NMC skipping mandatory RT-PCR if swab tests antigen -ve

Nagpur: Many high risk suspects testing negative in the rapid antigen tests need confirmatory RT-PCR, as chances of false negatives are as high as 60 to 70%. Yet many are not opting for the confirmatory RT-PCR test, which is more reliable as far as a negative test is concerned. Even NMC does not have procedures in place to conduct the mandatory RT-PCR test as follow-up.
A positive report in antigen test is confirmed, as there is negligible chance of error, say experts.
Private practitioners have complained that symptomatic cases referred by them to NMC’s newly-established 21 testing centres are flashing negative antigen certificates to roam freely in the city, thereby increasing spread of Covid-19.
As per ICMR norms, testing agencies need to simultaneously collect two swabs — one for antigen test and other for RT-PCR, if needed. Yet, NMC testing centres are not inclined to do so.
A senior doctor told TOI that half the centres can be made exclusively RT-PCR test centres for high risk groups and confirmatory tests. “RT-PCR is being done only at OPDs of IGGMCH, GMCH, AIIMS and certain special camps. Rest all other places, antigen is used because it gives a quick report and positive is never false,” the doctor said, adding that second sampling is not being done.
The doctor said even if anyone tests positive in antigen, there is no reason to worry because most patients are advised home isolation nowadays.
Civil surgeon Dr Devendra Patturkar said repeat sampling is needed for RT-PCR in case symptomatic person tests negative in antigen test. “It is being done at all testing centres under me,” he said.
An official said many of the samples coming from district places are for confirmatory test only.
Infectious disease expert Dr Nitin Shinde said the burden on government and private labs has increased due to which people are forced to opt for antigen test. “We have been counselling patients to get RT-PCR done as many of them, though asymptomatic, show signs of Covid-19. They are not ready to listen and argue with us. They are roaming around freely,” he said
Dr Shinde suggested that testing needs to be further increased at the level of each colony to contain rapid spread of the disease.
Dr Meena Mishra, professor and head of the department of microbiology, AIIMS, Nagpur, told TOI that according to ICMR guidelines, if symptomatic persons are testing negative in antigen test, they need to be tested by RT-PCR test. “In case of asymptomatic patients who are in high risk category or in early stage of infection testing negative by antigen test, they will spread the disease if not tested with RT-PCR test,” she said.
Dr Mishra said, “The need is to properly counsel people to go for RT-PCR whenever indicated. A strong message must go out that it is not about false negative or testing positive but getting a correct report, which helps in early intervention and control further spread of the virus.”
Dr Mishra warned that early detection is key in Covid management as the virus directly hits the lungs. “We are following the ICMR guidelines and taking two swabs of suspects who fit the criteria. Same swab can’t be used for two different methods,” she said.
NMC chief medical officer Dr Yogendra Sawai didn’t respond to TOI’s repeated calls and messages.