Coronavirus disease (COVID-19): Update #13

In South Australia testing for COVID-19 is recommended in people who satisfy any of A, B, or C

A.If the patient satisfies epidemiological AND clinical criteria, they are classified as a suspect case. Epidemiological criteria: at least one of the following:

• International travel in the 14 days before the onset of illness OR
• Contact in the 14 days before illness onset with a confirmed case of COVID-19 OR
• Interstate travel in the week before the onset of illness  Clinical criteria: at least one of the following
• Fever (≥38°C) § or history of fever (e.g. night sweats, chills) OR  Acute respiratory infection (e.g. shortness of breath, cough, sore throat) with or without fever
• See CDNA National Guidelines for contact definition

B. If the patient has bilateral community-acquired pneumonia (critically ill)* and no other cause is identified, with or without recent international travel, they are classified as a suspect case.

C. If any healthcare worker (HCW) with direct patient contact has:

• Fever (≥38°C) § or history of fever (e.g. night sweats, chills) AND
• Acute respiratory infection (e.g. shortness of breath, cough, sore throat) § Measured using a tympanic, oral or other thermometer proven to consistently and accurately represent core body temperature *Requiring care in ICU/HDU, OR respiratory/multi-organ failure. Use clinical judgement re the likelihood of COVID-19.

General recommendations

• Travellers who have recently returned from overseas (including transit): mainland China, Iran, South Korea, Italy (on or after 11 March), and all other countries (on or after 16 March); and close contacts of a confirmed case, must be isolated for 14 days from departure/last contact irrespective of test results.
• Healthcare workers/staff with close patient contact who have returned from Italy who do not meet the isolation requirements above should be advised not to undertake work in a health care or residential/aged care facility for 14 days since leaving Italy.
• HCW with an influenza-like illness should not work while symptomatic. In addition, if a HCW meets the case definition above the HCW should be tested and isolated whilst awaiting result

Medical practitioners are advised to:

• Test for SARS-CoV-2 in anyone meeting the suspected case definition above.
• Isolate patients who have been tested pending results.
• Refer to earlier Public Health Alert of 26 February 2020 for further details of PPE, infection control and specimen collection
• Follow the updated Infection Control Guidelines Flowchart
• Send specimens to SA Pathology. Request respiratory viruses including COVID-19.
• Do not send patients to a general pathology collection centre.
• Do not test patients for ‘medical clearance’ certificates for schools or workplaces.
• Notify suspected and confirmed cases by phone to CDCB on 1300 232 272.
• See the Australian Government Department for Health for further information
• See the SA Health website for information on
  • COVID-19 Clinics and Testing Centres
  • SA specific information