In a bid to reduce pressure on diagnostic labs, the ICMR has issued new guidelines for COVID-19 testing and now says that an RT-PCR test must not be taken under certain conditions. The decision was taken by the Indian Council of Medical Research at a time when diagnostic centres across the country are experiencing tremendous amount of pressure to test and meet its testing target.

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Background

As per the ICMR India currently has 2506 molecular testing labs that include platforms such as the CBNAAT, RT-PCR, TruNat, etc. The total daily testing capacity of the country is close to 15 lakh tests. This number takes into consideration three –shift operations of the existing lab network. Due to high number of caseload and lab employees also getting infected with COVID-19, the labs are experiencing challenges to meet the testing target. To overcome this challenge, the ICMR has issued fresh set of guidelines.

Details

In the revised ICMR guidelines, COVID-19 testing will be optimized in this way. A person needs not get RT-PCR test when:

1) An individual has tested positive by Rapid Antigen Test or RT-PCR test once.

2) A COVID-19 recovered person needs not be tested again with RT-PCR mode of test at the time of hospital discharge.

3) Healthy individuals that are traveling inter-state may not be needed to take RT-PCR tests during their travel (while this is different for each state, the ICMR guideline suggests that this may be completely removed).

4) An individual that has completed 10 days of home isolation without succumbing to fever for the last 3 days may not need to take the RT-PCR test.

The Indian government is now focusing on Rapid Antigen Test (RAT) for mass-level detection and in the new guidelines, it laid down the measures taken to ramp up testing through RAT:

1) Testing through RAT may be available at all the private and government healthcare facilities.

2) Cities, villages and towns will see new dedicated RAT booths that will test people.

3) To increase the accessibility and availability of the testing, these RAT booths may be open 24×7.

4) At certain locations drive through RAT-facilities may be set up.

What is testing through RAT?

Rapid Antigen Tests or RAT was Indian govt’s first response to testing during the first wave of the COVID-19 pandemic. The tests have a short turn-around time of around 15-20 minutes due to which it offers quick detection of cases. The RAT tests are currently restricted to containment zones and health care settings like hospitals.

Difference between RAT and RT-PCR tests?

One key difference between RAT and RT-PCR tests is that the latter is capable of detecting dead cells of virus in a human body making it the highly sensitive gold standard of the testing. RAT on the other hand detects virus that is below a fixed mark. RATs are also cheaper compared to RT-PCR tests but RT-PCR tests are more reliable. According to a virologist that consulted The Economic Times, RATs offer sensitivity of about 50-60% and are also unreliable because they have shown false negatives in the past.

Outbreak

On Tuesday, May 4, India registered its highest death toll since the pandemic began. As many as 3,780 people died on Tuesday making it the darkest day in the fight against COVID-19 yet. Maharashtra contributed with 900 deaths while Delhi reported 338 deaths. Meanwhile, India reported 3.82 lakh new COVID-19 cases on May 4.

As many as 15,89,32,921 COVID-19 vaccine doses have been administered till now.