Updated on March 26th, 2020
All medical investigations involve a cost benefit analysis. This is not only financial cost. We have explained in a recent article the unexpected consequences of exceeding public health advice.
It is well recognized that excessive medical investigations have the potential to increase not only anxiety but also create complications and illness from subsequent tests and procedures.
Tests which may be performed for COVID-19 can be divided as follows:
- Tests which specifically look for the virus.
- Tests on the blood that look for evidence of antibodies which suggest current (IGM) or previous (IGG) infection.
There are several tests available which check for the COVID-19 virus. In a community setting these tests are now being performed at home.
There's a blood test which measures antibodies against COVID-19 IGG and IGM. The IGM test becomes positive within the first few days of illness. It will take a bit longer before we have a greater understanding of the role of the blood tests in early diagnosis. Any positive blood test will require further investigation.
We are aware that there is an increasing discussion about COVID-19 testing and we fully expect that our patients wish to make informed decisions on matters regarding their health. Before considering testing it should be recognized that:
- The majority of patients contracting COVID-19 have a relatively mild illness and make a full recovery.
- If the test is positive, the doctor will have an obligation to inform the Department of Health, and you will be admitted to hospital for quarantine and any close contacts may be asked to quarantined in a government facility.
- The sensitivity of the tests is currently evolving. A negative today does not guarantee that you will not become infected or develop symptoms in the future.
The incidence of COVID-19 remains low in our population. Whilst that may change currently it is statistically most likely that in low risk cases symptoms are likely to be caused by another form of infection.
Our current advice is that testing for COVID-19 should only be taken in situations in which it is clinically indicated and the patient should be assessed and the best option for testing discussed with a doctor. This can be by telephone. For individuals who have been out of Hong Kong in the last 14 days, have been a direct contact of a COVID-19 case or have fever and/or respiratory symptoms, our policies on consultation and testing can be found HERE.
We recognise that external agencies may ask for evidence of negative tests regardless of the lack of evidence and false reassurance that may result. For testing in very low risk situations blood testing may end up being a more readily available and cheaper option.
The WHO have advocated a policy of testing, case identification and quarantine. Hong Kong has world class systems and expertise in the management of infectious disease. This has been reflected in the number of COVID-19 cases in Hong Kong in comparison to other countries which were hit later by the epidemic. All OT&P clinics have been fully operational throughout this process. We are supporting the Hong Kong public health strategy and have been working closely with the Department of Health. We have performed more than 500 tests for COVID-19 with more than 97% being negative. We have enhanced infection control procedures in compliance with CHP recommendations and our ongoing accreditation with ACHS. We will continue to care for all of our patients.
If you have any concerns or specific questions regarding this issue or if you wish to discuss the implications or logistics of testing for COVID-19, please arrange an appointment to discuss with your doctor.
1. Harris, R. (2020, February 28). How A Coronavirus Blood Test Could Solve Some Medical Mysteries. Retrieved from https://www.npr.org/sections/health-shots/2020/02/28/810131079/how-a-coronavirus-blood-test-could-solve-some-medical-mysteries