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Viral Testing

B.C. is conducting COVID-19 diagnostic testing for patients who need it with compatible symptoms, however mild.

Last updated: September 17, 2020 8:15 AM


Testing and laboratory guidance

Who to test

Testing individuals with new symptoms compatible with COVID-19. 

The symptoms most commonly found with COVID-19 infection include:

  • Fever (see below)
  • Chills
  • Cough or exacerbation of chronic cough
  • Shortness of breath
  • Sore throat
  • Runny nose
  • Loss of sense of smell or taste
  • Headache
  • Fatigue
  • Diarrhea
  • Loss of appetite
  • Nausea and vomiting
  • Muscle aches
If symptoms are consistent with a previously diagnosed health condition and are not unusual for that individual, testing may not be required

Less common symptoms of COVID-19 infection include stuffy nose, conjunctivitis (pink eye), dizziness, confusion, abdominal pain, and skin rashes or discoloration of fingers or toes. Children who are suspected of having multisystem inflammatory syndrome (MIS-C) should also be tested. 

For pediatric populations: COVID-19 illness causes mild illness in the majority of cases in children. Children have similar symptoms to adults, but are less likely to have fever, shortness of breath or cough. Signs and symptoms of COVID-19 in children may be similar to those of other childhood illnesses. Infants less than three months of age who are febrile or have suspect COVID-19 should be assessed by a health care provider.

Clinical judgement remains important in the differential diagnosis and work-up of individuals presenting with these symptoms (e.g., people with allergies). For more information on the diagnosis and management of COVID-19 infection, please refer to the clinical guidelines

Testing is particularly important for some individuals who are: 

  • Residents and staff of long-term care facilities
  • Requiring admission to hospital or likely to be admitted, such as pregnant individuals near-term, patients on hemodialysis, or cancer patients receiving radiation or chemotherapy.
  • Children who have a chronic medical condition, or are immunocompromised due to medication or treatment
  • Children who live with someone at risk of severe disease from COVID-19 infection (e.g., elderly, chronic conditions)
  • Healthcare workers
  • Contacts of a known case of COVID-19
  • Travellers who in the past 14 days returned to B.C. from outside Canada, or from an area with higher infection rates within Canada
  • Residents of remote, isolated, or Indigenous communities
  • Attending child care, school, camp or other congregate setting
  • Living in congregate settings such as work-camps, correctional facilities, shelters, group homes, assisted living and seniors’ residences
  • Homeless or have unstable housing
  • Essential service providers, such as first responders

Find a collection centre for patients to be assessed and tested

Individuals with symptoms can find a collection centre where they can be assessed and tested by:

Medical Health Officers may recommend testing as part of public health investigations.

COVID-19 testing is not recommended for asymptomatic individuals in B.C.


  • Testing of asymptomatic individuals is only recommended for use in public health investigations of a case, cluster or outbreak, and under the direction of a Medical Health Officer.
  • B.C. does not recommend routine COVID-19 screening of asymptomatic people in schools, prior to surgery or other procedures, in hospitals or health care settings, as a condition of employment or for travel. Read the letter from the Provincial Health Officer on testing prior to travel in B.C.
  • This recommendation may differ from that of other provinces or countries, and other national or international health professional societies.
  • B.C.’s recommendation is based on current provincial and local epidemiology, the expected yield of screening tests, resource implications, and known limitations of COVID-19 NAT testing.
  • Read the information for Health Care Providers on Testing Asymptomatic Individuals for COVID-19.

There are some private pay clinics that offer testing for a fee to people who require asymptomatic testing for reasons that fall outside of B.C. public health recommendations, as outlined in the testing guidelines, such as for travel or employment.

Please contact these clinics directly to learn more and to arrange for this testing.


Specimen collection


Personal protective equipment 

Use contact and droplet precautions with a surgical mask and eye protection when collecting a nasopharyngeal or throat swab or sputum. A N95 respirator is recommended for aerosolizing procedures. For more information, visit the page on personal protective equipment.


For adults and older youth

Collect a Nasopharyngeal (NP) Swab using the instructions provided in this video “How to perform a nasopharyngeal swab”.  Note the instructions for donning and doffing of personal protective equipment (PPE). 
 


Use the swab/collection device provided by your institution. The following swabs are currently validated and are available for use in B.C.:
  • YOCON Virus Sampling Kit
  • VWR Starplex Multitrans Collection Kit
  • Roche cobas™ PCR Dual Swab Sample Kit† 
  • Columbia Plastics Swab Kit
  • Copan swab with red top tube*
  •  Hologic Aptima Unisex Swab Specimen Collection Kit**
† These swabs have limited availability.
* These swabs are currently restricted to pediatric collections
** DO NOT use the orange packaged Hologic Aptima Multitest swabs for NP collection

For hospitalized patients and/or patients with evidence of lower respiratory tract disease, collect a lower respiratory tract sample (e.g., sputum, endotracheal aspirate, bronchoalveolar lavage, etc.) in a sterile screw-top container in addition to a nasopharyngeal swab.

