Testing Patients

Please note that as things change rapidly, Q&As and guidelines will be updated. Review this website often to ensure you have the most up to date information or consult your leader if you have concerns or identify discrepancies.

Should patients come to the hospital for testing?  

COVID-19 testing for British Columbians is available at hospitals and outpatient collection sites. For COVID-19 testing locations, as well as additional information and helpful links, please click here.

Please only visit an emergency department if you are experiencing health conditions that require urgent and emergency care.

Who should be tested for COVID-19? 

On December 17, 2020, updated BC testing guidelines were released for people with no known COVID-19 close contacts and who have new or worsening symptoms:

Recommend testing if any ONE of the following symptoms more predictive or strongly associated with COVID-19 are reported.

  • Fever or chills
  • Cough (either new onset or worsening/exacerbation of chronic cough)
  • Loss of sense of smell or taste
  • Difficulty breathing

Recommend testing if any TWO or more of the following general symptoms persist after 24 hours, and are not related to any other pre-existing conditions.

  • Sore throat
  • Loss of appetite
  • Extreme fatigue or tiredness
  • Headache
  • Body aches
  • Nausea, vomiting or diarrhea

For those who have had close contact with a COVID-19 case, and have even a single symptom included above, testing is recommended.

For further details regarding the indications for testing of people who are not hospitalized, please refer to the updated Adult & Pediatric Viral Testing Guidelines for British Columbia.

Note that the updated testing guidelines are intended for people not in hospital, and clinical judgement/assessment is necessary for consideration of COVID-19 testing in admitted patients or healthcare workers.

Consider a lower testing threshold for symptomatic individuals who:

  • Are residents or staff of long-term care facilities
  • Require admission to hospital or are likely to be admitted
  • Are healthcare workers
  • Are travellers who in the past 14 days returned to BC from outside Canada, or from an area with higher infection rates within Canada
  • Are residents of remote, isolated, or Indigenous communities
  • Live in congregate settings such as work-camps, correctional facilities, shelters, group homes, assisted living and seniors’ residences
  • Are homeless or have unstable housing
  • Are essential service providers, such as first responders.
  • Have a chronic medical condition, are at risk for severe illness, or are immunocompromised due to medication or treatment
  • Live with someone at risk of severe disease from COVID-19 infection (e.g., elderly, chronic conditions) 
Who should not be tested for COVID-19?

If an individual has no symptoms, even if they are a contact of a confirmed case or a returning traveller and self-isolating at home, they do not require a test. Physicians or nurse practitioners may also decide that a person with symptoms that can be managed at home does not need to be tested. Please refer to the clinical guidance for outpatient management.

Please advise patients, with or without a history of travel, who have respiratory symptoms that can be managed at home, to isolate at home for a minimum of 10 days after onset of their symptoms or at least 14 days for travellers returning to Canada. More information for patients is available on the If you are sick page.

How do we order a test for COVID-19?  

For those individuals where testing for COVID-19 is clinically indicated and it is safe for them to go home, please ask them to stay at home and avoid contact with others (self-isolate) until they get their results. Please distribute this information to them before they leave.

How do I order COVID-19 testing?
Order COVID-19 NP swab on Cerner. If other testing is indicated (e.g. - Influenza), order separately. More updated information can be found here.

What is the expected turn-around-time?
Expected turn-around-time is within 24 hours.  Large batches of specimens are run and reported almost continuously, seven a week.

Where can I view the results for my patient?
COVID-19 results are reported in Cerner and CareConnect:

How do I know if the COVID-19 results are still pending?
In Cerner, pending tests are not displayed in the ‘Results Review’ tab.  The ‘Orders’ tab must be viewed to determine which laboratory tests are still “In Process”:

In CareConnect, the ‘Test Status’ is displayed under the ‘Labs’ tab.

What samples to collect?
In the outpatient setting collect a Nasopharyngeal NP swab.

