COVID-19 testing and case definition

COVID-19 testing and case definition

Test all cases that meet the case definition for COVID-19 and advise any suspected cases to isolate until results can be provided. Only if clinical deterioration occurs, should patients call 000 or attend an emergency department.

For a full suite of COVID-19 clinical resources - including assessment and management, referrals and referral advice - visit Murray HealthPathways. Note you must be registered and logged in to view. Health professionals in our region can request free access here.

Patient assessment advice for clinicians

As at 21 December, Clinicians should be asking patients if they are from or if they have been in New South Wales and if so, to check the areas of risk defined by the NSW Government and recommended actions.

If you have a patient who meets the testing criteria, you need to:

  • Separate from other patients.
  • Place single-use surgical mask on the patient.
  • Use droplet and contact precautions (gown, gloves, eye protection and single-use face mask) when assessing the patient.
  • Conduct a medical assessment, and focus on:
    - History of contact with sick people or confirmed COVID-19 cases
    - Travel history, occupation and/or residence in high risk settings
    - The date of onset of illness and especially whether there are symptoms or signs of pneumonia. If the patient has symptoms and signs suggestive of pneumonia, viral load might be higher. These patients should be tested and treated in hospital. If clinically required, ambulance transport should be used - advise 000 operator of suspected COVID-19.

Testing resources:

Victorian testing criteria (as of 31 August 2020)

  • Fever OR chills in the absence of an alternative diagnosis that explains the clinical presentation* OR
  • Acute respiratory infection (e.g. cough, sore throat, shortness of breath, runny nose, loss or change in sense of smell or taste).**

*Clinical discretion applies; consider potential for co-infection (e.g. SARS-CoV-2 and influenza).

** Older people may present with other atypical symptoms including functional decline, delirium, exacerbation of underlying chronic condition, falls, loss of appetite, malaise, nausea, diarrhoea and myalgia.

Additional testing note
People who are at higher risk of infection due to their environmental exposure should also be tested if they have new onset of other clinical symptoms associated with COVID-19 e.g. headache, myalgia, stuffy nose, nausea, vomiting, diarrhoea AND meet the following epidemiological criteria:

  • Close contacts of a confirmed case of coronavirus (COVID-19).
  • Returned overseas travel in the past 14 days.
  • Health care or aged care workers.
  • Residents of an aged care facility or older people in the community

Case definition: confirmed case

  • A person who tests positive to a validated SARS-CoV-2 nucleic acid test OR
  • has the virus isolated in cell culture, with PCR confirmation using a validated method OR
  • undergoes a seroconversion to or has a significant rise in SARS-CoV-2 neutralising or IgG antibody level (i.e. four-fold or greater rise in titre)

Note: A new temporary MBS item 69501 commenced 28 July for bulk-billed pathology testing for asymptomatic staff of Victorian residential and in-home aged care service providers. On 3 August, it was expanded to workers required to travel interstate as a driver of a heavy vehicle. From 22 September, it was further expanded to apply to interstate rail crew members: factsheet for MBS item 69501.

GPs in Bendigo and Loddon Mallee who have a patient who tests positive can contact the Public Health Unit Bendigo and Loddon Mallee 1800 959 400 to initiate contact tracing.

Probable case
A person who has detection of SARS-CoV-2 neutralising or IgG antibody AND has had a compatible clinical illness AND meets one or more of the epidemiological criteria outlined in the additional testing note above.

Only confirmed and probable cases need to be notified to the department. Notify the department of confirmed cases as soon as practicable by calling 1300 651 160, 24 hours a day.

For full details on the assessment and testing criteria for COVID-19 click here.

Notify COVID-19 cases online
Medical practitioners can now notify the department of a confirmed diagnosis of COVID-19 online or by phone. The online form is available on the DHHS website and the Health.vic website. If phone notifications are preferred, practitioners can call the 1300 651 160 hotline.

NSW testing criteria (as of 17 December 2020)

Symptoms of COVID-19 include fever (≥37.5), cough, sore throat, shortness of breath (difficulty breathing), runny nose, loss of smell and loss of taste.

Other reported symptoms of COVID-19 include fatigue, muscle pain, joint pain, diarrhoea, nausea/vomiting and loss of appetite. In more severe cases, infection can cause pneumonia with severe acute respiratory distress.

Unexplained chest pain and conjunctivitis have also been reported as symptoms of COVID-19.

If these symptoms present in the absence of any clinical focus of infection or alternate explanation of illness, they may indicate infection with COVID-19.

**NSW Health recommends that anyone with at least one respiratory symptom, loss of sense of smell or taste, or unexplained fever should be tested for COVID-19.

This is especially important for:

  • anyone who lives or works in a high risk setting, including healthcare facilities, aged care and other residential facilities, schools, prisons, and other closed settings
  • Aboriginal and Torres Strait Islander people
  • people who are close contacts of a confirmed case
  • people who have returned from overseas in the last 14 days
  • anyone admitted to hospital

Please make sure any health care, aged care or disability support workers or residents are noted on the laboratory request form so their test can be prioritised.

Routine tests for acute pneumonia/pneumonitis should also be performed where indicated according to local protocols.

Click here for more information on testing.