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38.C AND cough with onset within the last l0 days.

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' All healthcare workers and frontline workers coming in contact with suspect/confirmedCOVID-19 patients should ensure use of appropriate ppE.

o Home quarantine for l4 days is recommended for all individuals before undergoing electivesurgery to minimise chances of infection before the procedure.

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INDIAN COUNCIL OF MEDICAL RESHARCH

DEPARTMENT OF HEALTH RESTABCH

Strategy for COV|Dlg testing in lndia {Version 5, dated 1S/05/1020}

1. All symptomatic (lLt symptorns) individuals with history of international travel in the

last 14 days.

2. All symptomatic (lLl symptoms) contacts of laboratory confirmed cases'

3. All symptomatic (lll symptoms) health care workers / frontline workers involved in

containment and mitigation of CCIVlD19'

All patients of Severe Acute Respiratory lnfcction (SARI)'

Asymptomatic direct and high-risk contacts of a confirmed case to be tested once

between day 5 and day 10 of coming into contact'

All symptomatic tLl within hotspots/containment zones'

Sll hospitalised patients who develop lLl lymptoms'

All symptomatic lLl among returnees and migrants within 7 days of illness'

No emergency procedure (including deliveries) should be delayed for lack of test'

Howeuer, sample can be sent for testing if indicated as above {1-8), simultaneously'

N8:

tLlcase is defined os onr with ocute respirotory infection with fever Z \gL AND cough'

sARt csse is defined 05 on€ with ocute respiratory int'ection with fever z 38"5*aAO

cough ANA requiring haspitalit^ation.

Atltesting in the abave catcgades is recommended by realtime RT-PCR test only'

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9.

have..beeq i-rlicated in balt!.s All chanoes incorporoted in these.auidelines..as camp,ared to the previous version

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lndian Council of Medical ResearchDepartment of Health Research, Ministry of Health

and Family Welfare, Government of lndia

Advisory on Strategy for COVID-19 Testing in lndia(Version Vl, dated 4th September 2O2Ol

Recommended by the National Task Force on COVID-19

ICMR's advisory is generic in noture ond moy be modified as per discretion of the stote heolth

authorities.

A. Routine surveillance in containment zones and screening at points of entry:

Choice of Test {in order of priority}:

i. Ropid Antigen Test (RAT) [os per ottached olgorithm]

ii. RT-PCR or TrueNot or CBNAAT

1. All symptomatic (lLl symptoms) cases including health care workers and frontline workers.

2. All asymptomatic direct and high-risk contacts (in family and workplace, elderly > 65 years\/

of age, imniunocompromised, those with co-morbidities etc.) of a laboratory confirmed case

to be tested once between day 5 and day 10 of coming into contact.

3. All asymptomatic high-risk individuals (elderly 2 65 years of age, those with co-morbidities

etc.) in containment zones.

*RATfor containment zone: ldeolly, it is suggested that 100% people living in containment zones

should be tested by RAT porticulorly in cities where there has been widespreod tronsmission ofinfection.

B. Routine surveillance in non-containment areas:

Choice of Test (in order of priority):

i. RT-PCR or TrueNot or CBNAAT

ii. Rapid Antigen Test (RAT)*

4. All symptomatic (lLl symptoms) individuals with history of international travel in the last L4

days.

5. All symptomatic (lLl symptoms) contacts of a laboratory confirmed case.

6. All symptomatic (lll symptoms) health care workers / frontline workers involved in

containment and mitigation activities.

lNplAH couNclr 0FMEDICAL RESEARCIT1!:rv,?t_i} i$"t

^nt{i*11 iir{{q :'Ci i

rcm?INDIAN COUNCIL OFF4EDICAL RESEARCf.,I$dra!+{tr lhr !}sti$l riili{ litll

7. All symptomatic lLl cases among returnees and migrants within 7 days of illness.

8' *All asymptomatic high-risk contacts (contacts in family and workplace, elderly > 65 years ofage, those with co-morbidities etc. [RAf is recommended as the first choice of test in order ofpriorityl

C. ln Hospital Settings:

Choice of Test (in order of priority):

i. RT-PCR or TrueNat or CBNAAT

ii. Ropid Antigen Test fiAf)

9. All patients of Severe Acute Respiratory lnfection (SARI).

10. All symptomatic (lLl symptoms) patients presenting in a healthcare setting.L1,' Asymptomatic high-risk patients who are hospitalized or seeking immediate hospitalization

such as immunocompromised individuals, patients diagnosed with malignant disease,transplant patients, patients with chronic co-morbidities, elderly 2 65 years.

