The Ministry Of Health, Government of India, has issued guidelines that require all state and UT governments to subject all passengers coming from UK to Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) tests on arrival. In case of a positive sample, spike bases RT-PCR tests have to be performed as per the guidelines. This is apart from the declaration of the travel history of the last 14 days by all international travellers. Those passengers who test negative through the method will be advised home quarantine.
The guidelines come in the wake of the distinct phylogenetic cluster of SARs-CoV-2 which is believed to be more transmissible than the current strain of the virus that has already infected around 77 million people worldwide and caused about 1.7 million deaths globally, including 1853 in Jammu and Kashmir.
While the directive is a correct step and administration in Srinagar has already put in place the mechanism in compliance to the SoPs, it is also indicative of less reliability of rapid antigen tests that administration has been markedly using to detect novel coronavirus. Governments around the world have been looking for an accurate test for COVID-19 infection. The diagnostic RT-PCR test to confirm the presence of the virus, using a nasal swab in a laboratory setting, remains the most reliable. However, what transpires on the ground is that rapid test is used more than the RT-PCR.
Indian Council of Medical Research (ICMR) has recommended the use of Standard Q COVID-19 Ag detection assay (antigen detection test) as a point of care diagnostic assay for testing under certain settings in combination with RT-PCR test.
Those who test negative for COVID-19 by rapid antigen test are to be definitely tested sequentially by RT-PCR to rule out infection, whereas a positive test should be considered as a true positive and does not need reconfirmation by RT-PCR test. In this scenario, the over-reliance on rapid test detection is not something to be followed as a sole test. Rather RT-PCR should now be used solely for testing the virus.
Also, it is important that the new variant of the virus is not beyond the control of the people and it is for the entire society to fight it together. In March people might be ignorant about the virus but a lot has been known about the virus now. Everyone knows how it spreads from person to person. We also know that two-fifths of infected people can be asymptomatic and is life-threatening for the elderly and people with comorbidities. Importantly prevention remains the key while awaiting the vaccine.