Six Covid-19 cases were reported on Wednesday after screening 3,476 passengers of 11 flights that arrived in India from "at-risk" countries and the samples have been sent for genomic sequencing, the Health Ministry said amid concerns over the 'Omicron' variant of coronavirus.

The Centre's revised guidelines for international travellers came into effect on Wednesday. The fresh guidelines have been issued because of the new SARS-Cov-2 variant which has been designated as a 'variant of concern (VOC)' by the World Health Organisation.

"On the first day of operation of the Guidelines for International Travellers issued by the Centre as public health response measures for control and management of the newly reported variant of coronavirus, which has been designated as a 'variant of concern' by WHO, six passengers were reported to be Covid positive," the Union Health Ministry said.

Eleven flights from "at-risk" countries landed at India's various airports, except Lucknow, from midnight to 4 pm on Wednesday carrying 3,476 passengers.

"All 3,476 passengers were administered RT PCR Tests, wherein only six passengers were found COVID-19 positive," the ministry said, adding the samples of COVID-19 positive passengers have been sent to INSACOG labs for 'Whole Genomic Sequencing'.

The 'at-risk' nations (updated on November 30) are countries in Europe, including the United Kingdom, South Africa, Brazil, Botswana, China, Mauritius, New Zealand, Zimbabwe, Singapore, Hong Kong and Israel.

Travellers from these countries need to follow additional measures on arrival in India, including post-arrival testing.

The Union Health Ministry on Tuesday further revised the Guidelines for International Arrivals mandating that two per cent of the total passengers coming from countries that are not in the 'at-risk' category will also be tested for COVID-19 on a random basis at the airports.

The two per cent of such travellers in each flight shall be identified by the airlines concerned (preferably from different countries).

Apart from that, travellers from nations excluding the 'at-risk' countries, will be allowed to leave the airport and shall self-monitor their health for 14 days after arrival.

Passengers originating or transiting from 'at-risk' countries will have to undergo an RT-PCR test after arrival and will be required to wait for the results at the airport before leaving or taking a connecting flight, according to the revised guidelines which came into effect from December 1.

If tested negative, they will have to be in home quarantine for seven days and will undergo a re-test on the eighth day of arrival in India. If again negative, self-monitor of health would continue for seven more days, it said.

However, if such travellers test positive for COVID-19, their samples should be sent for genomic testing at the INSACOG laboratory network.

They shall be managed at a separate isolation facility and treated according to the standard protocol, including contact tracing. Contacts of such positive cases should be kept in institutional quarantine or at home quarantine monitored strictly by the state government concerned, the guidelines said.

The dos and don'ts shall be provided along with the ticket to the travellers by the airlines/agencies concerned. The airlines will allow boarding by only those passengers who have filled in a self-declaration form on the Air Suvidha portal and uploaded their negative RT-PCR test report, it stated.

This test should be conducted within 72 hrs before the journey.

Only asymptomatic travellers will be allowed to board a flight after thermal screening and all passengers shall be advised to download the Aarogya Setu app on their mobile devices.

The health ministry added that the Government of India continues to keep track of the evolving situation, and support states and Union territories in the fight against the pandemic through a "whole of government" approach.

International passengers subject to random Covid sampling: MoCA

The Ministry of Civil Aviation (MoCA) on Wednesday said only two per cent of the passengers coming from countries that are not in the 'at-risk' list will be subject to random sampling for coronavirus and such passengers will be permitted to leave the airport after giving the samples.

Amid mounting concerns over the new COVID variant Omicron, stricter norms for international passengers came into effect from Tuesday midnight and all passengers coming from 'at-risk' countries have to compulsorily undergo COVID test, among other requirements.

Issuing a set of Frequently Asked Questions (FAQs), the ministry said that travellers undergoing random sampling may give the sample and be allowed to leave.

"Now, the random sampling would be limited to 2 per cent as per latest MoHFW (Ministry of Health and Family Welfare) guidelines and it would be on self-paid basis. Airlines/Airports may coordinate with the officials of State/UT governments to select the passenger at random sampling," the ministry said in a release.

There is also a question about travellers from countries, excluding those 'at-risk', transiting through the airports of countries 'at-risk' but staying within the airports.

On whether such travellers can be exempted from post-arrival testing based on the self-declaration form, the ministry has provided a clarification.

"Post-arrival testing can be exempted if a person is travelling from a not at-risk country and has only a transit (without leaving immigration) in at-risk country before taking the destination flight.

"However, if the person has travelled to any at-risk country in last 14 days, he/she will be asked for post-arrival testing and other additional restrictions...," the release said.

On whether travellers who have submitted their sample for post-arrival COVID test at the point of arrival (self-paid) have to wait for their test results before leaving or taking a connecting flight, the ministry said, "after the negative results are received, the passengers can take connecting flights to reach their final destination".

Further, the ministry said a passenger can exit the airport or can take connecting flights for final destination once the negative report is received. "He/she need not wait for the report of all the co-passengers," it added.

The ministry said the FAQs are being issued for better understanding of the passengers and to enable them for a safe, secure and hassle-free international air travel.

"It may be noted that these steps are being taken to ensure the good health and safety of every citizen of the country so that the subsequent problems do not arise," the release said.

As per the update by the health ministry on November 30, the 'at-risk' list includes "countries in Europe including The United Kingdom", South Africa, Brazil, Botswana, China and Mauritius.

Other countries in the list are New Zealand, Zimbabwe, Singapore, Hong Kong and Israel.

The Indian Council of Medical Research (ICMR) has approved various systems for molecular testing of SARS-CoV-2 and all of them are considered equivalent to RT-PCR, according to the release.

They are Open system RT-PCR, TrueNat, GeneXpert, RTLAMP, CRISPR/TATAMD CHECK/FELUDA, Abbott ID Now, Accula by Thermofisher, Rapid RT-PCR and CoviDx DirectPlex.

WHO warns of ‘Toxic Mix’

Amid the spread of Omicron, World Health Organization (WHO) chief Tedros Adhanom Ghebreyesus said the world has a “toxic mix” of low vaccine coverage and very low testing – a recipe for breeding and amplifying variants. "Globally, we have a toxic mix of low vaccine coverage, and very low testing – a recipe for breeding and amplifying variants. That's why we continue to urge countries to... ensure equitable access to vaccines, tests and therapeutics all over the world," Tedros said at a press briefing.

"But if countries and individuals don't do what they need to do to stop transmission of Delta, they won't stop 'Omicron' either,” he added.

"We need to use the tools we already have to prevent transmission and save lives from Delta. And if we do that, we will also prevent transmission and save lives from 'Omicron'," Tedros said.