Patients anywhere in the country with symptoms of respiratory illness may be tested for the coronavirus disease, the Indian Council of Medical Research has said in a fresh advisory, removing the fetters on testing amid the epidemic’s exponential growth.
The advisory asks the states and public and private healthcare institutions to scale up testing, in line with demands from doctors and health experts.
The experts had warned that the restrictions on testing were causing suspected patients to be excluded and fuelling the spread of the infection.
“It is imperative that tests should be made widely available to all symptomatic individuals in every part of the country,” the ICMR said in the June 23 advisory, which also recommends the wide use of an antigen test that yields results within 30 minutes.
The ICMR’s earlier May 18 advisory had expanded the criteria for testing but specified that people with influenza-like symptoms may be tested only if they live in containment zones, delineated by local authorities wherever Covid-19 patients have been detected.
Many people living outside containment zones did seek tests but sometimes had to face obstacles.
Doctors and public health experts have for over eight weeks been arguing that everyone with symptoms, irrespective of their place of residence, should have access to Covid-19 tests. They have cited mounting evidence that many people outside the containment zones are infected too.
The typical symptoms that would make a person eligible for a test would be fever, cough and a sore throat — or an influenza-like illness.
“Testing all symptomatic patients everywhere is the right way to go — this should have been done two months ago,” said T. Jacob John, former professor of clinical virology at the Christian Medical College, Vellore. “We would have had a much better picture of the spread of the infection in India by now.”
The ICMR has asked central and state government medical colleges and hospitals, private hospitals and private labs accredited by the National Accreditation Boards to use the Covid-19 antigen test that does not require a specialised machine and can be interpreted with the naked eye.
Any symptomatic, suspected patient who comes positive in the antigen test should be considered as infected with SARS-COV-2, the virus that causes Covid-19, but negative tests should be confirmed through a standard diagnostic test that looks for the viral genetic material, the ICMR said.
Doctors at government and private hospitals have for weeks expressed concern that the restrictions on testing are likely to have contributed to the growth of India’s Covid-19 epidemic, which recorded 16,922 new cases — a fresh highest-ever single-day increase — on Thursday.
Health researchers have also argued that restricting testing to symptomatic people in containment zones alone was an inappropriate policy because evidence had emerged of community transmission across multiple districts more than two months ago.
The ICMR had detected evidence of community transmission at 36 districts in 15 states in early April, and in a yet undisclosed number of districts in May where 15 to 30 per cent of sampled populations were found to have been infected and recovered.
“It is hard to understand why they imposed restrictions all this while — the ICMR itself claimed more than a month ago that India had enough testing capacity,” said a senior surgeon at a private hospital in New Delhi.
“Hopefully, everyone who needs a test will get one now.”
Around 730 government labs and 270 private labs across the country can now test for Covid-19. This network of labs collectively tested over 207,000 samples on Wednesday, the ICMR said.
India’s count of total lab-confirmed Covid-19 cases on Thursday increased to 473,105, of whom 186,514 are under medical supervision, 271,697 have recovered and 14,894 have died.
