ICMR Strategy Of COVID19 Testing In India

COVID19 testing Strategy in India 

Indian Council Of Medical Research – Department of Health Research
ICMR releases the COVID19 testing strategy in India (17.03.20)

Background:

In December 2019, an outbreak of febrile respiratory illness of unknown etiology in the Hubei province of China, Wuhan was declared by the World Health Organization (WHO). The disease has been rapidly spreading to neighboring provinces in China and also to 151 other countries mainly through International travel since its emergence. The transmission of COVID-19 infection is through droplets of an infected patient generated by sneezing or coughing or through prolonged contact with patients who are infected.

In India, currently, there are only imported cases of COVID19 and limited local transmission from imported cases to their immediate contacts has been witnessed. Until now, the community transmission of the disease has not been documented. The testing strategy will undergo changes to evolve into a stage-appropriate testing strategy in case if community transmission is documented.

Objectives:

• Improving access to suppress the spread of COVID19 infection or community transmission of the disease.
• To all individuals meeting the inclusion criteria of COVID19 testing, free of cost and reliable diagnosis is to be provided.
• To scale-up facilities for testing and to optimally utilize the resources of the country and to avoid indiscriminate testing and reducing panic.

Current scenario:

• Testing at no cost is being offered to all the individuals who require testing.’
• Every week, an optimum number of testing laboratories are added and the accessibility and availability of the test are being increased every day.
• Right now, the first step screening assay cost is INR 1500 and INR 3000 for additional confirmatory assays.
• To initiate testing facilities, ICMR has engaged with non-ICMR /MOHFW Govt., including CSIR, DBT, DRDO, Govt. Medical Colleges etc., as a part of the laboratory expansion process.
• To understand the modalities of increasing access to the test while ensuring appropriate safeguards, ICMR is also engaging with high-quality private laboratories that include NABL accredited labs.
• In heavily overloaded states, to exponentially augment the testing capacity, ICMR is operationalizing already existing high throughput diagnostic systems (up to 1400 samples per day).
• To augment the existing stockpile of reagents to 1 million tests which would be available soon, ICMR-NIV, Pune has already placed orders. An additional 1 million probes for testing has been requested from WHO.
• Advisory for testing are being reviewed and updated periodically (09/03/2020 and
  16/03/2020). A high-level Expert Committee constituted by Secretary DHR & DG, ICMR and Chaired by Prof, Randeep Guleria, Director, All India Institute of Medical Sciences, Delhi, reviews the testing strategy.

Current testing strategy:

1. The asymptomatic individuals who have international travel history:
   – For 14 days, they should stay in house quarantine.
   – Only if they become symptomatic (difficulty in breathing, cough, fever, etc.), they must be tested.
   – They should be isolated and treated according to the protocol if they test positive for the infection.
2. The contacts of positive cases confirmed:
   – For 14 days, they should stay in house quarantine.
   – Only if they become symptomatic (difficulty in breathing, cough, fever, etc.), they must be tested.
   – They should be isolated and treated according to the protocol if they test positive for the infection.
3. When the health care workers who manage Severe Acute Respiratory Illness / respiratory disease are symptomatic, they should be tested.

Guidelines for private sector laboratories intending to initiate COVID19 testing:

• COVID19 test must be done as per ICMR guidance for testing and it should be only offered when prescribed by a qualified physician. The latest revised version must be followed as the guidance evolves periodically.
• Right after the concerned private laboratory has procured the primers, probes, and reagents as per SOPs, the SOPs for laboratory testing and provide positive controls for
  establishing the test will be shared by ICMR.
• While collecting samples from a suspect patient, appropriate biosafety and biosecurity precautions should be ensured or a disease-specific separate collection site can be created, alternatively.
• For timely initiation of contact tracing and research activities, all the private testing laboratories must ensure immediate/ real-time reporting to the State officials of IDSP (Integrated Disease Surveillance Program of Govt. of India) and ICMR Hq.
• It is strongly appealed by ICMR that free COVID19 diagnosis much is offered by all the private laboratories.

Source

Author: Sruthi S