12. Asymptomatic patients undergoing surgical / non-surgical invasive procedures (not to betested more than once a week during hospital stay).

13. All pregnant women in/near labor who are hospitalized for delivery.

Points to be noted:

o No emergency procedure (including deliveries) should be delayed for lock of test.However, sample can be sent for testing if indicated as obove (1-13), simultaneously.

o Pregnant women should not be referred for o lock of testing facitity. All orrangementsshould be mode to collect and transfer somples to testing focilities.

o Mothers who test positive for COVID-19 should be odvised to wear a mosk ond undertake

frequent handwashing while handling their boby for 14 doys. They should olso be advisedon breast cleaning before feeding the neonote. These meosures are likely to reducetransmission of COVID-19 to their bobies.

14. All symptomatic neonates presenting with acute respiratory / sepsis like illness.(Features suggestive of acute respiratory illness in a neonate are respiratory distress oraDnea with or without cough, with or without fever. Neonates may also manifest with only,Cnon-respiratory symptoms like fever, lethargy, poor feeding, seizures or diarrhea).

15. Patients presenting with atypical manifestations [stroke, encephalitis, hemoptysis,pulmonary embolism, acute coronary symptoms, Guillain Barre syndrome, Multiple Organ

'\\

2l|);ili:

ffiffi''{fu$*)i4\w7

rcrn?INDIAN CO{JNCIL OFMEDICI\L RESEARC}.,I

;rrv;r.,i llrit tEll*. siilts J'll1:

Dysfunction syndrome, progressive gastrointestinal symptoms, Kawasaki Disease (in

pediatric age group)l based on the discretion of the treating physician'

,

,D. Testing on demand (State Governments to decide simplified modalities):

16. All individuals undertaking travel to countries/lndian states mandating a negative COVID-19

test at Point of entry'

lT.Allindividualswhowishtogetthemselvestested.

Trocking and contoct tracing mechanisms should be ensured by the testing laboratories by notifying

the public heolth authorities.

FrequencY of testing :

o A single RT-PCR/TrueNaI/CBNAAT/RAT positive test is to be considered confirmatory'

without anY rePeat testing'

o No re-testing is recommended prior to discharge from a CovlD-19 facility after clinical

recovery (please refer to MoHFW guidelines), including for transfer from a coVlD areaf

facility to a non-COVID area/ facility'

o lf symptoms develop following a negative RAT test, a repeat RAt or RT-PCR should be done

(AlgorithmforinterpretingRATisplacedatAnnexurel).

Points to be noted:

o WHO cose definition for /L/; lndividual presenting with acute respiratory infection with fever

> 38'C AND cough with onset within the last 10 days'

o WHO case definition for SAR/: lndividual presenting with acute respiratory infection with

history of fever > 3g.c AND cough with onset within the last 10 days AND requires

hosPitalization.

o All healthcare workers and frontline workers coming in contact with suspect/confirmed

covlD-lgpatientsshouldensureuseofappropriatePPE'o Home quarantine for 14 days is recommended for all individuals before undergoing elective

surgery to minimise chances of infection before the procedure.

3ll'ir*':

rcm?INDIAN COUNCIL OF

x::*:*":::::,:::

Annexure t:\

AlgorithmforCOVID-19 test interpretationusingrapid antigen point-of<are test

To be reported as positive

All po:ilire alrd rregative r'esult shouk{ lre ente,r'etl iutrr tl're IC}IR }rortal on a real tir:ne lr.rsis afte*.

Fellgrrning the .rrrtiger.r tertRexrlt oI samples sulrjected to RT PCR shoriltl l,e *ntrretl .rftel the RT PCR resnlts are.rr,"lilntrk

Symptomatic: feveq cough,sore throat

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4lPiru*

Asymptomatic

Rapid Antigen Test