Takshashila Discussion Document - COVID-19 Testing Strategy for India
Executive Summary
The rapidly spreading COVID-19 can be contained only with rapid, accurate testing and isolation of infected individuals. Various types of tests are available, but in India, only select tests have been approved for diagnostic purposes. Testing can however be done for purposes beyond diagnosis. Purposes include community testing for preparation of healthcare measures or surveillance of communities coming out of lockdowns. Hence, testing strategies should be determined by the needs of the test. Further, shortages of approved testing kits have been reported. Instead of having a centralised policy to determine testing strategies, local governments should be empowered to use available resources intelligently. Our main recommendations are:
Allow local governments to determine testing strategies based on available resources and the density of cases. The Union government can recommend testing standards and share data available on testing strategies.
For community testing, waste water-based testing or pooled PCR test may be useful.
For diagnostic testing, molecular diagnostic using RT-PCR is the gold standard. Ramping up capacity is essential and should be done in parallel to exploring other testing methods.
In the absence of sufficient RT-PCR tests, rapid tests can be deployed after categorisation of patients based on their contact with a COVID-19 positive patient, the exhibition of symptoms, and the estimated period since infection.
An intelligent strategy can help increase coverage of testing through optimal usage of immunodiagnostic and RT-PCR kits. Immediate and local decision-making to test all possible COVID-19 carriers is essential to stop the spread of the disease.
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