Prioritisation of COVID-19 testing On 14 August, laboratories around the country delivered 23,846 completed tests for COVID-19, a huge increase on previous capacity. However, the unprecedented level of demand for COVID-19 testing is resulting in an increase in turn-around times. It is important to ensure COVID-19 testing is prioritised to minimise delays in receiving test results for priority cases, so the public health response can quickly find and isolate cases.
Separating tests into high and low priority CBACs, general practices and other testing sites should physically separate and clearly label their test samples into two separate ‘buckets’ using the following prioritisation: 1. High Priority test samples are for: •
People symptomatic for COVID-19
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those who work at Managed Isolation and Quarantine Facilities or at the border
2. Low Priority test samples are from people who should not have received a test because they were without symptoms or did not meet the HIS criteria. Please note that close contacts should not be presenting for testing as they should be in isolation. However, any test samples taken from close contacts should be given the highest priority. Please also ensure that testing forms are fully completed, particularly ensuring that NHI numbers are provided. Lack of data significantly slows down the process in registering samples into the lab.
General practices General practices can further help ensure COVID-19 testing is prioritised appropriately by encouraging testing for only those patients who present with symptoms or who have been advised by Healthline to take a test. Within this, priority should be given to those who meet the HIS criteria (set out below) or who have been identified as casual contacts. General practices should also let their patients know that due to the unprecedented demand for testing, the turn-around time will increase over the next few days. General practices and patients should not phone testing laboratories to enquire about results. Please be assured that when a test result is positive, the notification process is prioritised. General practices may also choose to exercise discretion in commissioning non-COVID testing to reduce the demand on laboratories.
Laboratories Nationally, laboratories should prioritise testing of samples for people with symptoms and those who meet the HIS criteria (set out below). Laboratories may wish to defer non-urgent, non-COVID-19 testing. This can be achieved by:
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prioritising requests from CBACs and GPs labelled as HIGH PRIORITY, and
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transferring tests between labs to ensure that swabs from symptomatic people are treated in preference to other tests.
Healthline Healthline should continue to re-assure people that they do not need to be tested unless they have symptoms or have been identified as a close or casual contact of a case of COVID-19. Healthline should also let people know that due to the unprecedented demand for testing, the turn-around time will increase over the next few days and they should not try to phone the testing laboratory to expedite the process. Notifications for positive test results are prioritised.
Higher Index of Suspicion (HIS) criteria Either, in the 14 days prior to illness onset have: •
had contact 3 with a confirmed or probable case
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had international travel
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had direct contact with a person who has travelled overseas (eg Customs and Immigration staff, staff at quarantine/isolation facilities)
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worked on an international aircraft or shipping vessel
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cleaned at an international airport or maritime port in areas/conveniences visited by international arrivals, or
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any other criteria requested by the local Medical Officer of Health
Some people may present with less typical symptoms such as only: fever, diarrhoea, headache, myalgia, nausea/vomiting, or confusion/irritability. If there is not another likely diagnosis, and they meet the HIS criteria then test.