The Indian Council for Medical Research (ICMR) has allowed on-demand testing for Covid-19 even as it has allowed states to tailor the recommendation based on their requirements. “The ICMR notice is generic in nature and may be modified at the discretion of state health authorities,” the national investigative agency said in its notice.
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The notice came after the Delhi high court asked the state government to rethink its policy to include asymptomatic patients for testing. The ICMR told the court that it is only an advisory body and states were free to make changes based on their needs.
Rapid antigen testing (RAT) is the preferred strategy for detection in containment areas of Covid-19. People with influenza-like illnesses, all direct and high-risk contacts (family members, colleagues, people over 65, immunosuppressed, or who have conditions such as diabetes, hypertension, or heart, kidney, and lung disease) should undergo screening detection. .
The new strategy lists situations where molecular tests, such as reverse transcription polymerase chain reaction (RT-PCR), should be preferred over cheaper and faster but less accurate RATs. “Ideally, it is suggested that 100% of people living in containment zones should be screened by RAT, particularly in cities where there has been widespread transmission of the infection,” the ICMR guidelines say.
In uncontained areas, the ICMR strategy suggests that preference should be given to molecular methods to assess all those with influenza-like symptoms, all symptomatic contacts from confirmed cases, and all high-risk asymptomatic contacts. Test methods like RT-PCR should also be used for routine surveillance of all symptomatic travelers within seven days of illness and medical care or front-line workers involved in managing Covid-19.
ICMR’s strategy says molecular testing should be preferred over RAT within hospitals to evaluate those with severe acute respiratory infections, all patients with flu-like symptoms, all high-risk asymptomatic contacts in need hospitalization, asymptomatic patients undergoing surgery or other invasive procedures. , and all pregnant women at or near delivery.
The guidelines say that no emergency procedures should be delayed for the lack of a test.
Hospitals have been ordered not to refuse admission of pregnant women on the grounds of lack of testing facilities. “All arrangements must be made to collect and transfer samples to a testing facility. Mothers who test positive for the infection have been advised to wear masks, wash their hands frequently while handling babies, and clean their breasts before feeding.
ICMR guidelines say that all newborns with acute respiratory or sepsis-like illnesses, or those with non-respiratory symptoms such as fever, lethargy, poor diet, seizures and diarrhea, should be tested for Covid-19 using RT-PCR .
The strategy also suggests testing those with atypical presentations for Covid-19, such as stroke, encephalitis, sputum mixed with blood, pulmonary embolism, acute heart conditions, etc.
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