Friday, March 27, 2020

Should India adopt a mass testing policy similar to South Korea?

CORONA Medtalks

Dr KK Aggarwal
President CMAAO, HCFI and Past National President IMA

Should India adopt a mass testing policy similar to South Korea?

The CDC has provided a “Coronavirus Self-checker” called Clara on its website for US citizens. People can use this online symptom checker to make decisions about what they should do, if they think that they have symptoms of Covid-19. Following a series of questions, the tool gives recommendations if they need medical care. The CDC has however made clear that it is not a diagnostic tool for the disease.

Should everyone who has symptoms of corona-like illness be tested for the Covid-19 virus? Testing helps to identify people who are infected with the virus; but there is also a concern, perhaps reasonable, that it would be a drain on resources (personal protective equipment, swabs, viral transport media, etc.).

South Korea has been aggressively testing its citizens through a mass testing program, including drive-through testing centers and mobile alerts about people who have tested positive for the virus. It has been successful in slowing down the spread of the disease. From a peak of 851 new cases per day on 3rd March, the number of new cases has declined to 100 cases per day, as on 26th March.

Initially, India carried out “need-based testing” i.e. only people with history of history of travel to areas with active transmission and their close contacts were tested. But, last week, the ICMR has revised the strategy of COVID19 testing in India.

  • “All asymptomatic individuals who have undertaken international travel in the last 14 days:

o   They should stay in home quarantine for 14 days.
o   They should be tested only if they become symptomatic (fever, cough, difficulty in breathing)
o   All family members living with a confirmed case should be home quarantined

  • All symptomatic contacts of laboratory confirmed cases.
  • All symptomatic health care workers.
  • All hospitalized patients with Severe Acute Respiratory Illness (fever AND cough and/or shortness of breath).
  • Asymptomatic direct and high-risk contacts (those who live in the same household with a confirmed case and healthcare workers who examined a confirmed case without adequate protection) of a confirmed case should be tested once between day 5 and day 14 of coming in his/her contact”

India has the second largest population at 1.3 billion. Latest data show that India has 650 corona positive cases with 13 deaths.

Are we seeing just the tip of the iceberg when it comes to the number of positive cases? Or, have we managed to escape the worst? We do not know. This is a matter of speculation.

ICMR has been emphatic in its assertion that there is no need for “indiscriminate testing” in the country.

Social distancing is the answer to prevent the spread of the infection. If you think that you have symptoms of Corona, the best approach would be to self-quarantine or self-isolate, which also means staying away from others at home and adopt all infection control measures (hand washing, face masks).

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