Covid-19 - Testing
If you’re an essential worker, you can apply for priority testing through GOV.UK by following the guidance on testing for essential workers . You can also get tested through this route if you have symptoms of coronavirus and live with an essential worker.
For anyone else who has any of the symptoms of coronavirus, they can ask for a test through the NHS website.
For technical issues related to booking tests and results enquiries contact the Coronavirus Testing Helpdesk - 0300 303 2713. There are a number of routes available including regional test centres, home test kits, mobile testing centres and NHS facilities.
NHSE have also produced a handy printable "How do NHS Staff get a test for Covid-19" It may be a useful to print off and display in the practice.
Thank you to University Hospitals Birmingham - Health Partners for sharing the poster below.
Test and Trace Service
The government have introduced this service to help return life more to normal, in a way that is safe and protects our NHS and social care. The service will allow them to trace the spread of the virus and isolate new infections and play a vital role in giving public health early warning if the virus is increasing again, locally or nationally.
The NHS test and trace service:
- ensures that anyone who develops symptoms of coronavirus (COVID-19) can quickly be tested to find out if they have the virus, and also includes targeted asymptomatic testing of NHS and social care staff and care home residents.
- helps trace close recent contacts of anyone who tests positive for coronavirus and, if necessary, notifies them that they must self-isolate at home to help stop the spread of the virus.
Essentially, anyone who has symptoms will need to self isolate for at least 10 days, have a test and if positive will need to continue to the end of the isolation period and share all their recent close contacts ( see website for full details on what is defined by close contact) with the NHS Test and Trace service. Any household contacts of the symptomatic patient will also need to self isolate for 14 days from when the patient's symptoms started and if their test is positive continue the isolation to the end of the 14 day period.
If you are contacted by the NHS test and trace service, because you have been identified by a patient (who has had a positive test result) as a close contact, you will be told to begin self-isolation for 14 days from your last contact with the person who has tested positive. If you develop symptoms you will need to request a test at www.nhs.uk/coronavirus or call 119 if you have no internet access.
The government advise that if you work in a health or care setting, you should follow the separate guidance for health and care workers on testing and when to return to work.
It is worth noting that this guidance does say that:-
If a staff member has been notified that they are a contact of a co-worker who has been confirmed as a COVID-19 case, and contact with this person occurred while not wearing PPE, the 14-day isolation period also applies.
This would imply that if the contact was whilst wearing the correct PPE then isolation period is not required
July 2020 NHS Digital confirms that test results are now being automatically sent to GP systems as well as being communicated to the individual
The Primary Care Bulletin 5.6.20 gave the following update on COVID-19 National Testing: Flowing results to GP records
PCR swab testing is now routinely available to members of the public by visiting nhs.uk/coronavirus or calling 119.
When a patient receives their test result from the national COVID-19 PCR swab testing, this will also be sent to GP systems and appear in the patient’s record as a laboratory test result. Results from tests previously undertaken through the same route will also shortly be sent to GP systems – with the exception of a small number of cases where there was insufficient information to identify the patient’s NHS number.
The test results will have the Requesting GP as G9999981 and Requesting GP Surname of COVIDpillar2; this will ensure they are clearly distinguishable from other test results. Bulk upload of test results into GP records will take place without any manual patient by patient process. GP practices will shortly receive further guidance by their own system supplier about how this will work in their own system of choice, as well as details on how results will be filed in the system.
There will be no action required from the practice on receipt of these results. In particular:
- There will be no need to communicate results to patients, as these will have already been sent to them by text and email;
- No clinical action will be necessary, as patients will have also received links to national guidance in their text and email, such as requirements on isolation or what to do if symptoms worsen;
- The results will not need to be notified to Public Health England under the notifiable diseases requirements, as this will have already been done.
Results from the test will be communicated as one of the following three options: negative, positive or unclear. They will appear in patients’ records as “SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) RNA (ribonucleic acid) detection result negative / positive / unknown”. When a result is “unknown” it means this was unclear and the patient will be advised to be tested again through the original route they use to request a test.
Covid-19 Antibody Testing
Wessex LMCs opinion statement on Covid-19 antibody testing
The government has announced the start of a major new national antibody testing programme, with plans to provide antibody tests to NHS and care staff in England from the end of May.
Clinicians will also be able to request the tests for patients in both hospital and social care settings if they think it’s appropriate. There is no definition of what this means!
Understandably Practices and the wider public are asking what this means for them, and how,why and when they should be offering/accessing testing.
The LMC have raised the subject locally (with the CCGs) and it is being raised nationally by the BMA GPC as an issue that needs urgent clarification and clear direction.
Our understanding is that the current antibody test on offer via the NHS labs is looking at IgG ie evidence that you have had the virus and mounted an immune response. It is not looking for evidence of acute infection ie IgM.
The government is also working in partnership with the private sector to develop a ‘finger-prick’ type test, similar to a diabetes test, which will be suitable for use at home and without medical supervision but has not yet been validated for use. Again, it is not clear what purpose these proposed tests will serve.
There is no strong evidence yet to suggest that those who have had the virus develop long-lasting immunity which would prevent them from getting the virus again.
Therefore, the value of antibody tests is currently limited to answering the question of whether someone has had the virus or not, and providing data and a greater understanding on the spread of the virus.
If you receive a positive antibody result it does not mean that you’re immune, or that you cannot pass on the virus to others. It also does not mean that you can ignore social distancing measures.
Our understanding of the virus will grow as new scientific evidence and studies emerge. COVID-19 is a new disease, and our understanding of the body’s immune response to it is limited and the main reason for current antibody testing will be to enable this research.
Our view would be that if Public health want a universal antibody screening programme to inform population management and research then this needs to be properly commissioned. There are huge workload implications in delivering this at a time when hospital and GP capacity is significantly reduced.
At present we would recommend that:
- you shouldn’t offer your own staff testing. The CCG will be advising Practices as to how staff can access testing soon.
- the value of antibody tests is currently limited to answering the question of whether someone has had the virus or not, and providing data and a greater understanding on the spread of the virus.
- There is no current role for antibody testing in Occupational Health settings as a positive result doesn’t change the need to observe full PPE measures and social distancing/isolation measures.
Register for an antibody test kit to check if you've had coronavirus before - https://www.gov.uk/register-coronavirus-antibody-test?fbclid=IwAR2aDIsisbqVekvSdfJTuSJTcBXfdslEcxh3MiFyt1Yw10epN8oW8cgBzEo
CQC Guidance on Regulating independent providers offering coronavirus (COVID-19) testing
In recent weeks, CQC have been made aware of a small number of independent providers who are offering coronavirus swab testing kits for sale to the general public. They aim to provide clarification on when such activity will fall within scope of CQC registration, and also set out their expectations of providers offering this service. On 18 April 2020, Professor John Newton, national coordinator of the UK coronavirus testing programme, released a statement advising against the use of unapproved antibody tests in the UK.
The CQC guidance advises on which coronavirus swab testing that falls within the scope of CQC registration and what they expect of those providers. The full details can be read on their website at :- https://www.cqc.org.uk/guidance-providers/independent-healthcare/regulating-independent-providers-offering-coronavirus