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As of August 22nd, the Ministry of Health is recommending day-12 testing of all close contacts of a Covid-19 case.
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David Gollogly, Jasmine Mackay, Richard Chen, Kelvin Ward
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Pandemic Response Committee
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Updated Advice regarding close contact testing around day 12
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In line with advice from the New Zealand Micro Network (NZMN) and Public Health subgroup members of TAG, and in consultation with ARPHS, the Ministry is recommending testing of close contacts around day 12 of their self-isolation period following exposure to a confirmed case of COVID-19 as follows:
a) all household close contacts
b) others as determined by the local Medical Officer of Health e.g. when there are multiple cases at an institution or work premises.
For this current outbreak, colleagues at ARPHS are recommending under b) above that all close contacts are tested around day 12 due to the difficulty categorising levels of contact for this particular outbreak.
Rationale:
Close contacts, by definition, are recognised as being a group at higher risk of COVID-19 than the general population and in line with current MIF day 12 testing, and our advice for return to work for close contacts who are health care (including aged residential care) workers.
Advice:
The testing at around day 12 is a recommendation rather than a requirement. We strongly encourage testing around day 12 in communications with close contacts as providing an added level of assurance for them and their family and community, however, unless there is cause for public health concern (eg that a person may not be disclosing symptoms) there would not be any enforcement of the recommendation. At this stage, we are not proposing any extension to the quarantine period for close contacts if they refuse day 12 testing. A suggested script offering day 12 testing and the benefits of it is being developed by NITC and ARPHS and will be shared with other agencies involved in daily monitoring of close contacts.
Implementation issues:
We are mindful that there are a number of implementation issues that will need to be worked through including, but not limited to:
1. Timeliness of introducing this change in practice:
A number of close contacts in the current outbreak are at or nearing day 12 of their 14 day self-isolation period. As such, it may not be possible to offer testing for some close contacts in the current outbreak.
2. Consistent messages:
As there are a number of PHUs together with Healthline, CBG and NITC that are in communication with close contacts and/or are undertaking daily monitoring of close contacts, it will be important to align messages to ensure those from the same setting (eg church, or workplace) receive the same advice. A suggested script offering day 12 testing and the benefits of it is being developed by NITC and ARPHS and will be shared with other agencies involved in daily monitoring of close contacts.
3. Logistics:
We are aware that access to testing may be an issue. Agencies outside Auckland will need to identify local supports and advice on where people can get tested, and how to do this safely to minimise exposure to others.
4. Laboratory capacity. Due to current demand, there may be delays in receiving results. We therefore recommend testing around day 12 (eg could be day 11). While we would usually recommend someone remain in self-isolation until they have a negative test result, we also do not want to penalise or inconvenience those that take up the offer of a day 12 test. Therefore in the current environment, we would recommend self-isolation continue until day 14, and that people are able to leave self-isolation provided they are symptom free on day 14, even if their day 12 test result is not yet available. In the unlikely event that their test comes back positive, they would need to be rapidly contacted and advised to self-isolate and contact tracing undertaken as required.
5. Who will communicate the negative result to the close contact/s.
COVID-19 Health System Response
Ministry of Health
http://www.health.govt.nz
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