Additional clinical guidance on community testing for COVID-19 email

From: Debbie Baillie <debbieb@wboppho.org.nz> on behalf of Debbie Baillie Sent on: Wednesday, July 15, 2020 2:26:47 AM To: Practice.Managers <Practice.Managers@wboppho.org.nz> Subject: Additional clinical guidance on community testing for COVID-19 Urgent: High

Morena Practice Managers The media today is talking about further direction from MOH about community testing for COVID-19 and about who should be tested, please see below that additional guidance.

To support that guidance is new information from RNZCGP in the Risk Assessment Matrix (updated 9 July), which is designed to allow primary care clinicians to assess their own and their colleagues’ risk within the clinical setting. It also assists clinicians when advising patients not working in clinical settings who are concerned about their safety in the work environment. View the matrix via the following link: https://www.rnzcgp.org.nz/Covid19/Testing/COVID19_risk_assessment_matrix_/Covid19/Testing/Risk_assessment_matrix.aspx?hkey=d25cd63e-a05d4f9c-81e6-66ce36e24383

Ngā mihi Debbie Baillie WBOP PHO General Practice Liaison Team Lead 021 2625702 Subject: Additional clinical guidance on community testing for COVID-19

Kia ora koutou, Thank you to those who have provided feedback seeking further direction and clarity about community testing for COVID-19.

In response, we are providing the guidance below to assist practices when making clinical decisions about who to test, to help ensure a consistent approach and that we test sufficient numbers of people as part of our community testing.

Clinicians should apply the guidance when using their clinical judgement about who to test for COVID-19, when a person has symptoms consistent with COVID-19 but does not meet the Higher Index of Suspicion criteria.

1.

All people who are symptomatic and meet the High Index of Suspicion (HIS) criteria should be offered a test for COVID-19 2.

Clinicians should also offer a test for COVID-19 to others presenting to health services with symptoms consistent with COVID-19 and who are more likely to have severe consequences if they were to contract COVID-19. This group includes: seniors, Mâori, Pacific peoples, and those who have significant pre-existing conditions. (Examples of significant pre-existing conditions are chronic obstructive pulmonary disease, high blood pressure, heart disease, diabetes.)

3.

We also advise testing of all symptomatic health care workers and aged residential staff. All patients in this group presenting to primary and secondary care with symptoms consistent with COVID-19 should be offered a test.

It is important that clinicians use clinical discretion to determine if those outside the above groups presenting with symptoms consistent with COVID-19 should be offered a test. The following symptoms are consistent with COVID-19: â&#x20AC;˘Any acute respiratory infection with at least one of the following symptoms: new or worsening cough, sore throat, shortness of breath, coryza 1, anosmia2 with or without fever.

Only those meeting both the clinical and the HIS criteria need to be notified to the Medical Officer of Health on presentation. Only those meeting both the clinical and the HIS criteria are asked to self-isolate while awaiting test results.

This testing is part of stream one of our testing strategy: symptomatic community testing Please note that either nasopharyngeal and / or oropharyngeal swabs are appropriate for the collection of specimens for COVID-19 testing.

There is guidance for clinicians on the use of PPE when taking a swab for COVID-19.

This advice is available here. In brief, the Personal Protective Equipment (PPE) when taking a swab is the same for all patients with symptoms consistent with COVID-19, irrespective of Higher Index of Suspicion criteria.

The test is free of charge to the patient and fully funded by the Ministry of Health.

Many thanks for your continued efforts to keep COVID-19 out of our communities. The ministry of Health is reviewing the testing numbers weekly and we will provide further updates as required.

Dr Caroline McElnay Director Public Health Population Health and Prevention Ministry of Health For more information about PPE, please visit: https://www.health.govt.nz/system/files/documents/pages/alert-level-1-personalprotective-equipment-for-taking-covid-19-nasopharyngeal-or-throat-swabs-25jun20.pdf To view the full case definition, please visit: https://www.health.govt.nz/our-work/diseasesand-conditions/covid-19-novel-coronavirus/covid-19-resources-health-professionals/casedefinition-covid-19-infection

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