VIDEO: How to perform nasopharyngeal swabs (April 30, 2020)

For patients with severe respiratory illness or hospitalized patients, collect a NP and/or sputum, endotracheal aspirate, bronchoalveolar lavage, etc.

Given the global swab and collection media shortage, use either the Copan NP UTM swabs (used for Influenza or other respiratory virus testing), or the skin/mucosal swabs for HSV/VZV viral testing (the containers have a pink liquid in them and a red or blue cap); alternatively, use Becton Dickison UVT swabs.

How will we know if a swab comes back positive for COVID-19?
If the patient is positive for COVID-19 and admitted to hospital, the medical microbiologist on-call will inform the MRP directly and the result will be released on Cerner/Care Connect.  Infection Prevention and Control will be alerted if the patient is an inpatient.  There may be a delay before the positive result is communicated publicly by the Provincial Health Officer, but the treating team will be alerted immediately. 
What should we do if a patient is swabbed but then can go home?  
This patient handout sheet can be given to the patient, instructing them of where to call for results and instructions on self-isolating until the results are back.  If the swab is positive for COVID-19, VCH Public Health will also be in touch with them.  You do not have to follow up with them for results.
What if a patient is tested and they also need to be admitted before the results are available?  
1.) Ensure the patient is on droplet and contact precautions.  IPAC will be involved will all cases. 2.) Discuss with the patient care coordinator that they must be in a single room. If needed use Metered-Dose Inhalers (MDIs) with spacers to minimize the use of nebulized meds. 3.) If the patient is going to undergo Aerosol Generating Procedures (AGPs) including nebulizers, the patient will have to be on airborne and contact precautions and placed in a negative pressure room.  Please discuss with the respiratory therapy team if you have questions or concerns about AGPs. 4.) If patients are at risk of needing airway management you can discuss this with RT and ICU/CCOT.
Should trainees be involved if a patient is suspected or positive for COVID-19
There is no absolute restriction on trainees being involved. However, physician teams should be limited in size to only the attending physician plus one resident.  You may also want to recommend that pregnant providers not be involved with COVID-19 patients.
What is the treatment for a patient with COVID-19?
Please refer to updates on clinical recommendations through the BCCDC (http://www.bccdc.ca/health-professionals/clinical-resources/covid-19-care/clinical-care/hospital-and-critical-care).  
Do I have to call Infectious diseases or respirology for suspected or confirmed cases of COVID-19? 
No, but they are happy to assist in cases of severe illness, questions regarding diagnosis, etc.  If in doubt, feel free to call the staff on call.
Will staff be informed if their patient tests positive? 
We will inform all staff who have provided care to a positive patient and ensure that the proper precautions and protocols were following. ​
What do I ​do if I have a patient with a severe respiratory infection?  
PHC staff are encouraged to follow routine clinical practices around all respiratory infections. Please visit this page for more information on triage and assessment.​
How lon​g does it take to get results after we test someone for coronavirus disease?  
The St. Paul’s Hospital Virology Laboratory performs testing for all PHC sites, and results can be expected within 24 hours.
Are there stricter housekeeping protocols for COVID-19 cases? 
The current standards for cleaning and disinfecting surfaces in health care facilities are sufficient in preventing the spread of the virus. Coronaviruses are susceptible to soap and routine hospital disinfectants.

Because it is an envelope virus, the virus likely only survives on surfaces for a matter of hours, similar to other common respiratory viruses. Transmission could theoretically occur if people touched contaminated surfaces and then touched their mucous membranes (eyes, nostrils or mouth). That's why avoiding touching your eyes, nose and mouth along with regular hand washing is the most effective way of preventing spread.​

A health care worker advises you that they had contact with a suspect case while at work and is wondering what the next steps are in the event that this case is confirmed? 
In the event that this is a confirmed case, Public Health will work in collaboration with the Provincial Workplace Health Call Centre (WHCC) to initiate contact tracing of health care workers as per the direction of the Medical Health Officer.  ​
This page last updated Dec 21, 2020 10:07am PST