Labs say guidelines restricting repeat RT-PCR tests impractical
Path labs in Delhi said they are having a tough time implementing ICMR guidelines asking state authorities to restrict “unnecessary” repeat RT-PCR tests for people who have tested positive for Covid-19 in the past.
The Indian Council for Medical Research on May 4 released revised Covid-19 testing guidelines that do not recommend a repeat test in recovered patients.
However, several lab officials said it was difficult to ensure people did not get tested again.
“How can you refuse people who approach a lab to get tested? People get irritated, and rightly so. There still are a lot of places asking for a negative RT-PCR report... In some societies, if a flat is sealed because of positive cases, it requires the resident individual to submit a negative RT-PCR report for de-sealing,”
NEW DELHI:
said an administrative officer in one of the prominent private laboratories in Delhincr, on condition of anonymity.
Some services, such as airline and hotel booking, also need negative RT-PCR tests.
“We’re happy not to do extra tests, but more thought should have gone into figuring out how guidelines will be implemented... It’s not fair to say action will be taken against defaulters without understanding their dilemma,” said a Delhi lab owner on condition of anonymity.
When contacted, ICMR officials said that rapid antigen tests (RAT) can be used in these cases.“we have far better rapid test kits available in market that can be made use of to diagnose the disease as these have improved sensitivity and specificity. There is no need to repeat an RT-PCR test after that,” said Dr Samiran Panda, head, epidemiology and communicable diseases, ICMR.
Last Tuesday, ICMR issued a revised advisory stating that RT-PCR test must not be repeated in any individual who has tested positive once, either through RAT or RT-PCR tests. The guidelines added that no testing is required for recovered Covid-19 individuals at the time of hospital discharge.
But laboratories said the guidelines were not fully thought through.
“If a person has got the test done in some other laboratory, there is no way the current lab will get to know about that. We do not have access to that kind of data, only the authorities do...,” said an official in the operations department of another prominent Delhi lab, who too requested to not be named.
Citing an example of a woman who sent her two children -aged two and five -- to her parents’ house after testing positive, an official from a Delhi-based lab said, “Now that she had recovered, she wanted to see her children but she didn’t want to do so without being sure that she was Covid negative. Imagine her frustration when she was told it wasn’t allowed in the new guidelines. There are many cases.”
Meanwhile, doctors treating Covid-19 cases said that the repeat test once a patient has recovered is unnecessary from a clinical standpoint.
“As per scientific evidence and CDC guidelines, if a person has recovered 10 days after the onset of symptoms, or three days after being fever-free, there is no point in getting a repeat RT-PCR test done as you are no longer contagious. ICMR says 17 days, but only in ICU patients is it necessary to get tested again as their positivity stays for a longer period of time. Among the rest, it is not required to repeat the test as it would lead to wastage of resources,” said Dr G C Khilnani, former head, pulmonology department, AIIMS, Delhi.