As the lockdown eases across the country, and more migrant workers return to their home states, the Indian Council of Medical Research (ICMR) on Monday revised the testing protocol to include symptomatic “returnees and migrants”, hospitalised patients and “frontline workers”.
According to the revised strategy, “all hospitalised patients who develop lLl (influenza like illness) symptoms “, “all symptomatic ILI among returnees and migrants within 7 days of illness”, and all symptomatic “frontline workers involved in containment and mitigation of Covid-19” will now be tested.
Also, asymptomatic direct and high-risk contacts of a confirmed case will now be tested once between the fifth and tenth day of coming in contact (earlier, they were tested once between the fifth and fourteenth day).
With 5,242 new cases — the highest single-day jump so far — and 157 deaths in the last 24 hours, the total count is now 96,169 cases (3,029 deaths, 36,823 recovered).
Issuing detailed guidelines for workplaces, the Ministry of Health and Family Welfare said: “If there are one or two cases reported, the disinfection procedure will be limited to places/ areas visited by the patient in past 48 hrs. There is no need to close the entire office building/ halt work in other areas of the office and work can be resumed after disinfection as per laid down protocol.”
“However, if there is a larger outbreak, the entire building will have to be closed for 48 hours after thorough disinfection. All the staff will work from home, till the building is adequately disinfected and is declared fit for re-occupation,” it said.
“The high risk exposure contacts (those who were in close contact) shall be quarantined for 14 days. They will follow the guidelines on home quarantine and undergo testing as per ICMR protocol,” the ministry said. “The low risk exposure contacts shall continue to work and closely monitor their health for the next 14 days,” it said.
If there is a suspected case, employers must inform the health authorities who will assess the symptoms and case history to determine testing, home isolation or other measures.
“If there are a large numbers of contacts from a pre-symptomatic/ asymptomatic case, there could be a possibility of a cluster emerging in workplace setting. Due to the close environment in workplace settings this could even be a large cluster (>15 cases),” it said.
According to the ICMR’s earlier protocol, asymptomatic, high-risk contacts of positive cases, all SARI (Severe Acute Respiratory Infection) patients, and symptomatic people in the following categories – ILI patients in hotspots and large migration centres; those who have returned from abroad; contacts of positive cases; healthcare workers – were being tested.
The ICMR has specified that “no emergency procedure (including deliveries) should be delayed for lack of test.” If a patient fits the testing criteria, his/ her test can be done simultaneously with the emergency procedure.
The inclusion of all “hospitalised patients who develop ILI symptoms” indicates the concern over patients contracting the disease in hospital. And the inclusion of “returnees/migrants”, irrespective of contact history or whether they are travelling from a hotspot, signals the concern over possible community transmission.
The government, however, has maintained that there is no community transmission so far.
“Some patients may develop an infection in hospital, so we are testing for that. Also, on the same lines as testing international travellers, we are testing symptomatic domestic travellers with only the migrants,” Dr Manoj Murhekar, Director, ICMR-National Institute of Epidemiology (NIE), said.
While 23,02,792 samples have been tested so far, the positivity rate has remained around 4% since the beginning of April. However, the government stopped giving the number of individuals tested since April.
In terms of case count, India has already overtaken China. “In terms of confirmed cases per lakh population, India has so far about 7.1 cases per lakh population vis a vis approx 60 cases per lakh population for the world as a whole,” the Health Ministry said in a statement.