New Coronavirus disease (COVID-19)

General Information

New case definition and laboratory testing criteria

(updated 23/3/2020 based on the recommendations of the Scientific Advisory Committee for COVID-19)

Definition of a suspected case in the community (Algorithm 1)

Patient with symptoms1 : Recommendation for self-isolation at home, self-monitoring every 24-48 hours and follow advise from personal doctor (GP). Laboratory testing for COVID-19 is not recommended.

Self-isolation may be stopped once 14 days have passed from the improvement of the symptoms.
1 Note: Less common symptoms include sore throat/ dry throat/ nasal congestion/ runny nose/ anemia, headaches and gastrointestinal symptoms (vomiting, diarrhoea). Caution is required here as symptoms such as runny nose, sneezing, runny eyes, itching are most likely due to a seasonal allergy.


Management of suspected case that requires referral to Public Health Practice (Algorithms 1 AND 2)

Respiratory infection (without other clear cause) and at least one:

  • Age > 60 years
  • Fever > 38.5oC
  • Shortness of breath
  • Chest pain
  • Symptoms that persist for more than 2 days
  • Travel history or contact with confirmed COVID-19 case within 14 days of onset of symptoms
  • Recommendation for referral from GP to Public Health Practice by appointment, completion of electronic referral form or calling 1420, laboratory testing for COVID-19 and assessment of severity (see algorithm)

    Criteria of severity of patient for hospitalisation (Algorithm 2 AND 3)

    Patients with acute respiratory infection referred by Public Health Practice, 1420 or from A&E Dept and has at least one of the following conditions:

    Recommendation for laboratory testing for COVID-19 and Influenza A&B, admission to hospital (Suspected Case Management Unit) and appropriate management.

    Note: Laboratory findings supporting the potential diagnosis of COVID-19 are: Lymphopenia (<1000/mm3), Neutrophil/lymphocyte ratio >3, High Ferritin, Increased D-Dimers, Increased LDH, Hyperglycaemia, Thrombocytopenia, Transaminase

    Criteria for Laboratory Testing of Hospitalised patients (Algorithm 4)

    2 of the following 3 criteria must be met for laboratory testing of a hospitalised patient:

    For any other case please contact the Infectious Disease Officer at the Suspected Case Management Unit.
    Samples for laboratory testing for COVID-19 to be taken as well as Influenza A&B or Multiplex Respiratory Panel by designated staff for specimen collection.
    Transfer to single bed room or to Suspected Case Management Unit until infection is confirmed/ ruled out.

    Note: Laboratory findings supporting the potential diagnosis of COVID-19 are: Lymphopenia (<1000/mm3), Neutrophil/lymphocyte ratio >3, High Ferritin, Increased D-Dimers, Increased LDH, Hyperglycaemia, Thrombocytopenia, Transaminase