The Indian Council for Medical Research (ICMR) made public guidelines that detail how the country plans to manage a “large outbreak” as well as guidelines on how rapid antibody test kits ought to deployed. India’s official position is that there is no evidence of community transmission in the country.

According to Lav Agrawal, spokesperson, Health Ministry, 30% (about 1,000 positive cases spread across 17 States) of India’s total case count is attributable to the Tablighi Jamaat gathering in Delhi earlier this month.

The plan for large outbreaks, released on Saturday, specifies: active surveillance for cases and contacts in the identified geographic zone, expanding laboratory capacity for testing all suspect cases, high risk contacts and Sever Acute Respiratory Illness cases, operationalise surge capacities created for isolation (COVID-19 hospitals/COVID-19 dedicated blocks) to hospitalise and manage all suspect/confirmed cases, implementing physical distancing measures with strict perimeter control, provide chemoprophylaxis with hydroxy-chloroquine to all asymptomatic healthcare workers and asymptomatic household contacts of laboratory confirmed cases.

It also detailed guidelines on the use of rapid antibody testing kits. Unlike the real-time RT-PCR kits that are used to detect an ongoing infection, these kits — within 15 minutes to two hours at the maximum — can say if a person has ever been infected by the virus and gives authorities an estimate of whether there are asymptomatic carriers of the infection in a community.

Knowing the proportion of asymptomatic carriers to positive cases gives an insight into the infectivity of the disease, transmission patterns and helps prepare for the long-term management of the epidemic. Testing negative via an antibody kit doesn’t automatically rule out infection and needs to be supplemented by a PCR test, the ICMR guidelines specify.

Hundreds of antibody kit manufacturers have been approved in India in the last week to offer tests, according to the Health Ministry website.

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