What should providers do when asymptomatic staff receive an inconclusive test result for Covid-19?

On 31 July 2020 the Government released guidance on the management of staff and exposed patients and residents in health and social care settings.

The guidance is clear on what steps are to be taken for positive and negative test results for Covid-19 symptomatic persons when they are tested (not the antibody test).  If they are symptomatic and test positive they can return to work 10 days after the onset of their symptoms and they are not feverish and they are medically fit to return.  If a cough or change in sense of smell or taste is the only symptom that continues after 10 days and they are not feverish for 48 hours without medication they can return to work.  If they are symptomatic and test negative they can return to work when they are medically fit along with a risk assessment which is to be undertaken by providers.  So far so clear.

The lack of clarity in the guidance is in respect of inconclusive test results for asymptomatic individuals.  The guidance is silent on that eventuality and leaves providers in the dark as to what steps they should take where an asymptomatic member of staff receives an inconclusive test result.  This is what is known as an excluded middle and sees providers of health and social care potentially acting independently of the guidance potentially exposing patients, residents and staff and others to the risk of infection within their particular setting.

To further muddy the waters NHS guidance on Covid-19 testing more broadly states that if an inconclusive test for an asymptomatic person is returned then they should arrange to have another test as soon as possible.  But there is no requirement for the person who had the inconclusive test to self-isolate.

Clarity is needed to provide health and social care providers with certainty as to the position that they should be taking in respect of those asymptomatic persons who return inconclusive Covid-19 test results.  In the absence of clarification of the steps to take when asymptomatic persons return with inconclusive test results in health and social care settings a risk based approach would dictate that they are treated in the same way as their symptomatic colleagues, namely individuals should not able to return to work until a negative test is returned and they are medically fit to return to work.

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