Advisory on Purposive Testing Strategy for COVID-19 in India (Version VII, dated 10thJanuary 2022)

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:
A. Incommunitysettings:

  1. Symptomatic (cough, fever, sore throat, loss of taste and/or smell, breathlessness and/or other respiratory symptoms) individuals.
  2. 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].
  3. Individuals undertaking international travel (as per country-specific requirements).
  4. International travelers arriving at Indian airports/seaports/ports of entries as per laid down
    guidelines.
    B. InHospitalSettings:
  5. 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:
  6. Asymptomatic individuals in community settings
  7. Contacts of confirmed cases of COVID-19 unless identified as high risk based on age or co-
    morbidities
  8. Patients who stand discharged as per home isolation guidelines
  9. Patients being discharged from a COVID-19 facility as per revised discharge policy
  10. 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:
    https://www.icmr.gov.in/pdf/covid/kits/COVID_Home_Test_Kit_23112021.pdf
    https://www.icmr.gov.in/pdf/covid/kits/List_of_rapid_antigen_kits_30122021.pdfhttps://www.icmr.gov.in/pdf/covid/kits/RT_PCR_Tests_Kits_Evaluation_Summ_231
    22021.pdf
     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.
    2|Page 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 reasons Annexure
    Algorithm for COVID-19 Test Interpretation Using Home Test/ Rapid Antigen Point-of-Care Test
    Home Test/ Rapid Antigen Test
    Positive
    To be reported as positive
    Negative
    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

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