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States can use rapid testing for containment zones and hot spots: ICMR
Covid-19 update: ICMR director general Balram Bhargava has also written to state chief secretaries and principal health secretaries, asking them to use the rapid testing kits at places they deem fit, provided the protocols are followed.
The Indian Council of Medical Research (ICMR) has issued a new rapid testing protocol that allow states to use rapid testing kits wherever they want, including in Covid-19 containment zones and hot spots.
The new protocol was issued following requests from states, some of which wanted quicker results from tests in affected areas to speedily put in place aggressive containment measures.
ICMR director general Balram Bhargava has also written to state chief secretaries and principal health secretaries, asking them to use the rapid testing kits at places they deem fit, provided the protocols are followed.
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“I am writing to you with reference to the rapid antibody test kits for Covid-19 testing. It is understood that many states intend to use these kits in affected areas…The National Task Force at ICMR has carefully reviewed the data evolving from various countries on use of such kits,” he said in his letter.
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“Based on available evidence, the testing strategy for Covid-19 has been revised further…”
The rapid antibody test is a supplementary tool to assess the prevalence of diseases within a specific area or perimeter. This test will only be of use after a minimum of seven days of the onset of symptoms.
Experts in the ICMR also said data about these rapid tests is emerging, and the understanding of their utility for diagnosis is still evolving. As of now, rapid tests are mainly useful for epidemiological studies (to know the distribution, patterns and determinants of disease conditions), and for surveillance to get real-time data.
Since the gold standard frontline test for Covid-19 diagnosis is the real time polymerase chain reaction (RT-PCR)-based molecular test, which is aimed at early virus detection, the rapid antibody test cannot replace the frontline test, the ICMR recommended in its revised protocol.
An ICMR official, on condition of anonymity, said: “Many states want to go in for aggressive testing in containment zones and want to make use of rapid testing in these areas as they have to test almost everyone with influenza-like illness in those areas. We have drafted the new protocol keeping in mind the requests of the states. However, rapid diagnostic test is ideally a surveillance tool to capture trends. It cannot be used for early diagnosis.”
According to the new ICMR protocol, only those showing symptoms of influenza-like illness such as fever, cough and cold for seven or more days in hot spot areas should be made to undergo a rapid test.
Those who are found positive in the rapid test must be quarantined for at least the next seven days. Those who test negative should also remain under home quarantine for at least seven days as they are in a hot spot area.
“If clinical suspicion is high for Covid-19, then perform an RT-PCR test to reach a confirm diagnosis,” the ICMR protocol stated.
However, the rapid test is best suited to ascertain disease prevalence in an outbreak situation, and the ICMR has made special recommendations in the revised protocol that testing should also be done as a surveillance tool for epidemiological purposes in such areas where cases have not emerged so far, or areas with few cases that may emerge as potential hot spots in future.
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The testing, however, has to be done under strict medical supervision.
“The IgM antibody that is the first antibody to develop after one gets an infection can help in detecting a recent infection. It can be used in hot spot areas as a supplementary testing modality along with RT-PCR. It’s also cheaper and quicker,” said T Jacob John, former head of the virology department of the Christian Medical College, Vellore.
After delays in procuring kits, India on Thursday received 650,000 kits, including 500,000 antibody testing kits and 100,000 RNA extraction kits, from China. India has tested at least 300,000 samples so far, of which about 14,500 were positive, according to ICMR data.
