COVID-19 RT-PCR: One test, many guidelines

ET Bureau|
What is RT-PCR
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What is RT-PCR

Covid-19 Real Time Reverse Transcription Polymerase Chain Reaction or RTPCR test is prescribed to detect SARS-CoV-2 or corona virus in respiratory tract through a naso-pharyngeal swab collected from a patient. It detects the virus even if the viral load is less. India does not allow walk-in testing for fear of indiscriminate testing.

Tweaked from time to time, the guidelines formulated initially by Indian Council of Medical Research allowed testing symptomatic individuals who had travel history to affected nations and healthcare workers who had been in contact with confirmed cases.

As India initiated its lockdown from March 25 and later when migrants started arriving in their native states and air and rail routes were opened, the guidelines were expanded to allow testing of asymptomatic individuals who had been in contact with confirmed Covid patients. Even now, different states have different guidelines to ensure their caseload does not increase and put a burden on their healthcare system. ET takes a look at guidelines of states:

Agencies
Delhi
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Delhi

Delhi has conducted one of the highest number of tests. Till May it had followed ICMR’s testing guidelines. However, on June 4, it changed guidelines to prevent asymptomatic patients from getting tested. It tightened ICMR guidelines to exclude all asymptomatic patients. Any high risk contact of a laboratory confirmed case could only get tested if he had comorbidities. These have been reversed by Lieutenant-Governor Anil Baijal.

CHALLENGE: Three days, Delhi’s testing numbers dipped. The guideline change coincided with notices being served to 7 private laboratories for not following the rulebook.

Agencies
Telangana
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Telangana

Telangana, which has been criticised for testing very low numbers, broadly follows ICMR guidelines.

CHALLENGE: The biggest challenge in expanding testing, however, has been the state government’s reluctance to allow private laboratories. The state has not allowed ICMR approved private labs to begin testing. The state is also planning to challenge a high court order which allowed private labs to test.

ANI
Maharashtra
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Maharashtra

Maharashtra, which has the highest number of confirmed cases, follows guidelines prescribed by ICMR.

CHALLENGE: Home collection for Covid tests has stopped in Mumbai after the municipal corporation suspected private laboratories of testing asymptomatic patients also. This rule, however, means that any suspected patient has to visit a hospital or a laboratory and add to the risk.

PTI
Gujarat
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Gujarat

The state with the highest case fatality rate in the country at 6.28% (more than double the national average of 2.86%) tweaked its testing guidelines on June 4 making hospitalisation mandatory for every person to get tested for Covid-19.

CHALLENGE: Hospitals in Gujarat are getting full as people are getting admitted to get a confirmatory test. At the same time, it is a Catch-22 situation. As per health ministry guidelines, you cannot be admitted in the hospital unless you have severe symptoms. Doctors are now fearing that with the waiting list increasing for hospital beds, the more serious patients might be deprived of critical healthcare.

AP
West Bengal
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West Bengal

West Bengal followed ICMR guidelines till May end. However, with air and rail traffic opening up, on May 26 the government notified that asymptomatic people and those with no definite contact history could also be tested. It allowed private hospitals with approved labs to collect walk-in samples.

CHALLENGE: The state still has one of the lowest tests per million.

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