COVID-19: investigation and initial clinical management of possible cases
Updated 18 March 2020
According to the BBC News website on 24th March 2020, currently only people in hospital are being routinely tested, so if you have symptoms and you’re not sure if you have the virus, you may well not be able to find out, this includes NHS workers. You can read the article here
Take 1-minute to self-report daily, even if you are well. Designed by doctors and scientists at King’s College London, Guys and St Thomas’ Hospitals, this App will be used to study the symptoms of the virus and track how it spreads. Download to your Apple or Android phone here
This information is taken from the Government webpage: COVID-19: investigation and initial clinical management of possible cases. To read on the Gov.uk website click here
implement infection prevention and control measures whilst awaiting test results, including isolation and cohorting of patients in line with your Trust seasonal influenza operational plan
assess individuals in a single occupancy room
wear personal protective equipment (PPE) – as a minimum, this should be a fluid resistant surgical mask, single use disposable apron and gloves and eye protection if blood and or body fluid contamination to the eyes or face is anticipated. If a patient meeting the case definition undergoes an aerosol generating procedure, then a FFP3 respirator, long-sleeved disposable fluid-repellent gown, gloves and eye protection must be worn; refer to infection prevention and control (IPC) guidance
ask the patient to wear a surgical facemask while transporting them to the single room or cohort area
Note: Clinicians should consider testing inpatients with new respiratory symptoms or fever without another cause or worsening of a pre-existing respiratory condition.
Individuals with cough or fever should now stay at home.
Clinicians should be alert to the possibility of atypical presentations in patients who are immunocompromised.
Alternative clinical diagnoses and epidemiological risk factors should be considered.
Ensure the patient is placed in respiratory isolation or within a specified cohort bay and the PPE described in the infection prevention and control guidance is worn by any person entering the room.
Ensure that the patient, potentially contaminated areas, and waste are managed as per the infection control guidance.
Arrange diagnostic sampling for individuals meeting the inpatient definiton. Do not wait for results of local testing for other pathogens before sending samples for SARS-CoV-2 testing.
Testing should be organised through the local hospital. See how to arrange laboratory testing and the guidance for sampling and diagnostic laboratories that includes an overview of laboratory investigations and sample requirements.
Designated PHE regional laboratories, in addition to the Respiratory virus unit (RVU) Reference laboratory at PHE Colindale, are able to carry out testing. See how to arrange laboratory testing.
The local PHE Health Protection Team should be informed of cases or situations relating to contextual settings:
Laboratories performing testing must ensure that their local LIMS is set up to report daily to PHE by 7am.
In addition, any case meeting the criteria for avian influenza or MERS-CoV testing should be reported to the local HPT.
If the patient is clinically well and suitable for discharge from hospital, they can be discharged after:
appropriate clinical assessment
risk assessment of their home environment and provision of advice about staying at home
there are arrangements in place to get them home
People in hospital who are not confirmed to have COVID-19 can be discharged. Decisions about any follow-up will be on a case by case basis.
Enter relevant details on the HPZone system (using the specific topic ‘COVID-19’).
Decisions about de-escalation of IPC measures on admitted patients who will remain in hospital should be made on a case by case basis in discussion with local infection specialists.