COVID-19 Guidelines

Having a COVID-19 PCR swab test

• Self-isolate until the test result is known. .
• If positive:
  1. Self-isolate for 7days from the date of symptom onset, if mild symptoms. Return to work with no further testing needed. The PCR test is not an infectiousness test and can remain positive for some weeks after the initial infection.
  2. Please be mindful of possible false negative test results.  Perhaps we can discuss this risk before you de-isolate.
• If symptoms, especially respiratory symptoms deteriorate, do not wait for the test result which may take a few days.  Contact your treating doctor.
• Use Paracetamol 1g 6-hourly if not contraindicated for fever and discomfort.  Avoid over-the-counter ‘flu medications and use non-steroidal anti-inflammatories sparingly.
• Use only under the supervision of your treating doctor:  corticosteroids such as prednisone, Plaquenil (hydroxychloroquine) and/or Zithromax.
• Continue with your Vitamin D, C, Niacin, Zinc and other supplements.
• Deteriorating respiratory symptoms: Please let me (or your treating doctor) know in the unlikely event if you have meaningful deterioration in your symptoms – especially the respiratory symptoms (progressive persistent cough/and or shortness of breath/deteriorating oximeter to 94% or less). There are some blood tests that are helpful to predict admission risk for oxygen and anticoagulation. This may happen after about a week of onset of symptoms https://www.health.state.mn.us/diseases/coronavirus/pulseoximeter.html.In the case of concern at night, Casualty would assess if admission is required, in consultation with a specialist. Whilst waiting for results, supportive care such as oxygen and IV fluids would ne given.

Note the “close contact” definitions below, where the risk of transmission is higher.

Isolation and quarantine

For guidelines on quarantine or isolating at home, see the following:

• Government Regulations communicated on 31st January 2022 require only symptomatic Covid-19 patients to isolate for 7 days from the onset of their symptoms.
• https://www.dailymaverick.co.za/article/2020-07-28-how-long-should-i-isolate-or-quarantine-for/#gsc.tab=0.

If you cannot quarantine/self-isolate successfully at home, contact the NICD Hotline to arrange alternative accommodation.

Test procedure

• After consulting with me, I will send you an e-mail that will detail my practice and laboratory reference numbers to enable you to complete the laboratory referral form of your choice.
• You can complete the laboratory forms online or hardcopy.  If you are having difficulty with the forms, call me.  
• Call for an appointment at your choice of local laboratory
• Remember to at least wear a surgical mask when you go.
• Please use a photo of this email or the DrConnect App notes as a referral letter. 
• Call me if you are having difficulty at the point of care.

Some of laboratories testing for COVID-19

• AMPATH https://www.ampath.co.za/covid-19-collection-sites. Forms at https://www.ampath.co.za/pdfs/coming-in-for-a-test.pdf.

• LANCET  http://www.lancet.co.za/corona-virus-info-hub/. forms at PDF Download https://lancet.co.ke/wp-content/uploads/2020/04/New-Request-Form-For-COVID-19-Testing.pdf

• PATHCARE https://www.pathcare.co.za/locate-a-depot/. Forms at https://u7w5u8q9.stackpathcdn.com/wp-content/uploads/2020/05/Corona-virus-testing-request_Fillable.pdf

Definition of close contact for the purpose of the case definition

Close contact of a probable or confirmed case is defined as:

• A person living in the same household as a COVID-19 case;
• A person having had direct physical contact with a COVID-19 case (e.g. shaking hands);
• A person having unprotected direct contact with infectious secretions of a COVID-19 case (e.g. being coughed on, touching used paper tissues with a bare hand);
• A person having had face-to-face contact with a COVID-19 case within 2 meters and > 15 minutes;
• A person who was in a closed environment (e.g. classroom, meeting room, hospital waiting room, etc.) with a COVID-19 case for 15 minutes or more and at a distance of less than 2 meters;
• A healthcare worker (HCW) or other person providing direct care for a COVID-19 case, or laboratory workers handling specimens from a COVID-19 case without recommended personal protective equipment (PPE) or with a possible breach of PPE;
• A contact in an aircraft sitting within two seats (in any direction) of the COVID-19 case, travel companions or persons providing care, and crew members serving in the section of the aircraft where the index case was seated (if severity of symptoms or movement of the case indicate more extensive exposure, passengers seated in the entire section or all passengers on the aircraft may be considered close contacts).

The epidemiological link to a probable or confirmed case may have occurred within a 14‐day period before the onset of illness in the suspected case under consideration.

SOURCE: European Centre for Disease Prevention and Control