ICMR revises coronavirus testing strategy in India, includes symptomatic patients in hotspots

New Delhi, Apr 09: The Indian Council of Medical Research (ICMR) on Thursday updated its testing strategy for Covid-19 that now affected almost 6,000 people in the country.

According to the revised strategy, "asymptomatic direct and high-risk contacts of a confirmed case should be tested once between days 5 and day 14 of coming in his/her contact".

About 40 per cent of COVID-19 cases with severe acute respiratory infection did not have any history of contact with a positive patient or international travel, and they were reported from 36 districts of 15 states, an ICMR study found on Thursday while recommending these places for priority containment measures.

A total of 104 of the 5,911 patients with severe acute respiratory infections (SARI) tested positive for COVID-19, out of which 40 cases did not report any history of contact with a known case or international travel, according to the study. Also, males accounted for higher number of COVID-19 cases and also patients aged above 50 years of age.

According to the study, which has been published in the Indian Journal of Medical Research, a total of (104) 1.8 per cent of the 5,911 SARI patients tested were positive for COVID-19. These cases were reported from 52 districts in 20 states and union territories.

The ICMR in its study highlighted that COVID-19 containment activities need to be targeted in districts reporting positive cases among SARI patients and stated that intensifying sentinel surveillance for COVID-19 among SARI patients may be an efficient tool to effectively use resources towards containment and mitigation efforts, it said. Sentinel surveillance among SARI patients can help identify the spread and extent of transmission of COVID-19, the Indian Council of Medical Research said.

In India, the initial COVID-19 testing strategy included people who had international travel history with symptoms, symptomatic contacts of laboratory-confirmed COVID-19 patients and symptomatic healthcare workers managing respiratory distress/SARI. In addition, to track the progression of the epidemic in the early phase, stored samples of SARI patients hospitalised since February 15 were also tested for COVID-19 under the Virus Research and Diagnostic Laboratory Network (VRDLN).

Strategy for COVID19 testing in India
1. All symptomatic individuals who have undertaken international travel in the last 14 days
2. All symptomatic contacts of laboratory confirmed cases
3. All symptomatic health care workers
4. All patients with Severe Acute Respiratory Illness (fever AND cough and/or shortness of breath)
5. Asymptomatic direct and high-risk contacts of a confirmed case should be tested once between day 5 and day 14 of coming in his/her contact

In hotspots/cluster (as per MoHFW) and in large migration gatherings/ evacuees centres
6. All symptomatic ILI (fever, cough, sore throat, runny nose)
a. Within 7 days of illness - rRT-PCR
b. After 7 days of illness - Antibody test (If negative, confirmed by rRT-PCR)

As of now, in India, hydroxychloroquine is being recommended only to asymptomatic healthcare professionals who are taking care of confirmed or suspected COVID-19 patients.