How do you test for coronavirus?
Because infected people may have anything from mild respiratory symptoms to severe pneumonia, the only way to confirm someone has coronavirus is to test them.
There is currently one type of test in regular use in Wales – the antigen test. This is used to test whether someone admitted to hospital with symptoms has coronavirus. It is also used to see whether a frontline NHS professional may have coronavirus. Wales has been routinely testing NHS staff involved in patient care since March 18.
Antigen testing involves taking a swab of the throat. It looks for the presence of the genetic signature of the virus. The test is performed in a laboratory.
Another type of test is available – this is the antibody test. This tests a drop of the blood to see whether someone has been exposed to coronavirus infection and has developed antibodies – has some immunity to the virus.
This test is also performed in the laboratory but it can be adapted into a testing format for community use.
At the moment, the antibody test is not available for widespread use in the UK – work is ongoing to verify the reliability and effectiveness of the test. It is hoped an effective form of the antibody test will be confirmed, which can be used in the community to track the progression of coronavirus.
Once the antibody test has been validated, it will be available for use in Wales.
Who is being tested in Wales?
The Chief Medical Officer for Wales introduced new guidance for testing in Wales on March 18, which included who should be tested. This is available at: https://gov.wales/sites/default/files/publications/2020-03/coronavirus-…
It states people admitted to hospital with evidence of pneumonia or acute respiratory distress syndrome or flu-like illness and one of the following symptoms – a persistent cough hoarseness, nasal discharge or congestion, shortness of breath, sore throat, wheezing, sneezing – should be tested.
Testing is also available for NHS staff in patient-facing roles if they have symptoms. A negative test will enable them to return to work.
More than 1,500 tests have been carried out on NHS staff since March 18 – threequarters of the tests were negative.
Social care staff are also being tested in Wales.
Overview Of Coronavirus Testing
- This policy sets out a needs based approach testing criteria for NHS and non-NHS workers known collectively as “Critical Workers”, and is issued for the benefit of competent authorities, stakeholders and the public.
- This policy updates the current policy of NHS Health Worker (HCW) testing CEM/CMO/2020/8, and extends it to include non-NHS Critical Workers.
- This policy only relates to people who have symptoms of the virus and tests that detects the virus i.e. swab or antigen testing. It does not consider antibody testing.
- In Wales there are 438,000 Critical Workers; this includes 164,700 Healthcare workers, 9,900 police and prison staff . The broad categories of Critical Workers includes:
- Health and social care workers
- Public safety(emergency workers) and national security workers
- Local and national government workers
- Education and childcare workers
- Food and other necessary goods
- Transport workers
- Utilities, communication and financial services workers
- Key public service workers
- At the discretion of Medical Directors, other workers may qualify as Critical Workers for testing purposes.
- Within each Local Resilience Forum area there are local referral arrangement is place.
- Initially, it is expected that resource for testing will be deployed to health and social care staff and to the wider group of critical care workers where there is risk to business continuity for critical infrastructure or service delivery.
- The current policy of testing of patients, people in a care settings or confined space is not included in this document.
Purpose of this policy
Purpose of this policy is to:
- Enable Critical Workers who have tested negative for SARS-CoV2 to return to work earlier if well enough and asymptomatic. It applies to workers, who according to their employer, cannot observe the seven day self-isolation or 14 day household quarantining due business continuity reasons; it also assumes that a person testing negative does not risk spreading other illness (e.g. influenza) in the work place.
- This policy also applies to one symptomatic individual who lives in the same household as an asymptomatic Critical Worker (as defined in this policy). Such that if the symptomatic household member tests negative for SARS-CoV2 the Critical Worker can return to work before 14 days.
- Identify workers and places of work where COVID-19 positive staff may have infected patients, shielded individuals or vulnerable people.
- Describe the process of scaling the availability of COVID-19 tests for Critical Workers whilst new systems are put in place and capacity increases.
- Unless explicitly indicated Critical Workers (or a household member) will only be tested if they are symptomatic. Worker (or a household member) who have been sent for testing or tests have been requested for them and they are not symptomatic will not be tested.
- If testing is requested for a Critical Worker (or a household member) and relates to early return to work:
- Testing should only be offered if they are self-isolating and symptom onset was less than five days
- If isolating because household member is symptomatic, there is only benefit if they have been doing so for 12 days or less
- The duty of the employer (and occupational health) is the same as for other notifiable diseases.
- The current process of managing requests for testing of front line NHS workers will remain the same, in that COVID-19 Coronavirus Testing Units (CTUs) within NHS Organisations will continue to undertake this task.
- This policy will be revised as testing capacity increases, front-end platforms come online and demand is understood.
18 April 2020
18 April 2020