Tasmania is promoting enhanced testing of all patients presenting with ARI, as part of an Australian wide surveillance plan. Please inform patients that their risk of having COVID-19 is low (unless they have epidemiological risk factors).
Symptomatic people should stay at home until their symptoms resolve. If symptoms resolve and patients were tested as part of the enhanced testing strategy, they do not need to stay at home until they receive their result.
Test/refer for testing patients with any of the following symptoms (even mild): fever or history of fever (eg night sweats, chills), rhinorrhoea, cough, sore throat, shortness of breath or loss of smell or taste. Also, test/refer for testing patients (including children) who have had symptoms in the last 7 days.
If you are unable to test within your clinic, please refer patients to a testing clinic: Tasmania Testing Clinics and access the Tasmanian HealthPathways referral form.
Use clinical judgment when considering retesting during the same illness if a patient’s first result is negative. Given the low probability of patients without epidemiological risk factors returning positive results, people tested as part of enhanced testing (ie without epidemiological risk factors) do not need to be re-tested. Please re-test for new episodes of ARI.
When collecting samples, oropharyngeal and bilateral deep nasal swabs are sufficient and less uncomfortable for patients than nasopharangeal swabs. See the Public Health Laboratory Network instructional sheet on COVID-19 swab collection and updated GP Info Sheet.
If specimen collection is the only procedure required (ie without clinical examination), the need for a gown/apron is based on risk assessment. A gown/apron is only needed during specimen collection if close physical contact with a symptomatic suspect case (meets epidemiological criteria) or splash/spray of body substances is anticipated. Don gloves, surgical mask and eye protection (safety glasses or face shield).
If collecting samples yourself, please provide the ‘I’ve been tested, now what?’ fact sheet
- Patients being referred for testing who are at low risk of having COVID-19 (ie not in quarantine) can now use public transport to access testing.
The ‘I’m being tested, what do I need to know?’ fact sheet has been updated.
Children under 5 years should be assessed by a GP before being tested. Callers to the Public Health Hotline seeking testing for children <5 years are encouraged to contact their GP.
For testing in residential aged care facilities (RACF)
To arrange testing of a resident in a RACF, call Sonic Healthcare (Hobart, Launceston, and North West Pathology) or COVID-19 hotline on 1800 570 573 – operating from 8:00 am – 6:00 pm.
After hours, initiate appropriate precautions and call the following morning.
Please see blow a range of information sources:
How to manage a suspect, probable or confirmed case
If the patient is not physically present in your clinic
- Discuss options for accessing testing. Instruct the patient to isolate at home while waiting to be tested.
- Emphasise the importance of physical distancing, hand hygiene cough etiquette.
If the patient is physically present in your clinic
- Provide a surgical mask for the patient to wear and ensure they put it on correctly. Instruct them to use alcohol-based hand rub and direct them to a single room. Minimise the number of staff in close contact with the patient.
- Perform hand hygiene.
- If clinical examination is required, don a surgical mask, gloves, disposable gown and eye protection as per the Personal protective equipment for contact and droplet precautions
- Proceed with clinical examination.
If you collect the sample yourself
- If specimen collection is the only procedure required (ie without clinical examination), the need for a gown/apron is based on risk assessment. A gown/apron is only needed during specimen collection if in close physical contact with a symptomatic suspect case or splash/spray of body substances is anticipated. Don gloves, surgical mask and eye protection (safety glasses or face shield).
- Collect samples through oropharyngeal and bilateral deep nasal swabs. See Public Health Laboratory Network Guidance on COVID-19 Swab Collection.
- Remove PPE safely as outlined in Personal Protective Equipment for Contact and Droplet Precautions. Place used PPE in a biohazard container and perform hand hygiene.
- Provide the fact sheet: ‘I’ve been tested, what do I need to know?’
- Provide a new facemask for the patient to wear when leaving your consultation room, to go straight home.
If you refer the patient for sample collection
- Remove PPE safely as outlined in Personal protective equipment for contact and droplet precautions. Place used PPE in a biohazard container and perform hand hygiene.
