Why Rapid Testing When False Negatives High: High Court To Delhi Government

The Delhi High Court on Monday asked the AAP government why it was going with Rapid Antigen Testing (RAT), which has a high rate of false negative results, as the primary test of COVID-19 infection.

It also made it clear to the Delhi government to "strictly" follow the guidelines on COVID-19 testing as issued by ICMR and not according to its own interpretation.

The high court also noted that the sero survey of the national capital carried out by the National Centre for Disease Control (NCDC) indicated that more than 22.86 per cent of the population have gone through the COVID-19 illness without even realizing they were infected as they probably were asymptomatic.

A bench of Justices Hima Kohli and Subramonium Prasad said in such a scenario how can the Delhi government go with RAT as its front line test, when its rate of false negatives was very high, with RT/PCR being recommended for only those who were symptomatic.

It added that the Indian Council of Medical Research (ICMR) has not said that testing has to be done in this manner.

RT/PCR, short for Reverse Transcription Polymerase Chain Reaction, is a laboratory technique widely used in the diagnosis of genetic diseases and to measure gene expression in research.

Delhi government additional standing counsel Satyakam told the bench that the health department was strictly adhering to ICMR guidelines which say that people testing negative for RAT but showing influenza like illness (ILI) have to undergo RT/PCR.

The stand was opposed by advocate Rakesh Malhotra, whose plea for increasing of the testing numbers in the national capital and getting speedy results was being heard by the court,
He told the bench that ICMR only said that persons showing influenza like illness (ILI) and testing negative in RAT have to go for RT/PCR and this strategy was not applicable to those having severe acute respiratory illness (SARI).

However, Delhi government had included SARI also in its list high risk group individuals who have to first undergo RAT.

ICMR, represented by central government standing counsel Anurag Ahluwalia, told the bench that it had never recommended SARI for RAT and that it was not similar to ILI.

Dr Nivedita Gupta from ICMR also told the court that it never said asymptomatic RAT negative persons should not undergo RT/PCR testing, it only said the symptomatic RAT negative patients be given priority.