Of Confirmed COVID-19 Cases Need Not Be Tested Unless Under 'High-Risk' Category: ICMR Advisory

The Indian Council of Medical Research (ICMR) announced that contacts of confirmed cases of COVID-19 unless identified as high risk based on age or co-morbidities, need not be tested.

In a fresh set of guidelines and advisory on purposive testing strategy for Covid-19 in India, ICMR said that asymptomatic individuals in community settings, patients who stand discharged as per home isolation guidelines and revised discharge policy, and individuals undertaking inter-state domestic travel need not be tested.

People Who May Be Tested

The advisory stated that tests should be conducted for symptomatic individuals (cough, fever, sore throat etc.) and at-risk contacts of laboratory-confirmed cases. Moreover, individuals undertaking international travel and international travellers arriving at Indian airports and seaports may be tested too.

In hospital settings, ICMR advised that testing may be undertaken as per the discretion of the treating doctor with a few considerations. These considerations include—no emergency procedure like surgeries and deliveries to be delayed for lack of a test and no referring of patients to other facilities for lack of a testing facility. Moreover, asymptomatic patients undergoing surgical/non-surgical invasive procedures, including pregnant women in/near labour hospitalized for delivery, should not be tested unless warranted or they show symptoms.

Why Such A Testing Strategy?

ICMR mentions that the scope of this advisory is for early detection of symptomatic cases for quick isolation and care. Moreover, they aim for early detection of infections in the elderly, that is, people above 60 years of age and individuals with co-morbidities (diabetes, hypertension, chronic lung or kidney disease, malignancy, obesity etc.) for immediate care.

Important Testing Points

A positive point-of-care test that is Home or Self-test/RAT and the molecular test is considered confirmatory, without ant repeat testing. Moreover, symptomatic individuals testing negative on Home/Self-test or RAT should undertake rRTPCR test.

The advisory also stated that genome sequencing is done for surveillance purposes and is not required for treatment purposes. Hence, it is to be performed only in a subset of positive samples as per recommendations of INSACOG (Indian SARS-CoV-2 Genomic Surveillance Consortium).

Experts Reaction

Speaking about no testing of individuals undertaking inter-state domestic travel, Dr Sonali Vaid, physician and public health expert, told India Today, "RTPCR for inter-state travel has turned into a scam, with exorbitant pricing at airports. ICMR has repeatedly advised against it. Recent ICMR advisories have been timely and mostly on point. Earlier in the pandemic, ICMR guideline updates were quite delayed."

Though regarding advice for healthy contacts to not get tested was challenged by her on Twitter, where she tweeted that a healthy person who has a Covid connection may infect other people who are at high risk. "If I am healthy and young but I live with an 80 yr diabetic- I MUST isolate and test after a covid contact!" she tweeted.

Incorrect to advise all healthy contacts not to test
A healthy person who has a COVID contact -may infect other high risk folks
If I am healthy & young but I live with an 80 yr diabetic -I MUST isolate & test after a COVID contact!
Need to #RampUp testing instead of curtailing it https://t.co/toyOV4oOhW

— Dr. Sonali Vaid (@SonaliVaid) January 10, 2022

India recorded 1,68,063 new coronavirus cases, according to the Union Health Ministry data on Tuesday. Various covid restrictions are being imposed in various states to curb the spread of the new Omicron variant.

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