Advisory on Purposive Testing Strategy for COVID-19 in India (Version VII, dated 10thJanuary 2022)
Scope: This advisory on COVID-19 testing strategy is for:
Early detection of symptomatic cases for quick isolation and care.
Early detection of infections in elderly (>60yr) and individuals with co-morbidities (diabetes,
hypertension, chronic lung or kidney disease, malignancy, obesity etc) for quick care.
Spectrum of Tests available for COVID-19:
Point-of-Care Tests: Home or Self-Test / Rapid Antigen Test (RAT)
MolecularTests: rRT-PCR, TrueNat, CBNAAT, CRISPR, RT-LAMP, Rapid Molecular
Testing Systems, Newer SARS-CoV-2 Omicron or variant detection rRTPCR assays##
Who may be tested:
- Symptomatic (cough, fever, sore throat, loss of taste and/or smell, breathlessness and/or other respiratory symptoms) individuals.
- At-risk contacts of laboratory confirmed cases.
[At-risk contacts are elderly (>60yr) and individuals with co-morbidity such as diabetes, hypertension, chronic lung or kidney disease, malignancy, obesity etc].
- Individuals undertaking international travel (as per country-specific requirements).
- International travelers arriving at Indian airports/seaports/ports of entries as per laid down
- Testing may be undertaken as per discretion of the treating doctor with the following considerations:
No emergency procedure (including surgeries and deliveries) should be delayed for lack
of a test.
Patients should not be referred to other facilities for lack of a testing facility. All
arrangements should be made to collect and transfer samples to testing facilities,
mapped to the health facility.
Asymptomatic patients undergoing surgical / non-surgical invasive procedures including
pregnant women in/near labour who are hospitalized for delivery should not be tested unless warranted or symptoms develop.
Admitted patients may not be tested more than once a week. People who need not be tested:
- Asymptomatic individuals in community settings
- Contacts of confirmed cases of COVID-19 unless identified as high risk based on age or co-
- Patients who stand discharged as per home isolation guidelines
- Patients being discharged from a COVID-19 facility as per revised discharge policy
- Individuals undertaking inter-state domestic travel
Important points to consider:
Testing can be undertaken either through rRT-PCR, TrueNat, CBNAAT, CRISPR, RT-LAMP, Rapid Molecular Testing Systems or through Rapid Antigen Test (RAT).
A positive point-of-care test [Home or Self-test / RAT] and Molecular Test is to be considered confirmatory, without any repeat testing.
Point-of-care test [Home or Self-test / RAT] should be interpreted as per algorithm at Annexure. Symptomatic individuals, testing negative on Home/Self-test or RAT should undertake rRTPCR test as detailed in the algorithm.
List of approved home tests, RAT and rRTPCR kits are available at the following links:
Home Testing advisory of ICMR is available at: https://www.icmr.gov.in/pdf/covid/kits/Advisory_Home_Test_kit_19052021_v1.pdf
All rRTPCR and RAT test results should be uploaded on ICMR portal at: https://cvstatus.icmr.gov.in.
The vaccination status of all individuals tested for COVID-19 must be entered into the Sample Referral Form (SRF) in the RTPCR app both for individuals tested by rRTPCR and RAT. This information is of critical importance.
Genome Sequencing is done for surveillance purposes and is not required to be undertaken for treatment purposes. Therefore, genome sequencing is to be performed only in a subset of positive samples as per recommendations of INSACOG (Indian SARS-CoV-2 Genomic Surveillance Consortium).
##The newer SARS-CoV-2 Omicron or variant detection rRTPCR assays are recommended to be used in areas with limited genomic surveillance capacity for quick detection of emergence of newer variants in such areas.
ICMR’s advisory is generic in nature and may be modified as per discretion of the state health authorities for specific public health and epidemiological reasonsAnnexure
Algorithm for COVID-19 Test Interpretation Using Home Test/ Rapid Antigen Point-of-Care Test
Home Test/ Rapid Antigen Test
To be reported as positive
Symptomatic: fever, cough, sore throat
Definitely send sample for retesting by rRT-PCR
• All positive and negative results should be entered into the ICMR portal on a real time basis after performing the te