Staff testing to exclude Covid-19 – 18 May 2020
There is targeted testing of key healthcare workers (HCW) in critical positions who are self-isolating for Covid-19. Also, there is targeted testing of the household contacts of key healthcare workers in critical positions who are family-isolating for Covid-19. The testing available identifies those currently infected with the virus. It does not identify infection in those who may have been exposed and are within the incubation period nor does it confirm either past infection or immunity in those whose symptoms have improved.
The aim is to identify staff members who are self or family isolating in order to facilitate a return to the workplace earlier than the 7 and 14 days currently recommended.
The HCW or their family member need be symptomatic for testing to be effective. For the majority this will be within the first 3 days of illness. Testing out with this period is less effective and does not confirm whether the person tested has had Covid-19 and will not alter the advice to self-isolate for 7 days or family-isolate for 14 days. We expect to be notified on the day that a staff member reports symptoms as this allows 24-48 hours to organise the testing.
The testing is via a single nose and throat swab. This is a bit unpleasant but is generally well tolerated even by children. The testing is in a drive through setting. The HCW or household member will need to be able to drive themselves or be transported to and from the centre. The swab will be taken with the HCW or household contact in the car.
This can be organised by managers through occupational health. After assessing the impact of the absence of the HCW (see table below) and the options for home working to determine whether the HCW is key and in a crucial role the manager can request Covid-19 exclusion. The manager will need to send the name, the job title, the job location, the date for the onset of symptoms, and the contact telephone number for the staff member – not the household contact to OHenquiries@nhslothian.scot.nhs.uk. Covid-19 staff testing must be the subject line. OH will contact the HCW to gather the necessary information and to organise an appointment for a test. We are unable to reply from this in-box so please use the same e-mail address with a separate heading if you have any queries.
All testing is taking place either at Chalmers Hospital, Edinburgh or West Lothian College, Livingston. Both are drive through only. Where there is no access to transport this can be arranged. Please listen carefully to the instructions you receive.
The result will be received by occupational health. All results are reported by SMS within 48-72 hours of the test. Consent for this is required at the time of testing from any household contact. No member of staff should break their period of isolation until they have received and understood their result. Managers and their staff should keep in touch with each other to identify the earliest point at which a return to the workplace can be achieved safely.
A negative result from a test taken during the symptomatic phase of either the HCW themselves or their household contact is reassuring that the symptoms are not due to Covid-19 and the currently advised isolation periods for the HCW need not apply. The HCW can return to the workplace as soon as they are feeling well enough.
A positive result from a test taken during the symptomatic phase of either the HCW themselves or their household contact is confirmation that the virus is present and that the symptoms are due to Covid-19. The exclusion criteria apply – 7 days from the onset of symptoms for the person swabbed and 14 days for anyone who is a household contact.
If the HCW has been symptomatic and has had a positive swab result they can return to work on day 8 as long as they have not had a fever for 48 hours.
A HCW who is a household contact of a positive case can return to work on day 15 from the onset of symptoms in their contact, assuming they themselves do not have symptoms.
If the HCW does become symptomatic with a new continuous cough OR a fever OR change in/loss of sense of taste or smell they must self-isolate until day 8 of their symptoms. The HCW can return to the workplace on day 8, as long as they have not had a fever for 48 hours. This return to the workplace can occur even if someone else in the household subsequently develops a new continuous cough OR a fever OR change in/loss of sense of taste or smell.