Updated Testing Guidance 4 November - 15 December - Key messages

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Nasopharyngeal/oropharyngeal swabbing A swab from the nasopharynx is the most effective way of detecting the presence of SARS-CoV-2 and should be taken wherever possible. Most people will tolerate this procedure however a combined oropharyngeal and bilateral anterior nasal swab can be considered as an alternative– particularly if there is concern about tissue fragility. While nasopharyngeal swabbing is the most widely used method, an oropharyngeal with bilateral anterior nares swab is acceptable – for both surveillance and diagnostic testing – for those who cannot tolerate nasopharyngeal swabbing.

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Rapid antigen testing The Ministry is currently reviewing the use of rapid antigen tests (RATs) to assess its potential efficacy as part of the public health response.

As part of this review, the Ministry is working with its clinical and science advisors to establish: o evaluation criteria for selecting tests to be considered for use in New Zealand; and o authorisation processes.

The use of RATs was piloted at Middlemore Hospital’s Emergency Department, Waitemata DHB Delivery Suite and Auckland DHB NICU in October 2021 and has now been expanded for use in managing workforce testing. Twenty-nine (29) businesses who have signed up to the MBIE Business Charter are also piloting the use of RATs as part of their health and safety obligations to keep their workforce safe and ensure business continuity. Any further use of RATs will be rolled out in a phased approach to ensure it is appropriately integrated into the public health response.

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Testing and vaccination status COVID-19 vaccination status of the person and their household members, and quarantinefree travel arrangements, do not change the need or decision to test for SARS-CoV-2.

Symptomatic testing At all Alert Levels, everyone should be offered testing free of charge if they have new onset of symptoms consistent with COVID-19 infection.

This includes: o elderly and children* o contacts who develop symptoms at any time in the 14 days after exposure to a case or attendance at a location of interest o people who meet the HIS criteria o those with no other obvious diagnosis o when a test is warranted under clinical judgement o those recommended to by a Medical Officer of Health o anyone who has received a vaccine within the last 48 hours and has developed one or more of the following symptoms: new respiratory symptoms, loss of smell or taste, fever or higher, or muscle aches getting worse over time.

After they have been tested, they should then stay at home or self-isolate as directed until they get a negative result and have been symptom free for 24 hours. It is particularly important with the increasing prevalence of the highly infectious Delta variant of the virus to test anyone aged 12 or older who is symptomatic during the spring months when colds and flu are still prevalent to ensure a COVID-19 outbreak does not spread undetected

*At Alert Level 1, symptomatic children under the age of 12 years may be excused from testing if they do not meet any of the following: o o o o o o o

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subject to a Border Order or Section 70 notice**. close or casual plus contacts of a confirmed COVID-19 case HIS criteria. there is no other obvious diagnosis when a test is warranted under clinical judgement it is recommended by a Medical Officer of Health. parents request this.

**Unless provided with an exemption by a Medical Officer of Health or a qualified health practitioner Asymptomatic people At all Alert Levels, everyone (including children and elderly) needs to be tested if they are: o subject to a Border order or Section 70 notice** o close or casual plus contacts of a confirmed COVID 19 case. o recommended to by a Medical Officer of Health o surveillance testing for essential workers and healthcare workers o required to by updated guidance from the Ministry of Health.

Community testing The impacts of COVID-19 are felt differentially across New Zealand communities. Māori and Pacific communities and those living with disabilities, in lower socio-economic groups and crowded or institutional settings bear a greater portion of both health and economic impacts and risks.

Equity of access to testing is a vital part of the Ministry’s Testing Strategy. Community testing needs to continue to focus on reducing barriers to testing and include non-appointment-based options and ensure testing is equitably available for all those with symptoms.

We encourage you to work with DHB cultural and community liaison roles to plan and implement approaches with our Māori and Pacific communities, health leaders and health providers.