Coronavirus Testing Strategy Revised In India, ICMR Decides To Test More In COVID-19 Hotspots

New Delhi: While the nation is heading towards the end of the 21 days nationwide lockdown, various states have undertaken containment strategy under which coronavirus hotspots are being sealed to contain the spread of the novel coronavirus. Amidst this, on Thursday (April 9), the Indian Council of Medical Research (ICMR), the nodal body for the fight against COVID-19, updated the coronavirus testing strategy for India. According to the revised strategy, individuals present in the hotspots and showing symptoms like fever, cough, sore throat, and runny nose, will be tested.

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Elaborating on the testing procedure, the guideline stated, “In hotspots/cluster (as per the Ministry of Health and Family Welfare) and in large migration gatherings/evacuees centres, all symptomatic individuals within seven days of illness.”

#CoronaVirusUpdates: @ICMRDELHI revises testing strategy in #COVID19 hotspots; every one with fever, cough, runny nose must be tested within a week. #IndiaFightsCorona #StayHomeStaySafe pic.twitter.com/Q8cbmsGCza

— #IndiaFightsCorona (@COVIDNewsByMIB) April 9, 2020

Within the seven days of illness, rRT-PCR (Reverse transcription-polymerase chain reaction) – a coronavirus confirmatory test will be done. After the seven days of illness, antibody test will be conducted. If the result comes out to be negative, a confirmatory rRT-PCR will be done.

Antibody tests are similar to blood tests. The results are available in 15-30 minutes. The test uses a few drops of blood to determine whether the human body has antibodies for coronavirus.

Appreciating the guidelines, Dr Rajesh Parikh, Director Medical Research and Neuropsychiatrist at Jaslok Hospital and Research Centre said,

Antibody test is not the best screening test. The best strategy is to ‘Test, Trace, Treat’.

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Talking about the revised testing strategy and inclusion of an antibody test, Dr Ravindra Mehta, Chief of Pulmonary and Critical Care Medicine at Apollo Hospitals in Bengaluru, said,

Antibody test is not a perfect test. It’s not only for coronavirus and there could be some extent of overlap. If the result of antibody test turns out to be negative and the suspicion of infection is high, you will have to confirm it with RT-PCR test.

Further elaborating on the pros and cons of antibody test, Dr Mehta said,

Antibody test is great for cluster areas but to put it in the general population to compensate for the lack of testing kits is probably not a recommended strategy at this point in time. Antibody tests cannot be used as a substitute for a conventional test. It’s an add-on to the strategy as a screener in the hotspot areas. It’ll help only if it’s part of a comprehensive strategy and not a lone strategy.

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Coronavirus Testing In India

Earlier only five categories of people were tested for the infectious disease. The previous guideline included – symptomatic individuals who have undertaken international travel in the last 14 days; all symptomatic contacts of laboratory-confirmed cases; all symptomatic health care workers; all patients with Severe Acute Respiratory Illness (fever and cough and/or shortness of breath); asymptomatic direct and high-risk contacts of a confirmed case – tested once between day 5 and day 14 of coming in his/her contact.

According to the ICMR, as on April 9 (9 PM), a total of 1,44,910 samples from 1,30,792 individuals have been tested. Among suspected cases and contacts of known positive cases in India, 5,705 individuals have been confirmed positive for SARS-CoV-2 (COVID-19). On April 9 alone, 16,002 samples were collected of which 320 turned out to be positive for SARS-CoV-2.

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ICMR Approves Use Of Diagnostic Machine For COVID-19

On Friday (April 10), ICMR approved the use of diagnostic machines used for testing drug-resistant tuberculosis for conducting coronavirus tests. According to PTI, a news agency, ICMR has validated ‘TruenatTM beta CoV test on TruelabTM workstation’ and has recommended it as a screening test.

To ramp up the country's testing capacity for COVID-19, the Indian Council of Medical Research (ICMR) approves the use of diagnostic machines meant for testing drug-resistant tuberculosis for conducting coronavirus tests.

— Press Trust of India (@PTI_News) April 10, 2020

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A PTI report stated, “Issuing guidance on the use of Truenat beta CoV, the ICMR said throat/nasal swabs will be collected in the viral transport medium (VTM) with virus lysis buffer provided along with the kit.”

Earlier studies have shown that virus lysis buffer neutralizes Nipah and H1N1 viruses. The results of stability of viral RNA after neutralization of SARS-CoV-2 by virus lysis buffer are awaited from ICMR-NIV, Pune. Till such time, Truenat beta CoV test should only be performed with all biosafety precautions in BSL-2 or BSL-3 setups at laboratories, said ICMR as quoted by PTI.

As of now, ICMR has not issued any revised guidelines on their official website and according to the PTI report, the guidelines will be issued once the results from ICMR-NIV, Pune are available.

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