Omicron overload prompted new testing norms: Experts

The latest guidelines of the Indian Council of Medical Research (ICMR) — which limit the testing of contacts of Covid-19 patients to elderly and at-risk individuals, and do away with the testing of interstate travellers, asymptomatics and patients awaiting discharge — is a response to Omicron having overloaded the system across the country, experts said on Tuesday.

The guidelines released on Monday push the testing regimen towards the early detection of symptomatic individuals, especially among high-risk categories such as senior citizens. However, this comes at the cost of weakened overall community surveillance.

Several experts said the new guidelines have become necessary because the virus has become ubiquitous and is in danger of driving the nationwide testing infrastructure to the breaking point.

Read more: Contacts of Covid patients don't need to get tested unless they are in 'at risk' category: ICMR

"The surge in cases means that identifying every case, especially asymptomatics, can no longer be a priority," said Dr V Ravi, a member of the State Technical Advisory Committee (TAC). He pointed out that Karnataka might record between 50,000 and 1 lakh cases per day (in the worst-case scenario) by the end of the month.

"The infection is spreading. It is everywhere. All contacts of a case will be positive. One tenet of public health in a wave is that we should not be testing everyone and instead focus on symptomatics because our resources will be limited,” he added.

For Dr T Jacob John, former director of ICMR’s Centre of Advanced Research in Virology, this was a crisis that could have been avoided had the Centre brought in decisive interventions a month ago that could have helped flatten the curve.

"The change in strategy is happening because the current wave of cases is already out of control,” he said. “The central government underplayed the looming crisis between November 27 and December 26, and did little to flatten the curve. The government began to look for evidence after the event had happened — which is a typical disaster management approach,” he said.

But the new guidelines, if implemented, could mean that states will have a less clearer picture of their outbreaks, in terms of case numbers and potentially even deaths. “It is one way to flatten the curve,” Dr John said.

Karnataka’s nodal officer for testing, for one, said that some of the new guidelines appear to go against the grain of Covid-19 management strategies.

“The central principle of Covid-19 containment is more and more testing,” said Dr C N Manjunath. “In my view we should absolutely be testing all contacts in the interests of containment, not just those who are at high risk based on age or comorbidities. Furthermore, interstate travellers, especially from high-risk states, must be tested.”

He added the guidelines still require substantial debate with epidemiologists and public health experts before they can be implemented at the state level. “The guidelines are only a recommendation and state authorities have to make their own decisions. The issue will likely be considered in the next TAC meetings,” he said.