Amid Omicron’s BF.7 scare, when should you get a Covid-19 test done (and which one)?

Who must be tested?

Who may be tested, according to the Indian Council of Medical Research (ICMR)’s Advisory on Purposive Testing Strategy for Covid-19 in India:

A. In community settings:

*Symptomatic (cough, fever, sore throat, loss of taste and/or smell, breathlessness and/or other respiratory symptoms) individuals.
*At-risk contacts of laboratory-confirmed cases. (At-risk contacts are elderly (>60yr) and individuals with co-morbidity such as diabetes, hypertension, chronic lung or kidney disease, malignancy, obesity etc)
*Individuals undertaking international travel (as per country-specific requirements).
*International travellers arriving at Indian airports/seaports/ports of entry as per laid down guidelines.

B. In hospital settings:

ICMR suggests that testing may be undertaken at the “discretion of the treating doctor”.

People who need not be tested:

*Asymptomatic individuals in community settings
*Contacts of confirmed cases of COVID-19 unless identified as high risk based on age or comorbidities
*Patients who stand discharged as per home isolation guidelines
*Patients being discharged from a COVID-19 facility as per revised discharge policy
*Individuals undertaking inter-state domestic travel

Why is testing important?

“Since a variant of Covid-19 had led to a spike in cases in China, we need to intensify testing and monitor all those who are coming with a cough, cold, and fever,” said Dr Ravi Shekhar Jha, director and head, pulmonology, Fortis Hospitals, Faridabad.

Here’s when testing should be done (Source: Express Photo by Amit Mehra)

What are the symptoms?

Unusual fever with body aches, headache, upper respiratory tract infection, etc needs to be monitored. “One also needs to be vigilant for new symptoms, or of regular symptoms deteriorating, like if the patient becomes breathless, oxygen saturation drops, and the X-ray shows viral pneumonia. There’s no way to differentiate between the variants based on the symptoms only,” Dr Bharesh Dedhia, chief, department of critical care, PD Hinduja Hospital, Khar, Mumbai told indianexpress.com.

He added, “Most of these variants differ in their transmissibility, but there is usually no change in symptoms. These variants have been mild for most Indians, except for the elderly or those with low immunity or co-morbidities.”

When should one get tested?

Dr Subhendu Mohanty, interventional cardiologist, Sharda Hospital, Noida said that the testing protocols remain as is. “There is no need for testing unless you have pneumonia with no apparent cause,” Dr Mohanty elucidated.

What tests are available?

According to ICMR, real-time RTPCR and Rapid Antigen Tests (RAT) are the mainstays of diagnosis of SARS-CoV-2 in India. According to ICMR’s guidelines, testing can also be undertaken through TrueNat, CBNAAT, CRISPR, RT-LAMP, and Rapid Molecular Testing Systems.

ICMR lists three main types of Covid tests — Molecular tests (also known as PCR tests) detect the genetic material of the coronavirus. Antigen tests detect coronavirus proteins. Antibody tests detect antibodies produced by your body‘s immune system in response to a previous Covid infection. However, antibody tests cannot be used to diagnose an active Covid infection.

“There are a few molecular tests run by the government and private lab networks as point-of-care tests. One of them is Truenat RTPCR which can provide samples to test results in an hour’s time. Apart from it, many homegrown tests and imported ones too are being used in labs. Several antigen tests are also widely available,” Dr Chandrashekhar Nair, CTO, Molbio Diagnostics told indianexpress.com.

The testing mechanism remains the same for any variant as the testing will only determine if someone is Covid-19 positive or not, Dr Dedhia said.

The only way to identify the variant is through genetic testing of the variant, which is being done at NIV – National Institute of Virology centres, to determine its lineage and its genetic sequence, Dr Dedhia noted.

How to do testing?

ICMR also states that “a positive point-of-care test (Home or Self-test/RAT) and Molecular Test is to be considered confirmatory, without any repeat testing”. However, “Symptomatic individuals, testing negative on Home/Self-test or RAT should undertake RTPCR test”, ICMR notes.

Negating the belief that “covid era has ended”, Dr Nair said that distributed point-of-care testing in the community should be continued as a regular practice, especially in vulnerable populations. “This would also help us monitor periodic outbreaks and, rise in cases, etc, and provide timely treatment,” Dr Nair noted.

Find the entire list of tests available in India here

Preparations before the test

– It is important you find a clean place.
– Identify a table and sanitise the surface.
– Wash your hands with soap, and make sure they are dry before you perform the test.
– Tear the pouch (of the test kit) and lay the contents of the kit on the table.
– Before you proceed, download the app mentioned in the testing kit and fill in the credentials. This is important so that no positive case is missed.

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