A prescription will no longer be required for people to get tested for Covid-19, the Indian Council for Medical Research (ICMR) said on Saturday in its revised testing notice to states, paving the way for walk-in testing. previous.
The move comes after a suggestion from the Delhi high court that asked why people who show no symptoms of the disease, which can be a large proportion of Covid-19 patients, cannot get tested. Until now, the rule required people to have flu-like symptoms or be in close contact with an infected person, after which a doctor could write a prescription for a test.
“The new guidelines will allow people to get tested for Covid-19 without a prescription. The guidelines also say that states can have their own “simplified modalities” for testing. What this means is that states cannot impose restrictive requirements on testing. In some states, people needed a medical director or someone to certify that they needed the test; those restrictions will have to be eliminated, ”said a senior official from the Union’s Ministry of Health, who asked not to be identified.
“The ICMR notice is generic in nature and may be modified at the discretion of state health authorities,” the notice said. At a hearing by HC Delhi on improving testing in the capital, the ICMR stated on September 3it was only an advisory body and states were free to make changes according to their needs.
“With the new strategy, doctors will have a little more freedom to request tests. Flu-like illnesses were too restrictive a category to test, especially since many Covid-19 patients are asymptomatic. Clinical trials or at the discretion of a doctor should have been allowed a long time ago. This is what’s good for healthcare, ”said Dr. Jacob John, former professor of virology at Christian Medical College in Vellore.
He added that the government should now take an approach in which patients with symptoms similar to Covid-19 who live in an area where the disease is transmitted should be considered a positive case and treated as such.
The guidelines also suggest testing people with an atypical presentation of Covid-19, such as stroke, encephalitis, sputum mixed with blood, pulmonary embolism, acute heart conditions, and Guillain-Barré syndrome (a condition in which the body’s immune system attacks the nerves and causes leg weakness, multi-organ dysfunction, progressive gastrointestinal symptoms, and inflammatory disease) in pediatric patients.
“The new guidelines make testing more freely available and this decision was made after increasing India’s testing capacity to more than one million per day,” the ministry official quoted above said.
Dr Lalit Kant, former chief of epidemiology at the Indian Council for Medical Research, said the unambiguous guidelines will help solve many systemic problems. “This will make the tests more accessible. Although, this was even true before, but clear guidelines on who to test in a hospital or when to do RT-PCR are helpful in addressing any ambiguity. Like in Delhi, we should increase RT-PCR testing (elsewhere), ”he said.
The guidelines also mention places where molecular tests, such as RT-PCR, CBNAAT, and TrueNat, should be preferred over cheaper and faster but less accurate rapid antigen tests (RATs).
Within containment zones, a rapid antigen test is the preferred mode of detection. Those to be screened include all people with flu-like illnesses, all direct and high-risk contacts (family members, colleagues, over 65, immunosuppressed, or suffering from conditions such as diabetes, hypertension, or heart, kidney, and lung disease ). diseases).
“Ideally, it is suggested that 100% of people living in containment areas should be screened by RAT, particularly in cities where there has been widespread transmission of the infection,” the guidelines mention.
In uncontained areas, however, the ICMR strategy suggests that preference should be given to molecular methods to assess those with influenza-like symptoms, all symptomatic contacts, and all high-risk asymptomatic contacts. RT-PCR, CBNAAT, or TrueNat should also be used for routine surveillance of all symptomatic travelers within seven days of illness and healthcare or frontline workers involved in managing Covid-19.
Within hospitals, the ICMR strategy says that molecular testing should be preferred for people with severe acute respiratory infections, flu-like symptoms, high-risk contacts needing hospitalization, asymptomatic patients undergoing surgery or other invasive procedures, and all pregnant women at or near delivery.
The guidelines state that no emergency procedure should be delayed for lack of a test; a sample can be sent simultaneously.
Hospitals have been instructed not to deny admission of pregnant women due to lack of testing facilities.
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