New Delhi: On Monday (January 10) evening, the Indian Council of Medical Research (ICMR) issued an advisory on purposive testing strategy for COVID-19 in India. According to the new guidelines, people need not take COVID-19 test if: asymptomatic; travelling domestic; have come in contact with a COVID-19 positive patient unless identified as high risk based on age group or comorbidities. Along with this, patients who stand discharged as per home isolation guidelines and those being discharged from a COVID facility also need not get tested. This comes at a time when India is battling the third wave of the COVID-19 pandemic.
Advisory on Purposive Testing Strategy for COVID-19 in India (Version VII, dated 10th January 2022) @MoHFW_INDIA @DeptHealthRes @PIB_India @mygovindia @COVIDNewsByMIB #ICMRFIGHTSCOVID19 #IndiaFightsCOVID19 #CoronaUpdatesInIndia #COVID19 #Unite2FightCorona pic.twitter.com/0bFN4R5gZ4
— ICMR (@ICMRDELHI) January 10, 2022
In the past, the government has heavily focused on testing to contain the spread of the COVID-19 pandemic. However, that seems to be changing now, amid the spread of the Omicron variant. NDTV spoke to Dr Jayaprakash Muliyil, Epidemiologist and Chairperson of the Scientific Advisory Committee of the National Institute of Epidemiology at the Indian Council of Medical Research (ICMR) to understand the change in guidelines.
Why Should Healthy Contacts Of COVID Patients Not Test For COVID?
Explaining the change in COVID testing guidelines, Dr JP Muliyil said,
We have a frame of mind set in the early days of COVID entering India. At that time, the whole focus was on elimination. The rule was to find the case and isolate it. If you remember, ICMR had much earlier come out with the directive to test only those who are affected and symptomatic. However, most state governments went on to check contacts but it didn’t make any difference in the evolution of the disease.
A healthy contact of a COVID patient can be asymptomatic carrier of the novel coronavirus hence, the new guidelines raise a question on why the healthy contacts shouldn’t be tested. Answering the same, Dr Muliyil said,
The rate of (Omicron) infection is so high and rapid that the doubling time of this virus is two days. By the time you identify a person who has got the disease, he has already infected a large number. So, even when you test, you are far behind. It is not something that will make any difference in the evolution of the epidemic. The only thing is we could go for very hard measures and just lockdown the whole thing and sit inside the house but for ow long? And also even that won’t make a difference.
How Worrying Is The Spread Of Omicron In India?
Dr Muliyil called to shift the focus dramatically as in the third wave of the pandemic, India is dealing with Omicron, which is much milder than Delta but spreads very fast. He said,
The issue is the consequence of a viral infection is just like that of a cold. It (Omicron) is almost unstoppable because it is highly infectious. Probably, more than 80 per cent of us will not know we have been infected.
Dr Muliyil said that though the Omicron variant is much more infectious than the Delta, the consequences are quite different. Only a few will be hospitalised when compared to the number of hospitalisations during the Delta wave.
We have to have a framework in mind that we accept that it is not a frightening disease anymore. Omicron is a disease we can deal with, he said.
The top government expert added that earlier COVID graphs used to reflect a high mortality rate among senior citizens but with Omicron, the curve has come down across all age groups. Very few young people are requiring hospitalisation and even in the older age group, the mortality has dropped, he said.
Uncontrolled diabetes and comorbidities like that are still a problem. The precaution they have to take continues in terms of personal protection. But there is a huge shift in the mortality pattern, he said.
We Have To Stop Counting The Virus: Dr JP Muliyil
The expert said that the shape of the COVID-19 curve is nowhere near the truth. When the Delta variant was spreading, epidemiologists used to multiple the number of COVID cases detected with 30 to get the real number. He added,
In Delta, we saw about 1 in 30 cases. In Omicron, it must be somewhere about 1 in 60 and 1 in 90. Sub-clinical infections have gone up. A surge seen after a decline in COVID cases due to the Delta variant is due to the Omicron; whether you test or not.
‘Whether You Give Booster Or Not, Omicron Infection Will Occur’
Dr Muliyil said that 85 per cent of Indians were already infected with COVID by the time vaccines were introduced in India in January, 2020. So, the first dose of the vaccine was practically the first booster dose as most Indians had natural infection-induced immunity.
Whether you give booster or not, Omicron infection will occur. It has occurred all over the world regardless of the number of doses. The Omicron ignores previously acquired immunity from the original virus. It’s a new breed completely. For those people who have been either exposed to natural infection or vaccine, the clinical outcomes are better. The precautionary dose may help in at least introducing the antigen, he said.
Repeating himself while concluding his opinions, Dr Muliyil once again said,
Omicron is highly infectious and most of us will somehow get it because it is a virus that spreads incredibly fast. The rate at which it is spreading is unbelievable. You will fall ill enough to be hospitalised but there won’t be a rush like in Delta, not at all.
NDTV – Dettol have been working towards a clean and healthy India since 2014 via Banega Swachh India initiative, which is helmed by Campaign Ambassador Amitabh Bachchan. The campaign aims to highlight the inter-dependency of humans and the environment, and of humans on one another with the focus on One Health, One Planet, One Future – Leaving No One Behind. It stresses on the need to take care of, and consider, everyone’s health in India – especially vulnerable communities – the LGBTQ population, indigenous people, India’s different tribes, ethnic and linguistic minorities, people with disabilities, migrants, geographically remote populations, gender and sexual minorities. In wake of the current COVID-19 pandemic, the need for WASH (Water, Sanitation and Hygiene) is reaffirmed as handwashing is one of the ways to prevent Coronavirus infection and other diseases. The campaign will continue to raise awareness on the same along with focussing on the importance of nutrition and healthcare for women and children, fight malnutrition, mental wellbeing, self care, science and health, adolescent health & gender awareness. Along with the health of people, the campaign has realised the need to also take care of the health of the eco-system. Our environment is fragile due to human activity, that is not only over-exploiting available resources, but also generating immense pollution as a result of using and extracting those resources. The imbalance has also led to immense biodiversity loss that has caused one of the biggest threats to human survival – climate change. It has now been described as a “code red for humanity.” The campaign will continue to cover issues like air pollution, waste management, plastic ban, manual scavenging and sanitation workers and menstrual hygiene. Banega Swasth India will also be taking forward the dream of Swasth Bharat, the campaign feels that only a Swachh or clean India where toilets are used and open defecation free (ODF) status achieved as part of the Swachh Bharat Abhiyan launched by Prime Minister Narendra Modi in 2014, can eradicate diseases like diahorrea and the country can become a Swasth or healthy India.