Coronavirus Q&A – Testing

Does Wales have a plan for testing?

Our national testing plan has two main aims – to reduce the harm caused by coronavirus and to help the public and professionals get back to their normal daily lives.

Who is being tested?

Wales started testing people on January 29, as they returned from countries where coronavirus was circulating.
The Chief Medical Officer for Wales introduced guidance for testing in Wales on March 18, which set out who should be tested.
People admitted to hospital with certain symptoms – evidence of pneumonia or acute respiratory distress syndrome or flu-like illness and one of the following symptoms: a persistent cough hoarseness, nasal discharge or congestion, shortness of breath, sore throat, wheezing, sneezing – should be tested.
It also stated that NHS staff with symptoms should be tested, to enable them to return to work if they test negative.
An updated policy, which extends testing to all critical workers was published on 18 April. Critical workers fall into the following categories: o Health and social care workers o Public safety (emergency workers) and national security workers o Local and national government workers o Education and childcare workers o Food and other necessary goods o Transport o Utilities, communication and financial services workers o Key public service workers
These critical workers will only need to be tested if they, or a member of their immediate family, have symptoms of coronavirus – a high temperature (38C or above), a persistent cough or shortness of breath.
From 22 April, we have been testing everyone in care homes with symptoms of coronavirus. A new testing and discharge pathway has been developed for people leaving hospital to go into a care home during the coronavirus pandemic – all those with a positive coronavirus test result or those who have symptoms will be discharged to appropriate step-down care. They will have a further test before they are discharged from step-down care to confirm they do not have coronavirus before returning to their care homes.
April 30, 2020

How do critical workers access tests?

Critical workers with symptoms should be referred for testing by their employer (using local referral arrangements) for an appointment to be tested. The test will be carried out at one of regional drive-through centres or at a community testing unit.

Online booking is available for employers of critical workers in South East Wales to book a test at the Cardiff and Newport drive-through centres.
More information is available at https://gov.wales/coronavirus-covid-19-testing-process-html

How many tests can Wales do a day?

The current daily capacity (as of April 30) is 2,100 but we are working hard to increase that number and to make sure all available tests are being taken up.
Although we currently have enough capacity to meet demand, we want to be able to test more critical workers – and categories of critical workers – to enable them to return to work. We are doing everything we can to increase the numbers of tests available and to simplify the system.

Why hasn’t testing capacity increased faster in Wales?

The measures we have introduced to control the spread of coronavirus have helped to slow the spread of the virus, which mean we do not need as many tests as we had originally planned.
However, we will need to continue to increase capacity as we move to the recovery phase – as we lift restrictions we need a comprehensive testing plan in place in place as part of our public health response so we can swiftly identify and trace new coronavirus hotspots.

Our testing capability is currently 2,100 tests a day and we will continue to increase this.
Four drive-through centres are available in Wales – in Newport, Cardiff, Carmarthen and Llandudno – community testing centres are available throughout Wales and a home testing kit is being developed for those who cannot easily access drive-through centres. From next week, eight mobile swab units will be in place across Wales to support local arrangements and to make immediate testing available in areas where it is most needed.

When will capacity increase in Wales?

We publish an update about testing twice a week – this includes information about capacity, tests performed and positive results.
We published our critical worker testing plan on April 18.

Testing capacity is increasing every week in Wales.

Why aren’t we testing the same people as England is?

Our testing policy is based on scientific evidence and we test people with symptoms in the following priority areas:

 People admitted to hospitals with suspected coronavirus
April 30, 2020

 Frontline NHS and social care staff

 Care home residents

 Other critical workers

We use our testing capacity in hospitals and care homes to support diagnosis and the effective treatment of coronavirus. For critical workers, testing is being used to ensure the services we all rely on are able to continue.

Why aren’t we using the English web-based booking system?

In Wales, we have introduced a tailored testing strategy, which takes account of Wales’ devolved health system.

