ICMR releases new guidelines for covid testing

Amid an unprecedented upsurge of COVID-19 cases and deaths in India, the laboratories are facing challenges to meet the expected testing target due to extraordinary caseload and staff getting infected with COVID-19. At present, India has a total of 2506 molecular testing laboratories including RT PCR, 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. The Indian Council of Medical Research has released a set of guidelines to optimize the RT PCR testing and simultaneously increase the access and availability of testing to all citizens of the country. 

ICMR has recommended avoiding RT PCR tests in the following cases:

  • If an individual has tested positive once either by RAT or RT PCR
  • If individuals have recovered from COVID-19 at the time of hospital discharge in accordance with the discharge policy of MoH&FW
  • If the individuals undertaking inter-state domestic travel are healthy

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 the opportunity to isolate and treat them early for curbing transmission. So far, ICMR has approved 36 RATs of which 10 are on the GeM portal. To meet the overwhelming testing demand, it will be prudent to upscale testing using RATs.

Measures to ramp up testing through RAT

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

Additional advice 

  • It advised states to ensure full utilization of the available RT PCR testing capacity, both in public and private laboratories 
  • RAT testing must be conducted in compliance with the ICMR advisory available at: 
  • Symptomatic individuals identified positive by RAT should not be re-tested and advised to go through home-based care as per ICMR guidelines available at: 
  • Symptomatic individuals identified negative by RAT should be linked with RT PCR test facility and in the meantime be urged to follow home isolation and treatment 
  • All RT PCR and RAT test results should be uploaded on the ICMR portal at: 
  • During the current upsurge of COVID-19 cases, any individual presenting with fever with/without cough, headache, sore throat, breathlessness, body ache, the recent loss of taste or smell, fatigue and diarrhoea should be considered as a suspect case of COVID-19 unless proven otherwise by confirmation of another etiology 
  • The vaccination status of all individuals tested for COVID-19 must be entered into the Sample Referral Form (SRF) in the RT PCR app both for individuals tested by RTPCR and RAT. This information is of critical importance 
  • Payment modalities for upscaled RAT testing may be decided by the state health authorities

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