September 20, 2020

ICMR points advisory permitting ‘testing on demand’ for COVID-19



The Indian Council of Medical Analysis (ICMR) has issued an advisory on COVID-19 testing technique, permitting ‘testing on demand’ for people however left it to states to change the method as per their discretion. It additionally suggested testing on demand for “all people enterprise journey to international locations or Indian states mandating a unfavorable COVID-19 take a look at on the level of entry”.

The ‘Advisory on Technique for COVID-19 Testing in India’ (model VI), issued on Friday, stated the state governments can simplify the modalities to facilitate testing on demand. It additionally advised that 100 per cent of individuals residing in containment zones ought to be examined by speedy antigen exams, notably in cities the place there was widespread transmission of the an infection.

The ICMR additionally harassed that no emergency process (together with deliveries) ought to be delayed for lack of exams, and pregnant girls shouldn’t be referred for a scarcity of testing facility. Additional, the present suggestions associated to testing for COVID-19 have been prolonged, elaborated and divided into 4 elements — routine surveillance in containment zones and screening at factors of entry, routine surveillance in non-containment areas, hospital settings and testing on demand — and selection of take a look at (RT-PCR, TrueNat or CBNAAT and speedy antigen exams) so as of precedence has been listed.

Beneath the class of ‘routine surveillance in containment zones and screening at factors of entry’, the advisory really useful testing of all asymptomatic high-risk people (folks above 65 and people with co-morbidities and so on.) in containment zones.

Moreover, it suggested testing all symptomatic (ILI signs) circumstances, together with healthcare and frontline employees. All asymptomatic direct and high-risk contacts (in family and office, folks aged 65 and above, those that are immunocompromised or have co-morbidities and so on) of a laboratory-confirmed case are to be examined as soon as between day 5 and day 10 of coming into contact.

So far as selection of take a look at is worried, speedy antigen take a look at (RAT) is listed first, adopted by RT-PCR or TrueNat or CBNAAT because the second choice. “Ideally, it’s advised that 100 per cent folks residing in containment zones ought to be examined by RAT, notably in cities the place there was widespread transmission of an infection,” the advisory stated.

Beneath the class of ‘routine surveillance in non-containment areas’, the advisory really useful testing all asymptomatic high-risk contacts (contacts in family and office, folks aged 65 and above, these with co-morbidities and so on), with RAT being the primary selection of take a look at so as of precedence.

Moreover, it suggested testing all symptomatic (ILI signs) people with historical past of worldwide journey within the final 14 days, all symptomatic (ILI signs) contacts of a laboratory-confirmed case, all symptomatic (ILI signs) healthcare and frontline employees concerned in containment and mitigation actions and all symptomatic ILI circumstances amongst returnees and migrants inside seven days of sickness, with RT-PCR, TrueNat or CBNAAT being the primary selection of take a look at so as of precedence.

Beneath the class ‘hospital settings’, the advisory really useful testing all sufferers of Extreme Acute Respiratory An infection (SARI), all symptomatic (ILI signs) sufferers presenting in a healthcare setting, asymptomatic high-risk sufferers who’re hospitalised or looking for rapid hospitalisation equivalent to immunocompromised people, sufferers recognized with malignant ailments, transplant sufferers, sufferers with power co-morbidities and other people aged 65 and above.

It additionally advised testing for asymptomatic sufferers present process surgical/non-surgical invasive procedures (to not be examined greater than as soon as per week throughout hospital keep) and all pregnant girls in/close to labor who’re hospitalised for supply.

The ICMR harassed that no emergency process (together with deliveries) ought to be delayed for lack of take a look at, and pregnant girls shouldn’t be referred for a scarcity of testing facility. It added that every one preparations ought to be made to gather and switch samples to testing amenities.

Moms who take a look at constructive for COVID-19 ought to be suggested to put on a masks and undertake frequent handwashing whereas dealing with their child for 14 days. They need to even be suggested on breast cleansing earlier than feeding the neonate.

These measures are more likely to scale back transmission of COVID-19 to their infants, the doc stated.

The advisory additionally really useful testing all symptomatic neonates presenting with acute respiratory/sepsis like sickness and sufferers presenting with atypical manifestations equivalent to stroke, encephalitis, pulmonary embolism, a number of organ dysfunction syndrome, progressive gastrointestinal signs, Kawasaki Illness (in pediatric age group) primarily based on the discretion of the treating doctor.

RT-PCR or TrueNat or CBNAAT ought to be the primary selection for exams so as of precedence in hospital settings and RAT ought to be the second selection.

The ICMR acknowledged {that a} single RT-PCR/TrueNat/CBNAAT/RAT constructive take a look at is to be thought-about confirmatory, with none repeat testing, and no re-testing is really useful previous to discharge from a COVID-19 facility after medical restoration, together with for switch from a COVID space/facility to a non-COVID space/facility.

If signs develop following a unfavorable RAT take a look at, a repeat RAT or RT-PCR ought to be achieved.

Residence quarantine for 14 days is really useful for all people earlier than present process elective surgical procedure to minimise probabilities of an infection earlier than the process.