MEDICAL ADVISORY: Retesting Previously Positive Patients

Issued by:  M. Mustafa Hirji, MD, MPH, FRCPC, Medical Officer of Health & Commissioner (Acting)

Niagara Region Public Health & Emergency Services (NRPH&ES) has been receiving an influx of patient calls to the COVID-19 information line. Callers are indicating that their health care provider has asked them to be re-tested following a positive test result, before returning to the health care provider’s office.

Asymptomatic Testing or Re-testing is Not Recommended

• Asymptomatic testing is not recommended by Public Health, as a positive test in an asymptomatic individual may represent prior infection.
• Previously confirmed cases should generally NOT be re-tested unless clinically indicated, as ongoing positive results after clearance are not uncommon.
• Clinical discretion should be used to consider re-testing after clearance if there is new onset of symptoms compatible with COVID-19 or when there is a new high-risk exposure to a known case or outbreak.
• Anyone with respiratory symptoms, other mild symptoms, or fever that you suspect may have COVID-19 or anyone concerned that they may have been exposed to COVID-19 should be referred to the assessment centre for testing, if you are not testing in your office.

Clearing Positive COVID-19 Cases

NRPH&ES is working closely with all cases and close contacts of all laboratory confirmed COVID-19 cases in Niagara. Individuals who previously tested positive for COVID-19, generally can discontinue isolation after 10 days from symptom onset (or 10 days from positive test collection date if patient is asymptomatic), provided that the individual is afebrile (without the use of fever-reducing medications) and symptoms are improving for at least 24 hours.  Absence of cough is not required for those known to have chronic cough or who are experiencing reactive airways post-infection.

For more information, please see the Ministry’s document on COVID-19 Quick Reference Public Health Guidance on Testing and Clearance.

Personal Protective Equipment  

The proper use of personal protective equipment is critical to keeping both clinicians and patients safe. Given community spread of COVID-19 in Ontario and evidence that transmission may occur from those who have few or no symptoms, masking (surgical/procedure mask) for the full duration of shifts for health care providers, and other staff working in direct patient care areas, is required. If two metre distancing cannot be maintained during your patient interaction, goggles/face shield must be worn in order to prevent a high-risk exposure. Additional PPE is to be worn based on your risk assessment. 

COVID-19 Primary Care Info-Line

Reminder: The primary care COVID-19 information line is open Monday to Friday, 9:15 a.m. to 4:30 p.m. at 905-688-8248 press 7, and then press 1 for physicians.

Public Health Resources

To prevent the spread of COVID-19, follow environmental cleaning and disinfecting recommendations for COVID-19 for health care settings and Public Health Ontario's guidance on cleaning and disinfection for public settings.

Public Health Ontario’s Infection Prevention and Control Assessment for Primary Care, Specialty and Walk-in Clinics during COVID-19 checklist provides guidance, supports and resources for:

• Screening staff, patients and visitors.
• Direction on how to provide care for patients who screen positive for COVID-19.
• Reprocessing of reusable medical equipment/devices.
• Ensuring physical distancing requirements.

Follow the Ministry of Health's COVID-19 Guidance for Primary Care Providers in a Community Setting for a summary of required precautions.