Guidance for clinicians on community testing for COVID-19

14 July 2020
This guidance is to assist practices when making clinical decisions about who to test, to help ensure a consistent approach and ensure the sufficient number of people are tested 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 (HIS) criteria.

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

• 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 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.

The Ministry of Health is reviewing the testing numbers weekly and we will provide further updates as required.

Further information

More information on the case definition can be found here: www.health.govt.nz/ourwork/diseases-and-conditions/covid-19-novel-coronavirus/covid-19-resources-healthprofessionals/case-definition-covid-19-infection

More information on PPE can be found here: www.health.govt.nz/system/files/documents/pages/alert-level-1-personal-protective-equipmentfor-taking-covid-19-nasopharyngeal-or-throat-swabs-25jun20.pdf

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