New change in testing guidance for suspect cases of novel coronavirus (COVID-19). Please follow the testing guidance below.

What’s New?

  • Change in testing indications
  • Test symptomatic individuals who are: Hospitalized (or likely to be hospitalized), Health care workers, Residents of long term care facilities, OR Individuals part of an investigation of a cluster or outbreak.
  • Label requisitions for these groups to help prioritize testing
  • DO NOT TEST asymptomatic patients, patients with mild symptoms, returning travelers with mild symptoms
  • Additional swab and collection medium options: Copan NP (red or blue swabs) and Hologic Aptima Unisex Swab accepted for testing  

Situation Update:

  • The World Health Organization declared COVID-19 a pandemic as new countries continue to identify cases.
  • (**new**) The Provincial Health Officer has advised that all returning international travellers (including USA) self-isolate for 14 days. Self-isolation does not apply to health-care workers who travel outside of Canada and provide direct patient care unless they have travelled to Hubei (China), Italy, or Iran.
  • (**new**) Patients with respiratory symptoms that can be managed at home should self-isolate for at least 14 days after onset of their symptoms. After 14 days, if their temperature is normal and they feel better, they can return to their routine activities. Coughing may persist for several weeks, so a cough alone does not mean they need to continue to self-isolate for more than 14 days.
  • Note that most people infected with COVID-19 have mild disease and recover. Approximately 80% of patients with lab-confirmed disease have mild to moderate symptoms and are able to recover at home with limited medical intervention.

Testing:

(**new**) COVID-19 testing guidance has changed to ensure that diagnostic testing is available for patients for whom the test will impact clinical and public health management.

Test for COVID-19 for:

Patients with respiratory symptoms (e.g., fever, cough, or difficulty breathing) who are:

  1. Hospitalized, or likely to be hospitalized
  2. Health Care Workers
  3. Residents of long term care facilities
  4. Part of an investigation of a cluster or outbreak (i.e. based on direction from Public Health) 

(**new**) Labs will now be prioritized for processing. Prioritize testing by labelling the requisition as coming from:

Hospital (label as HOSP) | Long-term care facility (label as LTCF) | Health Care Worker (label as HCW)

(**new**) Do not test for COVID-19 in asymptomatic patients (the exception is health care workers with COVID19 infection who require a negative test after symptom resolution to return to work), patients with mild symptoms (who can be managed at home), or returning travelers (with an onset of illness within 14 days of return to Canada).

Sample Collection:

Ensure patients suspected or confirmed to have COVID-19 are evaluated and tested using contact and droplet precautions (Required PPE includes: gloves, gowns, surgical mask and eye protection/face shield). Physicians can test for COVID-19 without consulting a Medical Health Officer. Collect either a nasopharyngeal (NP) or throat swab for COVID-19 testing (NP swab preferred).

 

To collect a NP swab OR throat swab

(**new**) Use either: 

 
 
The routine Copan NP swabs used for Influenza or other respiratory virus testing, or the skin/mucosal swabs for HSV/VZV viral testing (the containers have a pink liquid in it and a red or blue cap).

OR

The Hologic Aptima Unisex Swab Specimen Collection Kit used for endocervical and male urethra swab specimen collection. Use the blue swab to obtain an NP. (Please note: It is harder and less flexible. Insert the swab gently into the deep nares and rotate the swab for 10 to 30 seconds to obtain an adequate sample. Break the swab at the scoreline and place into the transport vial.)   

  Send the swab to the BCCDC Provincial Laboratory. Ensure that the requisition indicates testing for “novel coronavirus” and the appropriate priority code. For testing consultation, call the BCCDC Lab Medical Microbiologist on-call at 604-661-7033.    
 

Discharge:

  • Advise the patient to self-isolate and provide them with a Home Isolation handout.

  • Inform the patient that they can call the BCCDC Coronavirus Hotline (1-833-707-2792) for testing results.

  • If swab results are positive, Public Health will follow-up. 


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