ICMR’s purposive testing looks to avoid a repeat of second wave

Rutam V Vora | | Updated on: Jan 15, 2022
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Industry lauds strategy of reserving tests for senior citizens, those with co-morbidities

During the second wave of Covid-19 last April, when testing labs were flooded with samples and results took 5-7 days to arrive, the Ahmedabad Municipal Corporation (AMC) installed a 'drive-through' RT-PCR testing dome for citizens to reduce pressure on diagnostic labs and meet surging demand for testing.

In the current third wave, when India's daily test positivity rate (TPR) is 17 per cent and rising with each passing day, there is clearly wide community transmission. This, according to diagnostics experts, indicates that hundreds of thousands of people — both symptomatic and asymptomatic — would want to get tested. Notably, during the second wave, India's daily TPR had peaked to 25.03 per cent on April 25, 2021.

In such scenarios of concentrated pockets of infection, prioritised testing both eases the burden on labs and reduces test-related anxiety for people.

Purposive testing

And that's what the Indian Council of Medical Research's (ICMR) "Purposive Testing Strategy" sets out to do — relax requirements for tests for those undertaking domestic travel or for asymptomatic individuals in community settings. Instead, it prioritises symptomatic cases for quick isolation & care, and aims to detect the infection in senior citizens and individuals with co-morbidities.

Dr Harsh Mahajan, President, NatHealth (Healthcare Federation of India), said the advisory from the top medical research body comes at a time, "when there is significant community transmission, which is happening all across the country. This is the most appropriate advisory to not waste scarce resources. Infection is rampant and there is a finite capacity for tests, particularly RT-PCR, within the country."

Prioritisation was important, given the infection spread "so that people who deserve tests more don't lose out to those who are lower in the ladder of risk. We had observed this in the 2 nd wave, when labs were inundated with samples," he added.

India's testing capacities

As per ICMR data in testing infrastructure, currently there are 3,128 laboratories for RT-PCR and similar testing and there is daily RT-PCR testing capacity in excess of 20 lakh. There are 43 manufacturers of RT-PCR test kits with a combined capacity of 71 lakh units per day. Notably, though RT-PCR remains the gold standard to confirm the Covid-19 infections, there are other tests including rapid antigen tests (RAT) and home antigen test kits made available for mass testing and faster results. India can produce about 79 lakh RAT kits and 18 lakh home test kits a day.

Home testing under radar

Speaking to BusinessLine, Dr Arjun Dang, CEO, Dr Dangs Labs, termed the ICMR advisory the need of the hour as it prevents key testing infrastructure from getting overwhelmed.

"The advisory needs to be further strengthened by a good sense of community behaviour. There are home test kits available which give faster results; but patients using these tests at home should be discerning enough to understand that if it returns negative results despite continued symptoms, molecular tests such as RT-PCR must be conducted," he said.

"People don't understand the seriousness of a false negative result in home test kits and, as a result, may land us into the trouble once again," he added.

Doctors, however, flagged concerns regarding case numbers because people who tested posited using home test kits may not report their illness. On Saturday, Mumbai Mayor Kishori Pednekar stated that citizens buying self-test kits will be required to provide their Aadhar cards to chemists so that records are maintained and can be tracked.

Published on January 15, 2022

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