With the start of the third wave, all doctors are inundated with the most often asked question by the public- Doctor, should I be tested? In response to an increase in COVID-19 cases and greater discovery of the virus's newly discovered and highly infectious Omicron form, the Indian Council of Medical Research (ICMR) published updated recommendations on who should be tested and who should not.

ICMR said in a new set of rules for testing COVID-19 samples that contacts of COVID patients do not need to be examined unless they are recognised as high-risk due to their age or co-morbidities. Additionally, it said that at-risk contacts of patients include those over the age of 60 and those who have co-morbid conditions such as diabetes, hypertension, chronic lung or renal disease, cancer, or obesity.

According to the ICMR's Advisory on a Purposive Testing Strategy for COVID-19, testing may be performed at the treating physician's discretion, subject to specific factors.

The following are the ICMR's testing guidelines:

Individuals who should be tested

In community settings:

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

In hospital settings:

Testing may be undertaken as per the discretion of the treating doctor with the following considerations:

1. No emergency procedure (including surgeries and deliveries) should be delayed for lack of a test.
2. Patients should not be referred to other facilities for lack of a testing facility. All arrangements should be made to collect and transfer samples to testing facilities, mapped to the health facility.
3. Asymptomatic patients undergoing surgical/ non-surgical invasive procedures including pregnant women in/near labour who are hospitalised for delivery should not be tested unless warranted or symptoms develop.

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

Approved testing methods

Additionally, the ICMR said that testing may be conducted using RT-PCR, True Nat, CBNAAT, CRISPR, RT-LAMP, Rapid Molecular Testing Systems, or Rapid Antigen Test (RAT). Without repeat testing, the Home or Self Test/RAT and Molecular Test are to be regarded confirmed. Individuals with symptoms who test negative on home/self-test or RAT should undergo RT-PCR testing, according to the ICMR's updated recommendations.

Note: ICMR's advisory is generic in nature and may be modified as per the discretion of the state health authorities for specific public health and epidemiological reasons.

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Disclaimer- The views and opinions expressed in this article are those of the author's and do not necessarily reflect the official policy or position of M3 India.

The author is a practising super specialist from New Delhi.