Opinion Centre has done well to nudge states to increase Covid testing. Conflicting signals from ICMR guidelines must be sorted out

In the past week, the country’s daily Covid caseload graph has virtually flattened. The 2.38 lakh cases detected on Monday were the lowest in the past six days. The positivity rate has, however, continued to rise steadily, indicating that — other than in Mumbai and Delhi to an extent — the Omicron-driven third wave is weeks away from peaking in the country. It’s obvious now that the discordance between the two sets of figures owes to a sharp reduction in the number of samples being tested for Covid. On Tuesday, the Union Ministry of Health and Family Welfare flagged this concern to the state health departments. “The data available on ICMR’s portal shows that testing has declined in many states and Union Territories,” Additional Health Secretary Arti Ahuja wrote in a letter to the states. The nudge is much needed. But the Centre and its agencies must also clear the air on testing protocols, especially the revised set of guidelines issued by the ICMR last week. The guidelines, that do not require asymptomatic contacts of Covid-positive people to get tested, seem to have created an impression that testing benchmarks can be lowered during the current outbreak. By all accounts, the fall in the number of tests has followed the notification of these protocols. While the health ministry has rightly pulled up states for their laxity, its letter continues to give conflicting signals by reiterating the ICMR guidelines.

Given that Omicron has been behaving differently from the variants that drove the first two waves, many epidemiologists advocate a different set of metrics. These include making hospitalisation rates — and not the case count — the yardsticks for ascertaining the virus’s virulence. But these experts have also cautioned that the high transmissibility of the virus could offset its relatively milder character. Therefore, while tweaks in testing protocols and measures such as home testing may well be in order, these norms must be implemented in ways that do not undermine the importance of tests as a pandemic-management instrument or downplay their significance as an exercise to understand the trajectory of the current wave. It’s apparent from testing data that this message of caution has not been conveyed adequately: While the country’s daily case burden is about the same as June last year, states are barely testing 60 per cent of what they were doing seven months ago.

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The health ministry and the ICMR must elaborate on the testing protocols — and, if need be, revise them or issue clarifications. The message must be unequivocal: Testing remains crucial to dealing with the third wave.

This editorial first appeared in the print edition on January 20, 2022 under the title ‘Tests matter’.