COVID-19: Contacts with mild symptoms will not be tested, Kerala says

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Kerala’s revised novel coronavirus testing guidelines are in contradiction with ICMR’s. Already, only those who have returned from countries with ongoing novel coronavirus transmission and showing symptoms and their contacts are being tested in India. Kerala has narrowed it down further.

People — contacts and those who have returned from countries with ongoing novel coronvirus transmission — in Kerala showing mild symptoms of COVID-19 will not be tested based on the revised guidelines issued on March 12 by the Kerala Health Ministry. Accordingly, people exhibiting low grade fever, mild sore throat, cough, rhinitis or diarrhoea will not be tested for the novel coronavirus (SARS-CoV-2). Only those with severe symptoms or with underlying conditions of the lungs, heart, liver and kidney, pregnant women and those older than 60 years will be tested for the virus. The revised guidelines are for testing, quarantine and hospital admission of COVID-19 patients based on risk assessment.

“Patients with mild symptoms are advised not to come to hospitals for testing and treatment. Testing is not going to change either the clinical course or management of the patient with mild symptoms,” the Kerala Health Ministry guidelines say. Kerala has so far reported 22 cases of coronavirus disease (COVID-19).

What are ICMR’s guidelines on testing

According to the Indian Council of Medical Research (ICMR) testing guidelines for COVID-19 issued on March 9, individuals with travel history to the affected countries or close contacts of positive cases who are in quarantine will be tested if they show symptoms during the period of quarantine.

Explaining the rationale behind the revised testing guidelines, Kerala Health Minister K.K. Shylaja says: “Many of the mild symptoms are similar to other conditions. If we give importance to patients with mild symptoms then testing for the more deserving ones will get delayed.”

“We had traced and tested the samples of around 1,500 people who came in contact with the family that returned from Italy and tested positive for coronavirus. We are also testing samples of passengers arriving in Kerala airports if they exhibit symptoms,” the Health Minister says.

More labs to test the virus

National Institute of Virology (NIV) unit in Alappuzha was one of the first testing labs in the country that was permitted to confirm COVID-19 positive samples without sending them to NIV Pune for confirmation. Due to increased number of people being tested for novel coronavirus, Kerala has got the necessary permission from ICMR to confirm samples for novel coronavirus in two more labs in Kozhikode and Thiruvananthapuram.

According to Dr. Nivedita Gupta of ICMR, confirmatory assays have been shipped to the two labs in Kozhikode and Thiruvananthapuram. “After standardisation, both labs will be able to confirm for COVID-19 from Wednesday onwards,” she says.

The ICMR has also permitted Trissur Medical College Hospital to test for COVID-19 beginning March 16. However, the Trissur Hospital will be required to send samples to NIV unit in Alappuzha for laboratory confirmation. Kerala has sought permission from ICMR to carry out tests in two more institutions in the capital – Public Health Lab and the Rajiv Gandhi Centre for Biotechnology (RGCB).

Published in The Hindu on March 15, 2020

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