Random, large-scale Covid testing unnecessary, say experts
Amidst the Omicron driven third wave, several medical experts are now saying that large-scale Covid-19 tests are unnecessary
Mumbai: Last month, a 57-year-old Thane resident had a cataract surgery scheduled at a private hospital in Mulund. In addition to routine blood tests, the doctor also prescribed her an RT-PCR test for Covid-19. The woman was fully vaccinated and did not have any Covid-related symptoms. But the doctor insisted that it was the hospital’s protocol to get a negative RT-PCR before all medical procedures. Amidst the Omicron driven third wave, many medical experts are now recommending such routine, large-scale Covid-19 tests are unnecessary, and are rooting for targeted testing.
“There are two prominent reasons why we started testing,” said epidemiologist Dr Jayaprakash Muliyil, who is also a member of the National Technical Advisory Group on Immunisation (NTAGI). “First, to have some statistics on the transmission dynamics and second, in order to track cases and prevent the spread. In the presence of Omicron, the equation has changed. We are underestimating the numbers, tracking cases of such fast-spreading viruses is impossible. By continuing to conduct large-scale tests, we are simply burdening the healthcare systems,” he said.
Muliyil believes that testing should now be limited to hospitalised patients only. “For instance, if there is a patient admitted to hospital with pneumonia, doctor may want to test to ascertain if they are dealing with Covid-19 pneumonia,” he said, adding that doctors also need confirmed tests in hospitalised patients in order to keep them segregated from other patients.
Maharashtra has been conducting around 200,000 Covid tests every day. Following the latest testing strategy issued by the Indian Council of Medical Research on January 10, the state has directed its tests largely towards symptomatic persons. The ICMR document categorically states that asymptomatic patients undergoing surgical or non-surgical invasive procedures including pregnant women in or near labour and hospitalised for delivery should not be tested. The guidelines also state that contacts of confirmed cases, who are not high risk, should not be tested. Yet, such testing is common.
“We are moving from extensive testing to a narrowed-down, targeted testing phase. But these transitions take time to reflect on the ground,” said epidemiologist and health systems expert Dr Chandrakant Lahariya. “Personally, I think healthy, fully-vaccinated individuals don’t require testing if they develop mild symptoms. Our testing strategy has evolved in time, but it will require further refining in days to come,” he said.
The Indian Council of Medical Research (ICMR) guidelines mandate testing of international travellers, but some experts said that testing asymptomatic travellers was unnecessary as the guidelines otherwise don’t recommend testing asymptomatic people. “Some states are asking for reports even after domestic travel, which should not be required,” said Dr Shashank Joshi, member of Maharashtra’s Covid-19 task force. “There should not be a lax on testing symptomatic people. But otherwise, our focus should be on reducing mortality by preventing severe disease, vaccinating people and mounting their immunity with boosters,” he said.