Updated Covid-19 testing policy

Every inpatient should now additionally be tested for Covid-19 at day 3 of admission. This is in line with new NHS England guidance.

In summary, Covid-19 swabs are required on admission, day 3 and day 7 for all inpatients. Pre-admission swabs are required for elective patients.

Routine swabs (pre-admission, day 3 and day 7) should be sent to the PHE lab (order: 2019 nCoV PHE).

SAMBA POC swabs (order: 2019 nCoV POC) are reserved for urgent cases (symptomatic inpatients or on admission).

There is no need to swab a patient at day 3 or day 7 if a prior swab is positive.

To help with prioritisation of samples and in line with new national criteria, please see below for updated guidance on the Covid-19 patient antigen testing facilities to be used for different patient cohorts. This has been developed by the Trust’s testing taskforce.

Pre-procedure swabbing criteria:

  • Overnight stay or high likelihood of overnight stay;
  • National guidance to test;
  • Involves general anaesthetic;
  • Involves aerosol generating procedure; or
  • Independent sector and/ or location of procedure mandated.

For PHE testing order test: LAB8112 2019 NCOV (CORONAVIRUS), PHE

Sample labels will be prefixed MI.

Collection swabs and transport vials will vary.

Samples need to be sent to the PHE laboratory on level 6 of the Pathology block.

Point of care (POCT) testing:-

*Clinically high risk patient groups:

• Non-elective maternity patients.
• Patients who have received an organ transplant and remain on ongoing immunosuppression medication.
• Patients with cancer who are undergoing active chemotherapy or radiotherapy.
• Patients with cancers of the blood or bone marrow such as leukaemia who are at any stage of treatment.
• Patients with severe chest conditions such as cystic fibrosis or severe asthma (requiring hospital admissions or courses of steroid tablets).
• Patients with severe diseases of body systems, such as severe kidney disease requiring dialysis.
• Other immunocompromised patients.
• Elective patients whose test result has not been returned by the day of their surgery
• Patients for whom a short notice care package becomes available
• Children being admitted to Paediatric wards
• Patients requiring admission to Critical Care
• ED Patients requiring same day emergency surgery
• Minimal notice transplant retrieval (follow agreed protocol)

Please note:
1) The use of POCT testing for elective patients is only for exceptional cases where a result has not been returned or there has been an error with the swab. As per the above, elective patients should have a swab taken 3 days before admission and processed via PHE.

2) During outbreak management the Virologist on-call, could determine that POCT testing is used if a faster TAT is warranted.

3) Samples failing to meet the criteria above or are inadequately labelled will be rejected.

For POCT testing order test: LAB8125 – 2019 nCOV (Coronavirus), POC

Sample labels will be prefixed PC.
Only SAMBA swabs and vials can be used for POCT testing
Samples need to be sent to the SAMBA facility outside of ward N3.

SAMBA escalation – To escalate issues with SAMBA testing contact the Operations centre

Download PCR Patient testing overview flowchart

Covid testing incidents are reported to Brian Warner as the responsible manager.

Labelling specimen bags for Point of Care Testing (SAMBA II) facility

As per the above guidance, specimen bags for point of care testing are
required to be labelled to indicate the appropriate patient cohort. Please
label bags as one of the following:

  • “Symptomatic”
  • “Asymptomatic – High”
  • “Asymptomatic – Standard”

Antibody testing for patients

A new method for measuring antibodies against SARS CoV2 in our patients has gone live in our hospitals. This high throughput test will allow us meet the demands of the national antibody testing programme.

The assay measures antibodies against a SARS-CoV2 surface protein (Spike protein) and detects specific IgG, IGM and IgA.

The request name is SARS Co-V2 total antibody and the associated clinical comments should guide your understanding of the result.

A positive test result for antibodies correlates with previous exposure to SARS CoV2. There is currently no evidence to show that it means someone cannot be re-infected or that they have protective immunity. All current PPE/infection control measures must be followed irrespective of the presence or absence of antibodies.