 We use a dry swab test, which was developed in Wales, instead of wet nasal and throat swabs used in England;

 These tests use a single swab which the person performs themselves inside their car – if they are using a drive-through centre. This means a healthcare worker is not exposed to a potentially symptomatic person when the test is being carried out.

 Wales’ swabs are analysed by Welsh laboratories ensuring clinical data is held in local clinical systems. This ensures Wales remains in control of its own clinical data;

 This also allows the test and the result to be integrated with NHS clinical systems, such as the Welsh Clinical Portal and a person’s individual health record.

 This Welsh data will be particularly important as testing is scaled up for the recovery phase.

Why aren’t we testing everyone in care homes?

We are testing all care home staff and residents when they show symptoms of coronavirus.

We are testing anybody who is discharged from hospital to a care home, admitted to a care home or transferred from one home to another.

We are learning more about coronavirus every day – the evidence is constantly changing and emerging and we keep it under constant review.

Testing can only ever provide a picture of the level of coronavirus at any moment in time. It cannot yet tell us about immunity or who will develop the virus in the hours or days ahead. We do not fully understand the accuracy of testing on people who do not have symptoms.

We do know that people who have had the virus can still play a role in transmission as we know that transmission is largely through touch. So touching one surface and then another without washing your hands can spread the virus from one place to another.

On this basis, our approach has been and continues to be to support care homes to introduce as far as possible safe ways of working that recognise the fact that any worker or resident can transfer the infection at any point.

Local authorities, health boards and Public Health Wales are working together to provide rapid support to care homes wherever there is an outbreak or coronavirus. The nature of this advice and support is under constant review and we are examining it to see if this can be strengthened or improved.

How many tests do we need every day when we start to lift restrictions?

We will need to continue to increase capacity as we move to the recovery phase – as we lift restrictions we need a comprehensive testing plan as part of our public health response so we can swiftly identify and trace new coronavirus hotspots.

Public Health Wales has drafted a public health response plan, which is currently being shared with local authorities for comment and consultation, this includes ideas for testing and contact tracing.

How do you test for coronavirus?

Because infected people may have anything from mild respiratory symptoms to severe pneumonia, the only way to confirm someone has coronavirus is to test them.
There is currently one type of test in regular use in Wales – the antigen (swab) test. This is used to test whether someone admitted to hospital with symptoms has coronavirus. It is also used to see whether a frontline NHS professional may have coronavirus. Wales has been routinely testing NHS staff involved in patient care since March 18.
Antigen testing involves taking a swab of the throat. It looks for the presence of the genetic signature of the virus. The test is performed in a laboratory.
Another type of test is possible – this is the antibody test. This tests a drop of the blood to see whether someone has been exposed to coronavirus infection and has developed antibodies – has some immunity to the virus.

This test is also performed in the laboratory but it can be adapted into a testing format for community use.

At the moment, the antibody test is not available for widespread use in the UK – work is ongoing to verify the reliability and effectiveness of the test. It is hoped an effective form of the antibody test will be confirmed, which can be used in the community to track the progression of coronavirus.

Once the antibody test has been validated, it will be available for use in Wales.

I think I’ve got coronavirus – should I have a test?

The symptoms of coronavirus are a high temperature and a new, persistent cough. If you think you might have coronavirus, do not call 111 or go to a hospital or your local GP surgery because you could infect other people.

You should stay at home for seven days if you have symptoms. If you live with someone who has symptoms but you are well, you should self-isolate for 14 days.
If you feel you cannot cope with your symptoms at home or if your condition gets worse, or your symptoms do not get better after seven days, use the 111 online coronavirus service. If you do not have internet access, call 111.

In a medical emergency, dial 999.

Testing will only be carried out for people who are admitted to hospital with symptoms or critical workers with symptoms as set out here
Where can I get the latest data about tests?

Public Health Wales launched an interactive dashboard with the latest data relating to coronavirus in Wales.