Advisory BY ICMR on Purposive Testing Strategy for COVID-19 in India

Scope:This advisory on COVID-19 testing strategy is for:

(Version VII, dated 10thJanuary 2022)

India

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New Delhi, January 11, 2022:

• 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)
• Molecular Tests: 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. In community settings:

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. In Hospital Settings:

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:

1. Asymptomatic individuals in community settings

• 2. Contacts of confirmed cases of COVID-19 unless identified as high risk based on age or comorbidities
• 3. Patients who stand discharged as per home isolation guidelines
• 4. Patients being discharged from a COVID-19 facility as per revised discharge policy
• 5. 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.pdf https://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.
• 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

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