- Prepare the referral form for testing and fax it to a THS COVID-19 Testing Clinic or GP-Led Clinic; alternatively, the patient can make an appointment themselves.
- Give the patient: the fact sheets ‘I’m being tested for coronavirus, what do I need to know?’ V5 and ‘How to use facemasks safely’
- Provide three unused, packaged surgical masks for the patient to wear, to protect others:
- one to wear when leaving your consultation room to go straight home for home quarantine
- one to wear while travelling to the specimen collection centre for testing
- one to wear when returning home after specimen collection.
- Package spare masks in a zip-lock bag (eg a specimen bag) to prevent contamination.
- After the consultation, ensure contaminated and contacted surfaces are wiped with detergent then disinfectant by a person wearing PPE including gown.
- If you are moving from patient to patient, gloves must be removed and hand hygiene performed after each patient. Put new gloves on contaminated and contacted surfaces before the next patient.
- Safety glasses and face shields can be worn during consecutive patients’ specimen collections in the same location. If it is labelled as reusable, the face shield can be cleaned with a detergent/disinfectant wipe in between uses.
- Take care not to touch your mask while it is on; if the front of the mask is touched, remove and discard it, perform hand hygiene and put on a new one.
- Remember Five Moments for Hand Hygiene
- Patients tested through a Tasmanian Health Service (THS) clinic will receive negative results by text message from the THS.
- Patients tested through GP-led clinics will receive negative test results from that clinic.
- For patients you test yourself, please notify them of negative test results as per normal processes.
- Any patient who gets a positive result will be contacted, as a priority, by Public Health Services. (Where GP information is provided by the patient, the GP will also be notified of the result).
- If the test result is negative, patients can cease self-isolation unless they need to be in quarantine because:
- They are within 14 days of close contact with a confirmed case.
- They have been instructed by Public Health Services to quarantine because of potential exposure.
- They are within 14 days of arriving in Tasmania.
For testing in residential aged care facilities (RACF)
To arrange testing of a resident in a RACF, call Sonic Healthcare (Hobart, Launceston, and North West Pathology) or COVID-19 hotline on 1800 570 573 (operating from 8:00am – 6:00pm).
After hours, initiate appropriate precautions and call the following morning. Sonic Healthcare RACF COVID-19 Collection Coordinator will arrange delivery of the required number of specimen collection kits to the RACF. The kits include detailed specimen collection instructions, swabs and specimen transport bags. (For facilities that are remote from the major centres – Hobart, Launceston and Burnie – a small number of specimen collection packs [2–3 depending on the size of the facility] will be provided to be on hand to facilitate urgent testing if required.)
Collect the specimen following instructions for specimen collection in suspected COVID-19 cases, including using appropriate PPE.
Complete the pathology form with a request for ‘COVID-19, influenza and other respiratory viruses’. Write on the form that the patient meets criteria for COVID-19 testing and include the treating GP’s details.
The Sonic Healthcare RACF COVID-19 Collection Coordinator will arrange transport of specimens to the laboratory.
The results will be phoned to the referring doctor and RACF RN. If the result is positive, Public Health Services will be in contact with further advice and a specialised COVID-19 sample collection team will be sent to the RACF to collect specimens from all residents and staff.
While waiting for test results, the resident should be considered a suspect case. Follow appropriate infection prevention and control measures as outlined in the national guidelines.
Further information may be found in the Tasmanian Aged Care Toolkit
For testing in other residential care facilities
For testing in residential care facilities other than aged care, please follow site-specific protocols or call Public Health Services to discuss.
For more information and forms: visit Tasmanian HealthPathways (username: connectingcare | password: health).
For Tasmania: Coronavirus TAS and cases and testing updates.
For referral pathways/forms and general practice preparedness: visit Tasmanian HealthPathways.
For CDNA National Guidelines: (SoNG) for COVID-19 last updated 23 June 2020 with new information on retesting in low pre-test probability settings and a revised definition of COVID-19 death.
Source: Dr Julia Graham, Specialist Medical Advisor, Public Health Services.