Several nursing homes have had COVID outbreaks, meaning many of their residents are in hospital and there is extensive work to be done to decontaminate the nursing homes before they're ready for receiving the residents again. They are short of manpower due to a few of their staff having also caught nCoV.

Some nursing homes are back up and running again, but a few odd requests have popped up from the homes. One of them is all the hospitalised residents must have had their nCoV testing done and documentation that they are negative within three days of actual discharge before they'll be accepted back.

This is ridiculous on many levels.

Mainly:

One: we test based on clinical indication. If an elderly patient comes in after a fall and breaks their hip and get it fixed, we won't be testing for nCoV. If they have not had contact with anyone sick, if they have no chest symptoms or fever, there is no indication to test. Just as we don't do every single blood tests and scans for every single patient, whatever their admitting issue, we do not do nCoV tests for no reason.

Two: false negative rates are high in asymptomatic patients. This means people who are infected, but have no symptoms and/or are in the early stage of their infection, will very likely test negative. Just because someone tests negative, does not mean they are not actually infected. But this false negative gives a false sense of security, so doing the test at this stage is inherently unhelpful.

Three: it is a waste of resources. Getting nCoV testing is not just something done at the bedside. It is done by a trained professional in full PPE (that is: N95 mask, face shield, hat, protective gown, gloves), in a negative pressure room (of which we have very limited numbers for actual infectious patients), and the patient must remain in that room until the test results return (in 8-12 hours), so they have hogged that room for 8-12 hrs for a test they do not need. Multiply that by over a hundred, which is how many nursing home residents we have in hospital. Not to mention the cost of the testing itself in a lab.

Smaller points include:

Four: we do not provide documentation of test results on immediate demand. If official medical documents are requested, patients or their representatives must go to the records department and fill in relevant paperwork.

And Five: patients or their representatives do not actually have rights to insist on treatment or investigation. They can decline offered treatment or investigation, but they can't demand it.

Basically, we told the nursing homes that we have already tested those we believe to have indications and we will release them once they are fit and test negative, but that's it.