Opinion
Covid over-testing does exist and it should stop
Summary
Negative test results demanded as entry passes go against this week’s ICMR advisory on covid testing that effectively called off contact-tracing. Let’s rationalize test protocols at every levelTest, test, test" was a valid mantra in the early phase of covid, but two years into this viral pandemic, let’s accept that there exists such a thing as over-testing. As Omicron bared its hooks, India’s official 7-day moving average of daily infections shot past 170,000 this week, but unlike last year’s Delta scourge, our healthcare apparatus has not got jammed with patients. While the reduced virulence of this wave’s dominant bug should not let safety protocols lapse, since it can still lay many of us low as cases swell, we confront a peculiar inversion: Our health risk has dropped in comparison with the Delta spike of 2021, but covid barriers have actually risen in several settings. From private establishments to housing blocks, negative test results have been demanded for entry, often in addition to proof of vaccination, which the latest variant’s evasion of antibodies is seen to have nullified. Test kits are no longer scarce, with home packs now available off retail shelves. Yet, it is hard not to detect a Delta-scarred psyche at play in some of this extra stringency on display. Indeed, to the extent that zeal has beaten prudence, test mandates at various levels need to be rationalized.
A look at this week’s revised advisory on covid testing issued by the Indian Council of Medical Research (ICMR) would help. To be sure, there was a time when state administrations stood accused of trying to suppress numbers by going slow on tests. Also, for purposes of surveillance, we must expand test coverage in hotspots so long as the ‘positivity’ ratio seen in added-up results is both high and rising, as observed in many cities. But the ICMR has eased its advice on who all need a test, and in welcome ways. Inter-state domestic travel should not require a mandatory test, it said. Nor should medical interventions be held up by a test clearance. The ICMR’s head-turner, however, was its counsel that contacts of confirmed cases need not be tested unless they are at high risk on account of their age or co-morbidities. This effectively served to call off contact-tracing, the value of which crashed once our community spread began. With Omicron highly infectious, airborne and probably all around us, our exposure has turned relatively random. At this stage of a third wave, virus-carriers abound who show no symptoms and are not aware of their status. And false negative results could show up too, more so with rapid antigen tests (like self-test kits), which are designed largely to screen rather than confirm cases. All this means that we’re no longer far less likely to catch it going about our daily routines than from ‘contact’ with someone found positive. India’s testing capacity, thus, would best be directed at early detection of cases that risk turning morbid. While vaccines do help fend off the dreaded covid choke and the majority of our adults have taken both doses, anyone who develops tell-tale signs of covid should surely get a test done.
Voluntary demand for tests, however, differs from the forced kind. By the Centre’s count, some 1.8 million of them are being conducted everyday, and unreported self-tests could mean the real figure is larger, but we still do not know how many of these are for gate passage. Given the social hierarchy that prevails, it’s a fair bet that a heavier burden of access-testing is borne by those who can least afford it. Free tests also exist, no doubt, but these facilities are often too crowded for comfort. Yes, private employers and other entities have the right to set their own safety rules. But there’s no need to overdo it.
