BMC to release new testing protocol

According to BMC additional municipal commissioner Suresh Kakani, the comprehensive set of testing protocols will be released in a day or two. “If high risk contacts are in institutional quarantine and develop symptoms they will be tested. If no symptoms emerge, they will be tested after 14 days quarantine period is over,” he said. For those high risk contacts who observe home quarantine and have a home quarantine stamp by BMC, a Covid-19 test has to be conducted once between fifth and 14th day when viral load is usually expected to peak.

Testing remains necessary for senior citizens who are close contacts of Covid-19 cases specially if they have co-morbidity, for pregnant women three weeks before delivery, for healthcare workers and staff involved in treating Covid-19 patients and for people with symptoms of acute respiratory distress. Testing is also allowed for dialysis and chemotherapy patients.

Mumbai conducts 4,000-4,500 tests a day. Private laboratories have been asked to only test a person if there is a private or government doctor’s prescription. BMC is also planning to procure a new real time-polymerase chain reaction (RT-PCR) machine to expand its capacity for testing.

In last one month, BMC has twice changed its testing criteria for asymptomatic high risk contacts. Those who come within three feet of a Covid-19 patient are considered high risk, while those beyond three feet are low risk contacts.

For a week now, the civic body has begun conducting chest x-ray and CT scan of critically ill patients before discharge. Civic officials said apart from swab test, the CT scan and x-ray give a clear picture of chest of patients who suffered from severe infection. The scans are also being used to understand whether the viral infection has receded in lungs as swab test only gives indication of respiratory tract.

Based on latest ICMR guidelines, asymptomatic or mildly symptomatic Covid-19 patients will be discharged without a test after ten days of hospitalisation or isolation in Covid care centres provided they do not develop any symptoms like cough, cold, fever or breathlessness after eighth day of isolation. Asymptomatic or mildly symptomatic patients who observe home isolation need no test either at the end of home isolation period. Those with critical illnesses will be discharged after one swab test comes negative.

The new discharge policy is a shift from ‘test-based strategy’ to ‘symptom-based strategy or time-based strategy’. In a press conference, Lav Agarwal, joint secretary, Ministry of Health and Family Welfare, said various studies have suggested that the viral load starts reducing within seven days of developing symptoms. The earlier discharge policy mandated two negative tests in a gap of 24 hours and a chest radiograph.