Potential Scenarios for Covid-19 Testing
(10 Sept 2020)
Key points/ updates for clinicians: Latest advice is to “test all people with symptoms” • It is critical to encourage all patients presenting with symptoms consistent with COVID-19 to be tested. • The essential groups for community testing remain unchanged, as are the case definition, and HIS criteria. • There is new advice around testing asymptomatic individuals. (see p.2) • Please see potential scenario flowcharts (inc. costs) for symptomatic (p.1) and asymptomatic (p.2) testing.
Symptomatic
Patient A: Meets Clinical Case Definition, Meets HIS Criteria.
Diagnostic Swab Required & Funded Requires Swab, No Examination Identify HIS Criteria on Path lab & Halcyon Forms
Virtual Assessment + Refer to Pathlab ($69)
Simple Assessment + Swab (Swab at GP) ($138)
Full PPE: Change gloves between patients.
Requires Swab & Examination Identify HIS Criteria & MOH Informed on Halcyon Form
Full Assessment ($287.50)
Full PPE: Change of PPE + full decontamination of space afterwards
Patient B: Meets Clinical Case Definition, No HIS criteria. Surveillance Swab Offered & Funded Offer swab for surveillance purposes Requires Potential Swab, No Examination
Virtual Assessment + Refer to Pathlab (if swab needed) ($69)
Requires Potential Swab & Examination
Simple Assessment, No Swab ($69)
Simple Assessment + Swab (Swab at GP) ($138)
PPE: Gloves & Mask If seen at practice but referred to Path lab for Swab = “Virtual, Swab Taken” in Halcyon ($69)
Full PPE: Change gloves between patients.
Swab Completed
Swab Refused
No Swab Completed
Swab Completed
Patient must wait for negative swab result and be clinically well before returning to work. Patient must be in strict isolation until then. Must be notified to Public Health. Swab is for diagnostic purpose.
Patient must self-isolate. GP to notify public health who will advise further steps.
Patient must stay home until clinically well before returning to work/school.
Patient must stay home until clinically well before returning to work/school. Swab is for surveillance purpose.
Essential Groups for Community Testing: Symptomatic and meets HIS criteria; Meets HIS Criteria and has one or more less typical symptoms; (fever, diarrhoea, headache, myalgia, nausea/ vomiting, confusion/irritability) with no other diagnosis; Symptomatic but does not meet HIS criteria. HIS Criteria: In the 14 days prior to onset of illness patients has had: contact with a confirmed or probable case, international travel, direct contact with a person who has travelled overseas (includes Customs and Immigration & quarantine/isolation facilities staff), worked on an international aircraft or shipping vessel or cleaned at an international airport or maritime port in areas/conveniences visited by international arrivals, or any other criteria requested by the Medical Officer of Health. Full PPE: recommended when taking a swab: gown or apron, surgical face mask, eye protection (such as goggles or a face shield), gloves. For full guidelines on PPE requirements for interactions with people of unknown COVID-19 status, see: https://www.health.govt.nz/system/files/documents/pages/hp7372-level-2-ppe-guidelines-for-unknown-covid-status-130820.pdf
Potential Scenarios for Covid-19 Testing Advice for Testing Asymptomatic Individuals Priority Groups for Asymptomatic Testing Those who do not have symptoms of COVID-19 but are: • Health workers, including Aged Residential Care workers • Hospitality workers, including hotel, restaurant staff • Public-facing tourism workers • Public-facing transport workers (e.g. bus, taxi, uber) • Close contact of border worker group • Border worker groups: those working at managed isolation and quarantine facilities (HIS Criteria) • Close contacts of confirmed or probable case (HIS Criteria) • New Zealand based Air Crew (HIS Criteria)
Asymptomatic
Swab always needed for asymptomatic claim.
Patient C: Asymptomatic, Priority Group (e.g. Border Worker)
Surveillance Swab Offered & Funded
Requires Swab, No Examination
Virtual Assessment + Refer to Pathlab ($69)
Simple Assessment + Swab (Swab at GP) ($138) Full PPE: Change gloves between patients.
If seen at practice but referred to Path lab for Swab = “Virtual, Swab Taken” in Halcyon
Swab Completed
Patient can return to work/ school while awaiting test result (unless advised otherwise by public health – e.g. close contact of confirmed case.) Swab is for surveillance purpose.
Full PPE: recommended when taking a swab: gown or apron, surgical face mask, eye protection (such as goggles or a face shield), gloves. For full guidelines on PPE requirements for interactions with people of unknown COVID-19 status, see: https://www.health.govt.nz/system/files/documents/pages/hp7372-level-2-ppe-guidelines-for-unknown-covid-status-130820.pdf