Testing

In this section

Information, guidance and resources

Guidance

Symptoms

  • Coronavirus (COVID-19) symptoms in adults can include:
    • a high temperature or shivering (chills)
    • a new, continuous cough – this means coughing a lot for more than an hour, or 3 or more coughing episodes in 24 hours
    • a loss or change to your sense of smell or taste
    • shortness of breath
    • feeling tired or exhausted
    • an aching body
    • a headache
    • a sore throat
    • a blocked or runny nose
    • loss of appetite
    • diarrhoea
    • feeling sick or being sick
  • The symptoms are very similar to symptoms of other illnesses, such as colds and flu. 
  • RESTORE 2™  : Recognise early soft-signs, Take observations, Respond, Escalate. 
    • RESTORE 2™ is a useful resource as it can help care professionals spot deterioration from COVID-19 related illness or recognise non-COVID-19 related deterioration and act to decrease avoidable hospital admissions.

Summary

  • Symptomatic staff testing
    • Staff with symptoms should take 2 lateral flow tests: as soon as they develop symptoms (day 0); and another lateral flow test 48 hours after the first test (day 2) to confirm their COVID-19 status.
    • Symptomatic staff should stay away from work and conduct the lateral flow tests at home. 
    • Staff should only come into work if both lateral flow test results are negative. For those who test positive the guidance on ending self-isolation early through additional testing remains the same.
  • Symptomatic resident testing (excluding care homes)
    • People with symptoms in extra care and supported living should take 2 lateral flow tests: as soon as they develop symptoms (day 0); and another lateral flow test 48 hours after the first test (day 2) to confirm their COVID-19 status.
    • They should follow the guidance regarding staying at home and avoiding others – this can end if both tests are negative. 
    • For those who test positive, the guidance on ending self-isolation early through additional testing remains the same.
  • Symptomatic resident testing – care homes
    • Care home residents who have symptoms of COVID-19 should isolate and take 2 lateral flow tests: as soon as they develop symptoms (day 0); and another lateral flow test 48 hours after the first test (day 2) to confirm their COVID-19 status.
    • Residents who test positive for COVID-19 should isolate for 10 days and take part in daily lateral flow testing from day 5. They can end self-isolation after receiving 2 consecutive negative tests 24 hours apart, or after 10 days’ isolation.
    • Residents who are close contacts of a COVID-19 case should minimise contact with the person who has COVID-19, avoid contact with anyone who is at higher risk of becoming severely unwell if they are infected with COVID-19, especially those with a severely weakened immune system, and follow the advice regarding testing and isolation if they develop symptoms of COVID-19.
  • Asymptomatic testing
    • Staff in adult social care should test twice a week with lateral flow tests. Tests should be conducted before they begin work, spaced 3 to 4 days apart.
    • There should be no regular asymptomatic testing for residents of care homes.
  • Rapid response testing
    • If an individual (staff or resident) receives a positive result (from any test) in a care home, adult day care centre, or high-risk extra care and supported living setting, then all staff should conduct daily rapid LFD testing every day that they are working, for 5 days. 
    • Only the staff working in the setting over the rapid response testing period need to be tested; those not working during this period do not need to be tested. You should not bring people into work to get tested on their non-working days.
    • This testing is not extended if further positives are found in these 5 days. Instead, outbreak testing should commence.
  • Outbreak testing
    • Outbreak = 2 or more confirmed (or clinically suspected) linked cases of COVID-19 that occur in the same setting within a 14-day period. This applies to both staff and residents, and includes PCR and LFD results.
    • If you suspect an outbreak in your care home, contact the health protection team (HPT) and local authority immediately. 
    • In the event of an outbreak, initiate whole home outbreak testing: 
      • Day 1: all staff and resident tested with both LFD and PCR
      • Day 4 – 7: all staff and resident tested with both LFD and PCR
    • Once there have been at least 10 days with no new COVID-19 cases or newly symptomatic individuals, outbreak recovery testing should be undertaken. 
  • Outbreak recovery testing
    • All staff and residents (who have not tested positive in the last 90 days) should be tested with a PCR test, no earlier than 10 days after the last resident or staff member had a positive test result or showed COVID-19 symptoms.
    • If all recovery testing results are negative, the HPT will advise that outbreak restrictions can be lifted and the normal regular staff testing pattern should be followed.
    • If there are further positive results from recovery testing, the HPT may advise that outbreak restrictions should continue until no further positives are found before advising that the outbreak has ended. 
  • Testing to end isolation
  • Staff
    • Social care staff with COVID-19 should not attend work until they have had 2 consecutive negative lateral flow test results (taken at least 24 hours apart), they feel well and they do not have a high temperature. 
    • The first lateral flow test should only be taken from 5 days after day 0 (the day their symptoms started, or the day their test was taken if they did not have symptoms).
    • If both lateral flow tests results are negative, they may return to work immediately after the second negative lateral flow test result on day 6, if their symptoms have resolved, or their only symptoms are cough or anosmia which can last for several weeks.
    • If the staff member’s lateral flow test result remains positive on the 10th day, they should continue to take daily lateral flow tests. They can return to work after a single negative lateral flow test result.
    • If the staff member’s lateral flow test result is still positive on the 14th day, they can stop testing and return to work on day 15. If the staff member works with people who are especially vulnerable to COVID-19 (seek clinical advice as necessary), a risk assessment should be undertaken, and consideration given to redeployment.
  • Residents
    • All residents who test positive for COVID-19 with either lateral flow or PCR tests, regardless of whether they are symptomatic or asymptomatic, should isolate in the care home for 10 days from when the symptoms started, or from the date of the test if they did not have symptoms. 
    • Individuals who test positive for COVID-19 should take part in daily lateral flow testing from day 5 (counting the day of the original positive test as day 0). They can end isolation after receiving 2 consecutive negative tests 24 hours apart, or after 10 days’ isolation. 
    • Any individual who is unable to test should be isolated for the full 10 days following a positive test. Isolation should only be stopped when there is an absence of fever (less than 37.8°C) for 48 hours without the use of medication.
  • Accessing COVID-19 treatments for people in the highest risk group
    • Individuals who are in the highest risk group from COVID-19 can access new COVID-19 treatments directly. Tests are being sent directly to these individuals to enable faster treatment of COVID-19 if they develop symptoms.
    • Eligible individuals will receive a ‘pre-notification’ letter or email (to the contact details specified in their GP record) to alert them that they have a condition that may make them eligible should they test positive for COVID-19.
    • Service and care managers are requested to support residents who are eligible for treatment with where to store these priority tests so that they are available when needed. Each priority treatment test kit will have an information leaflet enclosed which details how these kits should be stored and provide full testing instructions.
    • If positive for COVID-19, the resident will be contacted by a COVID-19 Medicines Delivery Unit clinician who will assess the resident’s eligibility and decide on the appropriate treatment. In most cases the treatment prescribed will be monoclonal antibodies, which are given intravenously, however, if monoclonal antibodies are unsuitable for the individual, they will be given oral antivirals.
    • If the resident is not contacted within 24 hours of receiving the positive result, contact their GP or call 111.
    • Further information on treatments for COVID-19 is available on the NHS website. Any queries regarding priority treatment tests can be raised via 119.
    • If you have any concerns or queries in regards to clinically vulnerable residents/clients/service users and antiviral treatments, please contact their GP or call 119.

Other resources

Page last updated on April 22nd, 2022 at 4:23pm

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