SIMPLIFIED TESTING PROCEDURE AND ‘ON-DEMAND’
TESTING FOR THE FIRST TIME
Posted On: 05 SEP 2020
11:35AM by PIB Delhi
There has been an unprecedented upsurge in
India’s daily testing capacities. For two successive days more than 11.70 lakh
tests have been conducted per day. A total of 4 crore and 77 lakh tests have
been done so far across the country. There are now 1647 testing laboratories
operational which cover all States/UTs. It is in this background that the
Health Ministry has issued the updated Testing Advisory.
On recommendations of the National Task Force
on COVID-19, the new Advisory has further simplified the testing process and
given more freedom and flexibilities to the State authorities to facilitate
enhanced ease of testing for the people.
For the first time, along with more simplified
modalities, the updated Guidelines provide for ‘On-demand’ testing in order to ensure higher levels of
testing.
The Advisory elaborates on the choice of tests
(in order of priority) in various given settings.
- Routine surveillance in containment zones and screening at points of entry:
Choice of Test (in order of priority):
- Rapid Antigen Test (RAT) [as per attached algorithm]
- RT-PCR or TrueNat or CBNAAT
1.
All symptomatic (ILI symptoms) cases including health care
workers and frontline workers.
2. All asymptomatic direct and high-risk contacts (in family
and workplace, elderly ≥ 65 years of age, immune compromised, those with
co-morbidities etc.) of a laboratory confirmed case to be tested once between
day 5 and day 10 of coming into contact.
3. All asymptomatic high-risk individuals (elderly ≥ 65 years
of age, those with co-morbidities etc.) in containment zones.
- Routine surveillance in non-containment areas:
Choice of Test (in order of priority):
- RT-PCR or TrueNat or CBNAAT
- Rapid Antigen Test (RAT)*
4. All symptomatic (ILI symptoms) individuals with history of
international travel in the last 14 days.
5. All symptomatic (ILI symptoms) contacts of a laboratory
confirmed case.
6. All symptomatic (ILI symptoms) health care workers /
frontline workers involved in containment and mitigation activities.
7. All symptomatic ILI cases among returnees and migrants
within 7 days of illness.
8. *All asymptomatic high-risk contacts(contacts in family
and workplace, elderly ≥ 65 years of age, those with co-morbidities etc. [RAT
is recommended as the first choice of test in order of priority]
- In Hospital Settings:
Choice of Test (in order of priority):
- RT-PCR or TrueNat or CBNAAT
- Rapid Antigen Test (RAT)
9. All patients of Severe
Acute Respiratory Infection (SARI).
10. All symptomatic (ILI symptoms) patients presenting in a
healthcare setting. 11. Asymptomatic high-risk patients who are hospitalized or
seeking immediate hospitalization such as immunocompromised individuals,
patients diagnosed with malignant disease, transplant patients, patients with
chronic co-morbidities, elderly ≥ 65 years.
12. Asymptomatic patients undergoing surgical / non-surgical
invasive procedures (not to be tested more than once a week during hospital
stay).
13. All pregnant women in/near labor who are hospitalized for
delivery.
Points to be noted:
·
No emergency procedure (including
deliveries) should be delayed for lack of test. However, sample can be sent for
testing if indicated as above (1-13), simultaneously.
·
Pregnant women should not be referred
for a lack of testing facility. All arrangements should be made to collect and
transfer samples to testing facilities.
·
Mothers who test positive for COVID-19
should be advised to wear a mask and undertake frequent hand washing while
handling their baby for 14 days. They should also be advised on breast cleaning
before feeding the neonate. These measures are likely to reduce transmission of
COVID-19 to their babies.
14. All symptomatic neonates presenting with acute
respiratory / sepsis like illness. (Features suggestive of acute respiratory
illness in a neonate are respiratory distress or apnea with or without cough,
with or without fever. Neonates may also manifest with only non-respiratory
symptoms like fever, lethargy, poor feeding, seizures or diarrhea).
15. Patients presenting with atypical manifestations [stroke,
encephalitis, hemoptysis, pulmonary embolism, acute coronary symptoms, Guillain
Barre syndrome, Multiple Organ Dysfunction Syndrome, progressive
gastrointestinal symptoms, Kawasaki Disease (in pediatric age group)] based on
the discretion of the treating physician.
A totally new
section has been added in the Advisory on “Testing on Demand” which for all
practical purposes does away with prescription by a registered medical
practitioner although State governments have the freedom to decide on
simplified modalities.
The new
section reads thus-
- Testing on demand (State Governments to decide simplified modalities):
- All individuals undertaking travel to countries/Indian states mandating a negative COVID-19 test at point of entry.
- All individuals who wish to get themselves tested.
Tracking
and contact tracing mechanisms should be ensured by the testing laboratories by
notifying the public health authorities.
Frequency of testing :
·
A single
RT-PCR/TrueNat/CBNAAT/RAT positive test is to be considered confirmatory,
without any repeat testing.
·
No re-testing is
recommended prior to discharge from a COVID-19 facility after clinical recovery
(please refer to MoHFW guidelines), including for transfer from a COVID area/
facility to a non-COVID area/ facility.
·
If symptoms develop
following a negative RAT test, a repeat RAT or RT-PCR should be done (Algorithm
for interpreting RAT is placed at Annexure 1).
Points to be noted:
·
WHO case definition for
ILI: Individual presenting
with acute respiratory infection with fever
≥ 38◦C
AND cough with onset within the last 10 days.
·
WHO case definition for
SARI: Individual presenting
with acute respiratory infection with history of fever ≥ 38◦C AND cough with
onset within the last 10 days AND requires hospitalization.
·
All healthcare workers
and frontline workers coming in contact with suspect/confirmed COVID-19
patients should ensure use of appropriate PPE.
·
Home quarantine for 14
days is recommended for all individuals before undergoing elective surgery to
minimise chances of infection before the procedure.
For all authentic & updated information on COVID-19
related technical issues, guidelines & advisories please regularly visit:
https://www.mohfw.gov.in/ and @MoHFW_INDIA.
Technical queries related to COVID-19 may be sent to
technicalquery.covid19@gov.in and other queries on ncov2019@gov.in and
@CovidIndiaSeva .
In case of any queries on COVID-19, please call at the
Ministry of Health & Family Welfare helpline no.: +91-11-23978046 or 1075
(Toll-free). List of helpline numbers of States/UTs on COVID-19 is also
available at
MV/SJ HFW/COVID Advisory/5September2020/1 (Release ID: 1651508)
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