Delhi will revert to ICMR guidelines, asymptomatic contacts will be tested

Updated on Jun 09, 2020 04:48 AM IST

There were nine categories of people who need to be tested, according to the ICMR guidelines. These include asymptomatic direct contacts who are to be tested between Day 5 and Day 10 of coming in contact with the Covid-19 infected person.

A medical worker takes a swab sample for Covid-19 testing in a bus converted into a mobile coronavirus testing clinic in New Delhi,on Monday.(Sonu Mehta/HT PHOTO)
A medical worker takes a swab sample for Covid-19 testing in a bus converted into a mobile coronavirus testing clinic in New Delhi,on Monday.(Sonu Mehta/HT PHOTO)
Hindustan Times, New Delhi | ByAnonna Dutt and Jayashree Nandi, New Delhi

With lieutenant-governor Anil Baijal on Monday reversing the Delhi government’s restrictions on testing for Covid-19, the tests for confirming the viral disease in the national capital will now be done on the parameters set by the country’s apex health research body – the Indian Council of Medical Research (ICMR).

On June 2, the Delhi government had released its own testing strategy, deviating from the strategy laid down by ICMR.

There were nine categories of people who need to be tested, according to the ICMR guidelines. These include asymptomatic direct contacts (those living in the same house or working in close proximity to a positive person) who are to be tested between Day 5 and Day 10 of coming in contact with the infected person.

Delhi government had tightened this criterion to exclude asymptomatic direct contacts who weren’t aged or had no co-morbid conditions such as diabetes, hypertension and/or cancer.

Monday’s order from the Delhi Disaster Management Authority (DDMA), of which L-G Baijal is the chairman, said, “In order to contain the spread of Covid-19, it is essential to conduct a thorough contact tracing of affected persons, and as such, the ICMR strategy for Covid-19 testing should be followed without any deviation.”

“Any deviation from the ICMR guidelines can result in inadequate contact tracing of affected individuals and can result in further spread of Covid-19 in Delhi,” the order further said.

A person at one the laboratories conducting Covid-19 tests said on condition of anonymity, “Asymptomatic direct contacts must be tested as they are very likely to have the infection. What if the husband tests positive, and the wife is asymptomatic? As per Delhi government rules, she cannot be tested and may pass on the infection to others, who may become severely ill. Even the WHO says testing is the way to defeat the infection.”

Earlier, in an interview with HT, director of All India Institute of Medical Sciences (AIIMS) Dr Randeep Guleria had said the testing threshold had to be lowered so that even if there is a slight suspicion that a person is infected, then (s)he should be able to get tested.

The other categories set by ICMR for testing are – all symptomatic individuals with a history of international travel in the last 14 days; all symptomatic contacts of laboratory confirmed cases; all symptomatic healthcare/ frontline workers; all patients of severe acute respiratory infection; all symptomatic people within the hotspots or containment zones; all hospitalised patients who develop influenza-like illness; all symptomatic migrants within seven days of illness; and those in need of emergency procedure.

Here, symptomatic means people with fever of more than 100°F, cough, and respiratory infection.

“The testing strategies of ICMR so far have been based on the assumption that there was no community transmission. However, once there is community transmission, there is no point in contact tracing. Then, the strategy should change to testing all people clinically diagnosed to have Covid-19 to confirm the infection,” Dr T Jacob John, professor emeritus and former head of department of virology at Christian Medical College, Vellore, said.

“Had the Delhi government removed the other restrictions -- symptomatic people have to be tested only if they have a travel history or only those residing in hotspots -- and tested all symptomatic patients, I would have called Delhi’s testing strategy more forward and similar to those in developed countries where there is community transmission of the infection. The country as a whole now needs to rethink the testing strategy,” Dr John said.

NO COVID TESTS IN DELHI FOR SECOND DAY

Several private laboratories did not collect Covid-19 samples for the second day on Monday. Of the 10 private laboratories that HT called on Monday, four didn’t answer, while five said they were not providing the service “temporarily”. One lab had a token system in place—patients had to come early morning to give their samples on a first-come-first-served basis.

HT had reported on Sunday that most private laboratories in Delhi had either capped the number of people they test a day or were not collecting samples, making it difficult for patients to get tested for Covid-19.

The labs that have temporarily stopped collecting samples include City X-Ray and Scan Clinic in Tilak Nagar, and Lifeline Laboratory in Green Park (which is at capacity and cannot test any more samples until it clears the backlog).

Rajiv Gandhi Cancer Institute said it could collect samples only if the Conquest laboratory, the firm to which it had outsourced Covid-19 testing, was ready to test.

The government banned eight labs from testing on June 5 for not following protocols, and, according to health minister Satyendar Jain, taking too long to report results.

These include Dr Lal Pathlabs, Sir Ganga Ram Hospital, Prognosis laboratory, SRL reference laboratory, Fortis Hospital, Star Imaging Path laboratory, Pathkind labs and the National Centre for Disease Control (NCDC). The ICMR now recognises 23 private laboratories for Covid-19 testing.

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