Try not to find a hidden explosive can be a disaster. Testing after it has exploded, is of limited benefit.
Going by practical thought, testing for COVID-19 should be a non-issue, as Up to 44% of the infection may be transmitted by pre-symptomatic patients or asymptomatic patients.
Advantages of Covid testing at admission in hospitals
- Source to other patients; Any patient admitted with medical diseases or requiring surgery, if Covid status is not tested, the patient will be mixed with others. Any one patient having Covid infection will act as a source for other patients and health workers.
- Further progress of Covid-19 will be influenced by the incidence of infection in the population. The true numbers of spread will be the key to informed decision making therefore will influence the trends. Any orders or intention to restrict testing defies logic. Inconsistent strategies will result in projecting an incomplete picture of the transmission.
- Difficult to decide on history; It is impossible to identify all COVID-19 patients based on history alone. One such patient could infect several healthcare workers and can significantly impact hospital services. Thus, the implications of missing a single COVID-19 patient can be enormous, in a hospital.
- Clear history not available; Sometimes patients are not always clear about their history of contact or symptoms because of many reasons. Doctors also sometimes may not be able to elicit the correct history.
- Generation of Data;Testing at the hospital admission increases overall testing figures. It screens a population at risk of infection and source. Undertaking contact tracing and breaking the chain of transmission is helpful. For same reasons, doctors routinely carry out testing for HIV, hepatitis B and hepatitis C preoperatively for all patients. It is just another viral test.
- Hospitals turning into hotspots and risk to health workers; Hospitals are the only place, holding too many sick people. Chances of harbouring Covid, or catching infections are very high in hospitals. They can actually turn into hotspots, if testing is restricted in the hospitals. Liberal testing is one of the methods to contain infection in hospitals, so doctors can detect and segregate the source.
Disadvantages 0f Covid testing at admission
There are some equally reasonable concerns about mandatory testing of COVID-19.
- First is the cost and the delay in patient management.
- Stigmatisation if one tests positive and being refused treatment is a major fear for the patient.
- Universal safety precautions are always followed across all hospital surgeries, irrespective of the test result.
There are many reasons for and some against COVID-19 testing of all admitted patients. Doctors will strive to strike the balance between protecting patients and protecting the healthcare system and workers. While treating any patient without delay, a more rational and practical set of comprehensive guideline is needed for non-urgent or elective admissions from our national and international organizations to enable health care systems to practice medicine safely.
Otherwise every one may be at risk including patients, health care workers and doctors.
Inconsistent strategies of testing Covid will undermine decision making (Times of India)
Regardless of result have to follow precautions.
Should be included as pre op just like HIV and Hep B/C status included
There are false positive and false negative cases. Window period and improper sampling processing etc are other sources of error; need to addressed. These can lead to legal issues in future in addition
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Yes, that makes things more complex