Testing For COVID-19 In The Second Wave? Here's What You Need To Know

India is currently fighting the second wave of COVID-19 which is much worse than the first one. While cases are spiking every second, so much so, that hospitals have already run out of beds, oxygen cylinders and other COVID related essentials; increasing number of tests is also throwing a major challenge on laboratories.

According to the Indian Council of Medical Research (ICMR), “The total daily national testing capacity is close to 15 lakh tests considering a three- shift operationalisation of the existing laboratory network. At present, the laboratories are facing challenges to meet the expected testing target due to extraordinary case load and staff getting infected with COVID-19.”

Therefore, in an attempt to optimise the RT-PCR testing and increase accessibility to all the citizens of the country, ICMR has issued an advisory for COVID-19 testing during the second wave and here's what it says:

1. RT-PCR (reverse transcription polymerase chain reaction) test must not be repeated in any individual who has tested positive once either by RAT (rapid antigen test) or RT-PCR.
2. No testing is required for individuals who have recovered from COVID-19 at the time of hospital discharge in accordance with the Ministry of Health and Family Welfare's (MoHFW) revised discharge policy.
3. The need for RT-PCR test in healthy individuals undertaking inter-state domestic travel may be completely removed to reduce the load on laboratories.
4. Non-essential travel and interstate travel of symptomatic individuals, COVID-19 or flu like symptoms, should be avoided to reduce the risk of infection.
5. All asymptomatic individuals undertaking essential travel must follow COVID appropriate behavior.
6. Mobile testing laboratories are now available on Government-E-Marketplace (GeM) portal. States are encouraged to augment RT-PCR testing through mobile systems.

Moreover, to speed up the Rapid Antigen Test (RAT), and make it more accessible to the individuals, the ICMR, which is funded by the MoHFW, has added:

1. RAT may be allowed at all available government and private healthcare facilities.
2. Set up dedicated RAT booths in cities, towns and villages to offer testing to people.
3. Testing booths may be set up at multiple locations including healthcare facilities, RWA, offices, schools, colleges, community centers and other available vacant spaces.
4. These booths should be operational on a 24X7 basis to improve access and availability of testing.
5. Drive-through RAT testing facilities may be created at convenient locations as identified by local administration.
6. Stringent measures must be instituted to avoid overcrowding at RAT testing facilities.

The council has further advised the states to ensure full utilisation of RT-PCR testing capacity both in public as well as private laboratories; and to conduct RAT testing in compliance with the ICMR advisory.  

1. Symptomatic individuals identified positive by RAT should not be re-tested and advised to go through home-based care as per ICMR guidelines.
2. Symptomatic individuals identified negative by RAT should be linked with RT-PCR test facility and in the meantime be urged to follow home isolation and treatment.
3. All RT-PCR and RAT test results should be uploaded on ICMR portal.
4. During the current upsurge of COVID-19 cases, any individual presenting with fever with or without cough, headache, sore throat, breathlessness, body ache, recent loss of taste or smell, fatigue and diarrhea should be considered as suspect case of COVID-19 unless proven otherwise by confirmation of another etiology.
5. The vaccination status of all individuals tested for COVID-19 must be entered into the Sample Referral Form (SRF) in the RT-PCR app both for individuals tested by RT-PCR and RAT. This information is of critical importance.
6. Payment modalities for upscaled RAT testing may be decided by the state health authorities.

According to Johns Hopkins University & Medicine’s Coronavirus Resource Center, India stands second after the United States in the list of countries with maximum number of coronavirus cases in the world. As of May 5, 2021; the data shows India with a total of 2,06,65,148 cases of coronavirus, and 2,26,188 deaths.