India’s health research agency on Tuesday recommended a stop to Covid-19 RT-PCR tests before inter-state travel and asked for 24x7 booths for rapid antigen tests nationwide in efforts to scale up surveillance at a time labs are under intense stress.

The Indian Council of Medical Research, in a fresh advisory aimed at optimising and scaling up testing, said the existing labs were facing challenges to meet testing targets under the “extraordinary case loads” and staff also becoming infected with Covid-19.

The current daily testing capacity is 1.5 million, but the nationwide positivity rate — the proportion detected positive among those tested — is above 20 per cent. A high positivity rate implies that India needs to increase testing to try to reduce the figure to less than 5 per cent.

The ICMR said RT-PCR —the standard and high-reliability diagnostic test — should not be repeated on anyone who has tested positive either through RT-PCR or through the alternative but less reliable rapid antigen test (RAT).

“The need for RT-PCR test in healthy individuals undertaking inter-state domestic travel may be completely removed to reduce the load on laboratories,” the ICMR said. “Non-essential travel and inter-state travel of symptomatic individuals with Covid-19 or flu-like symptoms should essentially be avoided to reduce the risk of infection.”

The ICMR said there was a need to improve access and scale up RAT-based diagnosis, which has the advantage of quick detection of cases within 15 to 30 minutes and allows prompt isolation early to curb further transmission.

The agency has asked government and private healthcare facilities to offer RAT and set up dedicated 24X7 RAT testing booths in diverse places such as resident welfare association locations, schools, colleges, community centres and other areas. It has also asked district administrations to open drive-through RAT testing facilities.

Public health experts say the larger the epidemic grows, the greater the strain on testing labs, already evident through long waiting periods to return testing results. Patients in some cities have had to wait for up to four or five days before getting their test results.

India currently has 2,506 molecular testing labs offering RT-PCR or comparable diagnostic tests for Covid-19, but labs in multiple cities have become overwhelmed by samples in the wake of the sharp surge in numbers of cases — from a seven-day average of daily new cases of 73,000 a month ago to over 378,000 on Tuesday.

“The daily infections add pressure on the testing infrastructure,” said a public health specialist. “The number of daily tests required, ideally, taking into account contacts of cases, will exceed the number of daily new infections detected which is now over 3 lakh a day.”