ICMR guidelines on testing create confusion

New Delhi: Five set of guidelines issued by the Indian Council of Medical Research (ICMR) on the COVID-19 testing in India since March 17 have created a lot of confusion among the testing labs and the medical experts.

Its latest revised strategy circulated on May 18 recommends testing of even the asymptomatic persons, who may have come in direct and high-risk contacts with a confirmed case, between day 5 and 10 of coming into such a contact.

Dr Giridhar Babu, a member of ICMR's research task force on epidemiology, however, differs with the council's advisory as he affirmed that "there is no study available which indicates that asymptomatic patients are spreading the virus." Moreover, he said testing more is only putting extra burden on the existing testing infrastructure.

The ICMR, however, insists that even an asymptomatic person can be potential carrier or spreader of the dreaded virus as he may not be at risk, but he can put people with co-morbidity or elders at risk after the infection.

Its guidelines in vogue now lays more stress on testing all symptomatic (ILI symptoms), including the health care workers and front line workers involved in containment and mitigation, as also all patients of Severe Acute Respiratory Infection (SARI), all hospitalised who develop ILI symptoms and those from hotspots and containment zones.

The guidelines, however, make it clear not to delay the emergency procedure, including deliveries, due to lack of COVID-19 test, but th sample can be sent for testing simultaneously. ILI case is deefined as one with acute respiratory infection with fever and cough while SARI case is one with acute respiratory infection, fever andd cough andd requiring hospitalisation.

Some of the private hospitals in the capital, led by Sir Ganga Ram Hospital, have protested at Delhi government issuing a directive to admit the patients without testing them for COVID-19 so as not to delay the urgent procedures they require. They say such a directive may spread the virus among doctors and medical staff who may become unavailable for treating patients if the spread is large.

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