Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) remains the most reliable test in the covid diagnosis. It is considered the “gold standard” for the detection of SARS-CoV-2, the virus that causes COVID-19. This test actually detects RNA (or genetic material) that is specific to the virus and can detect the virus within days of infection, even those who have no symptoms. However, the Indian Council of Medical Research, in its new testing guideline issued on May 4, talked about reducing RT-PCR tests to take the load off the existing laboratories.
The ICMR has ordered that an individual who tests positive by rapid antigen test shall not be subjected to the RT-PCR test. Others barred include an individual who has tested positive once by RT-PCR ; one who has completed 10 days home isolation period with no fever for the last three days; at the time of hospital discharge and a healthy individual undertaking interstate domestic travel.
The ICMR’s guidelines are aimed to reduce the load on laboratories amid sudden surge in the number staff testing positive and thus being relieved from duties. Presently, the RT-PCR test report takes over 72 hours to process.
But the government should not construe these guidelines as a direction to stop RT-PCR tests altogether. According to ICMR, individuals with symptoms identified negative by rapid antigen testing should be linked with RT-PCR test facility. The government needs also to assuage grievances about delay as well as shortage of kit supply for testing. On May 4, a senior counsel also brought the issue regarding shortage of kit supply for testing and that RTPCR test reports are being highly delayed into the notice of the High Court hearing a Public Interest Litigation on covid-19 control measures.
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 continue to be used solely for testing the virus. Those with symptoms but test negative of rapid test and subsequently going for RT-PCR should isolate themselves as long as their test report comes.
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.