Who should be tested for COVID-19?
Updated 16 April 2021
See the Ministry of Health’s testing plan and guidance
How do I identify ‘at risk’ staff and patients if there was a COVID-19 outbreak in the community?
Reviewed 21 January 2021
The Government’s Covid19.govt.nz webpage identifies those most at risk as those with a severe illness or an existing underlying medical conditions. COVID-19 is especially dangerous if these conditions are not well controlled. Relevant conditions include:
- serious respiratory disease such as chronic lung disease or moderate to severe asthma
- serious heart conditions
- immunocompromised conditions
- severe obesity — a body mass index (BMI) of 40 or higher
- chronic kidney disease
- people undergoing dialysis
- liver disease.
Many conditions can cause a person to be immunocompromised, including:
- Cancer treatment
- smoking related illness
- bone marrow or organ transplantation
- haematologic neoplasms
- immune deficiencies
- poorly controlled HIV or AIDS
- prolonged use of corticosteroids and other immune weakening medications such as disease-modifying anti-rheumatic drugs.
- Those over 70: Older people often have underlying health issues, including respiratory issues that make them more vulnerable to COVID-19.
- Residents of aged care facilities: Aged care facilities are susceptible to rapid transmission of viruses like this. Residents are more susceptible to illnesses due to their age and they are also more likely to have underlying health conditions.
- Pregnant women: Health experts do not yet know if pregnant women are impacted by COVID-19 in the same way as other people. However, pregnant women experience changes in their bodies that may increase their risk from some infections.
The College has also produced an adaptation of a COVID-19 risk assessment matrix developed by occupational health physicians from the National Framework for the assessment of staff.
Members may like to read Rheumatologist Prof Andrew Harrison’s opinion piece relating to this.
Health Navigator has a good description of the virus and who it affects.
What do I do if a patient’s COVID-19 test result is negative?
Reviewed 15 October 2020
General Practitioners are responsible for informing patients if their COVID-19 test is negative and providing advice. (Note: Public Health Units will provide follow-up with patients who have positive tests).
The advice to patients who have negative results is:
- if they are still sick with the same illness at the end of the 14-day isolation period, they will need to stay in isolation until they have been symptom-free for 48 hours
- if they are well, and have been for 48 hours, they can return to normal daily activity.
For more information see the Ministry of Health’s ‘Primary care quick reference guide.’
Do patients who test positive for COVID-19 require admission to hospital for inpatient care?
Reviewed 21 January 2021
Guidance from the Ministry of Health advises that patients with suspected, probable or confirmed COVID-19 infection, or those under investigation, should be managed medically according to their symptoms and clinical state. They do not need to be hospitalised unless clinically indicated and their home care situation is suitable.
Red flags which should mandate urgent clinical review and potential hospital admission include:
- Respiratory distress
- Dyspnoea (included reported history of new dyspnoea on exertion)
- Altered mental state
- Clinical signs of shock e.g. low blood pressure, fainting
- Unable to mobilise without assistance by carers
- Unable to safely provide self-care
- No alternate carers available
- Any other reason that may require hospital admission as assessed by a medical practitioner
Discuss these patients with the on-call medical team, infectious diseases or clinical microbiology service and transfer to hospital, as per your local DHB pathways. Swabs will be obtained in hospital. Ensure safe transit and controlled entry to hospital through liaison with admitting service, and ambulance service if required.