** Use with care when inserting into the nasopharyngeal cavity, as these swabs may cause mild trauma.  Gently insert only as far as possible, and avoid forcing against resistance.  Inserting approximately 2-3 cm will allow swabbing of the mid-turbinate area. In this case, swab bilateral mid-turbinates using a single swab to optimize sampling quality.

 

Nasopharyngeal (NP) Swab Specimen Collection 

When testing is offered to children of any age, please ensure the tester is appropriately trained to perform the nasopharyngeal swab (NP) safely, and there are adequate supports available.


Collect a nasopharyngeal (NP) swab according to the procedure described in the Appendix A of the pediatric testing guidelines

Use the swab/collection device provided by your institution. The following swabs are currently validated for use in nasopharyngeal specimen collection in infants and young children in B.C.: 

  • Copan™ minitip swab with 2mL red top tube
  • BD™ minitip swab with 3ml red top tube 
  • Roche cobas™ PCR Dual Swab Sample Kit† 
† These swabs have limited availability.

For children >6 years of age, Yocon virus sampling kit is generally appropriate. 

Saline Gargle Specimen Collection 

Saline (salt water) gargle is an approved alternative to NP swab collection for outpatient, school-aged children and youth (grades K – 12) who are able to follow instructions on how to swish, gargle and spit a small amount of saline. Most children 5 years of age and older are able to provide a saline gargle sample with some guidance. 

For school-aged children, collect a saline gargle sample according to the procedure described in Appendix B of the pediatric testing guidelines

Please ensure that the child has not eaten, had anything to drink, smoked, used a vape or chewed gum for one hour before sample collection.

Use the collection device and saline provided by your institution. The collection system is sterile and consists of a funnel attached to a 10mL collection tube with cap and 5mL of sterile saline.


For hospitalized patients and/or patients with evidence of lower respiratory tract disease, collect a lower respiratory tract sample (e.g., sputum, endotracheal aspirate, bronchoalveolar lavage, etc.) if feasible in a screw-top sterile container in addition to a nasopharyngeal swab.

 

Labelling

All specimens (cylindrical tube) must have an attached label with: 
  • Patient name 
  • PHN or Date of Birth (DOB) 
  • Specimen type (e.g., NP swab) 
  • Date & time of collection 
Please add one of the following codes to the specimen label:

  • HCW1 – Health Care Worker – Direct Care
    • Essential service providers (incl. first responders)
  • HCW2 – Health Care Worker – Non Direct Care
  • LTC – Long Term Care Facility
  • OBK – Outbreaks, clusters or case contacts
    • Including people who are homeless or have unstable housing
  • HOS – Hospital (Inpatient)
    • Emergency Department (with intent to admit)
    • Symptomatic pregnant woman in their 3rd trimester
    • Renal patients
    • Cancer patients receiving treatment
  • CMM – Community
    • Community or Outpatient, including Urgent and Primary Care Centres
  • CGT – People living in congregate settings such as work-camps, correctional facilities, shelters, group homes, assisted living and seniors’ residences.
  • TREEPL – Tree planters
  • SCHOOL – People attending school in-person including students, teachers and support staff

COVID-19 testing and self-collected specimens

The interim guidelines describe an overall provincial approach for supporting self-collection of specimens for COVID-19 diagnosis in settings without accessible health services.


Self-collection is not broadly available at this time, and self-collection kits can only be ordered through an initial project phase in partnership with Northern Health and some remote work camp settings in the Northern and Interior regions. More information on the use of self-collection can be found here.

Patient hand out: Self-isolation while waiting for results

People who have been tested for COVID-19 are required to self-isolate while they wait for results. A handout for patients who have been tested is available.

Testing time

Tests are run multiple times throughout the day in laboratories across B.C. Testing time varies depending on testing location.  Patients who test positive will be contacted by Public Health.
Patients can get their negative results by phone, text or online. More information is available on the
test results page. 

Understanding COVID-19 tests and interpreting results

  • FAQ for health providers explaining how the test works, what the test results mean, reasons for false negative results, the levels of virus shedding, and the sensitivity of the test.

Outpatient management

Guidance for patients with a confirmed cases of COVID-19 that can be managed at home is available on the outpatient management page.

Guidance for caring for children with a confirmed case of COVID-19 can be found on the Pediatrics page.

Changes to testing guidelines over time

While COVID-19 testing was originally centralized at the BC Public Health Laboratory (BCPHL), testing capacity expanded to other B.C. laboratories over time.

SOURCE: Viral Testing ( )
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