Asymptomatic contacts of a laboratory confirmed Covid-19 case do not require testing unless they are at risk due to their age (if they are older than 60) or if they suffer from certain underlying medical conditions such as diabetes, the Indian Council of Medical Research (ICMR) said on Monday in its revised Covid-19 testing guidelines.
People with no symptoms in hospitals meant to undergo surgical or any other non-surgical invasive procedures, which includes pregnant women in or nearing labour, do not require to be tested unless warranted or symptoms develop.
The revised advisory has been issued for early detection of symptomatic Covid-19 cases for quick isolation and care, the ICMR said, while identifying infection in the elderly (60 years and above) and people with co-morbidities such as diabetes, hypertension, chronic lung or kidney disease, malignancy, obesity etc., for quick care.
Among others who may not require immediate Covid-19 testing are patients who stand discharged as per home isolation guidelines or discharged from a Covid-19 facility as per the revised discharge policy; and people undertaking interstate domestic travel.
However, the guidelines recommend testing for all symptomatic persons having cough, fever, sore throat, loss of taste and or smell, breathlessness and or other respiratory symptoms. Testing is also recommended for persons undertaking international travel as per country-specific requirements; and for international travellers arriving at Indian airports, seaports, and ports of entries.
Apart from broadly laying down rules for testing in a hospital, the guidelines say that eventually it will be the treating doctor’s call whether to get a person tested with certain 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…” read the ICMR guidelines.
The guidelines also underline that a positive result through rapid antigen test or home or self-test should be considered as confirmed positive, and the person does not require to repeat the test for confirmation. However, symptomatic individuals, testing negative through such tests should undertake RT-PCR test to confirm the diagnosis.
According to experts, because of its high specificity, a rapid test is reliable when the result is positive.
“Since positives are true positives, it is a good idea to deploy these tests in areas where case load is high for quick isolation and care of those who are infected,” said Dr Amita Jain, head of microbiology department, KGMU, Lucknow.