Page 51 - COVID-19 Inpatient Training Resources

Page 2 of 10

Nov. 4, 2020
Version 1
Prepared by: Dr. Larissa Matukas (Head, Division of Microbiology)

Infection Control Precautions
Patients admitted with suspected influenza require droplet-contact precautions. Early
collection of a nasopharyngeal (NP) swab for both influenza and COVID-19 can assist with rapid
reassessment and discontinuation of precautions, where appropriate. In general, patients can
come out of these precautions once fever is resolved for >24 hours, and influenza and COVID-
19 have been ruled out. However, please note that there are exceptions to this and precautions
should only be discontinued in consultation with Infection Prevention and Control (IPAC).

Updated COVID-19 virus detection orders
New order sets have been created for the upcoming fall and winter seasons to streamline
testing for COVID-19 and influenza. These include the “COVID-19/Influenza Virus Detection –
INPATIENT” order set and the “ED COVID-19 Virus Detection” order set. Important changes are
as follows:
 These order sets are to be used for our inpatients and patients in our EDs.
 Influenza testing was previously only available for inpatients and patients being
admitted from the ED. It is now available for inpatients and all patients in the ED with
respiratory symptoms, whether they’re going to be admitted or discharged.
 Given the difficulty in distinguishing these diseases clinically, all patients with respiratory
symptoms must have COVID-19 and influenza tests ordered simultaneously. Influenza
should rarely be ordered alone.
 Both COVID-19 and influenza tests can be performed on a single respiratory sample (i.e.
nasopharyngeal swab, sputum, deep nasal swab); one label will be printed with two test
codes on it. Separate COVID-19 and influenza NP swabs are not required if the tests are
ordered and collected simultaneously.
o If COVID and influenza tests are not ordered simultaneously, the lab is not able
to “add-on” the missing test, and a new specimen is required for the missing
test.
 The influenza and COVID-19 results will appear separately in Soarian and Sunrise
(respectively) and they will be reported at essentially the same time.
 The influenza panel previously consisted of influenza A, B, and RSV. This year, RSV needs
to be specifically requested in order to be tested since combining influenza and COVID-
19 does not permit the inclusion of RSV on our current platforms for testing. There are
options for adding RSV testing within the order sets. RSV is typically reserved for
neonates and should not need to be routinely ordered for adults. The RSV results will be
reported in Soarian and Sunrise along with the influenza results, when requested.
 Asymptomatic testing applies to COVID-19 only. Influenza should not be ordered for
asymptomatic COVID-19 indications.
 For ICU patients:
o If multiplex panel for other respiratory viruses is needed, a separate respiratory
sample from the COVID/influenza sample is required and a paper requisition
must be completed.