Asymptomatic staff testing
Staff should conduct 2 LFD tests per week, taking them before they begin work, spaced 3 to 4 days apart.
NOTE: There is no longer a requirement for routine testing of asymptomatic residents
Symptomatic testing for staff and residents
If an individual experiences any of the main symptoms of coronavirus (COVID-19), they should immediately take a lateral flow device (LFD) test as soon as they develop symptoms and take another LFD test 48 hours after the first test.
Symptomatic staff should stay away from work and conduct the LFD tests as highlighted above at home. Staff can come into work if both LFD test results are negative and medically fit to do so.
Symptomatic residents (in extra care settings, supported living settings, and care homes) should be isolated immediately and tested, as highlighted above, with LFDs. As far as possible, residents should be offered the choice to either self-administer the tests or to have the tests administered by a suitable member of staff. Residents can stop self-isolating if both LFD tests are negative.
Rapid response testing in care homes and high-risk extra care and supported living
If an individual (staff or resident) receives a positive result (from any test) in a care home, adult day care centre, or high-risk extra care and supported living setting, then all staff should conduct daily rapid LFD testing every day that they are working, for 5 days. Only the staff working in the setting over the rapid response testing period need to be tested; those not working during this period do not need to be tested. You should not bring people into work to get tested on their non-working days.
Outbreak testing in care homes
An outbreak consists of 2, or more, positive (or clinically suspected) linked cases of COVID-19 that occur in the same setting within a 14-day period. This applies to both staff and residents, and includes PCR and LFD results.
If the setting is advised by UKHSA/SWHPT to initiate whole home outbreak testing, all staff and residents should conduct both an LFD test and a PCR test on day 1 of the outbreak and another LFD test and PCR test between days 4 and 7. The LFD test will allow you to identify and isolate the most infectious cases immediately whilst awaiting PCR results, therefore reducing the risk of the virus spreading. If either test is positive, it is highly likely that the individual has COVID-19.
After the first week of outbreak testing has been completed, staff should continue regular twice-weekly asymptomatic LFD testing. Once there have been at least 10 days with no new COVID-19 cases or newly symptomatic individuals, outbreak recovery testing should be undertaken
Outbreak recovery testing
For outbreak recovery testing, all staff and residents (who have not tested positive in the last 90 days) should be tested with a PCR test, no earlier than 10 days after the last resident or staff member had a positive test result or showed COVID-19 symptoms.
If there are no positive PCR results from outbreak recovery testing, the HPT will advise that outbreak restrictions can be lifted and the normal regular staff testing pattern should be followed.
If there are further positive results from outbreak recovery testing, then the HPT may advise that outbreak restrictions should continue until no further positives are found before advising that the outbreak has ended. If there are 2 or more positive cases after outbreak recovery testing, this should be classed as a new potential outbreak and the care home must contact the HPT.
[SW Health Protection, UK Health Security Agency, firstname.lastname@example.org, Tel: 0300 303 8162]