Covid: Asymptomatic contacts of infected patients need not get tested, says Centre in new guidelines

Asymptomatic contacts of coronavirus-positive individuals do not need to get tested and can only monitor their health in home quarantine, the Union health ministry said in its revised guidelines on Wednesday.

The decision to end testing for asymptomatic contacts is in line with the guidelines announced in South Africa last month. The African country had said it will not test asymptomatic high risk contacts and also stopped mandatory isolation for asymptomatic positive cases.

India has so far continued the isolation rule for asymptomatic positive cases, but it has relaxed testing criteria for asymptomatic high risk contacts. Balram Bhargava, the director general of Indian Council of Medical Research, said people must adhere to the isolation protocol, continue hand sanitisation and masking.

“Contacts must maintain home quarantine, but they need not get tested,” he said.

On the revised guidelines, Dr Chandrakant Lahariya, a public health expert, said that it was time India modified its testing and isolation protocol to match the way pandemic is evolving.

“A huge population is already exposed to the virus, the vaccination coverage of the adult population is high, and most cases are asymptomatic or mild,” Lahariya told Scroll.in. “In such a scenario, it is not important to test each asymptomatic carrier.”

As part of the new guidelines, patients with mild or asymptomatic Covid-19 infection can end home isolation after at least seven days have passed since testing positive, if there has been no fever for three successive days. They also do not need to undergo another test for Covid-19 once the home isolation period is over.

Earlier, home isolation ended after 10 days from the onset of symptoms.

The guidelines define asymptomatic patients as those who test positive for the disease, but are not experiencing any symptoms, and who have an oxygen saturation above 93%. Mild Covid-19 cases are patients who have symptoms related to the upper respiratory tract, do not have shortness of breath and have oxygen saturation levels of above 93%.

Persons above 60 years of age and those with co-morbidities can only be allowed home isolation after they are evaluated by the treating medical officer. Immunocompromised people, such as HIV-positive persons, transplant recipients and those receiving cancer therapy, are not recommended home isolation, and can isolate themselves at home only after evaluation by the treating medical officer.

When a Covid-19 patient is in home isolation, all other members of the household also need to remain in home quarantine.

Meanwhile, NITI Aayog member Dr VK Paul warned about a tsunami of cases due to the spread of Omicron variant in India.

Paul said that data from the United Kingdom showed that more cases of elderly people and those with comorbidities getting infected are reported when infections rise.

“As young population gets infected and goes home, they pass on the infection to elderly at home,” he added. “This situation cannot be taken for granted.”

Other guidelines for home isolation

• Patients need to stay in one designated room, and isolate themselves from other members of the household, especially elderly persons and those with co-morbidities.
• They should use triple-layer medical masks at all times. When a caregiver enters the room, both the patient and the caregiver should preferably use N-95 masks.
• Patients are advised to monitor blood oxygen saturation with a pulse oximeter. 
• Caregivers need to ensure hand hygiene after contact with the patient, and the patient’s immediate environment.
• They should avoid direct contact with the patient’s bodily fluids, and should use disposable gloves while handling the patient.
• Caregivers should also avoid sharing dishes, utensils, used towels or bed linen with the patient.

According to the guidelines, immediate medical attention should be sought if any serious symptoms develop. These could include a fever of over 100 degrees Fahrenheit for more than three days, difficulty in breathing or oxygen saturation dropping below 93% for at least three reading in an hour.

The guidelines add that steroids must not be self-administered. “Overuse and inappropriate use of steroids may lead to additional complications,” the document noted.

The health ministry issued the revised guidelines after the country has reported a steep rise in coronavirus cases. On Wednesday, India recorded 58,097 cases, a 55.42% jump from Tuesday’s count of 37,379 cases.

Currently, there are 2,14,004 active cases in the country.