Who is at risk of getting COVID-19?
People who have been in contact with somebody with COVID-19 are at risk of contracting the virus.
Those at higher risk of severe illness are older adults and those with existing medical conditions such as chronic heart disease, diabetes, kidney disease, cancers, immune suppression or lung disease.
We request that all patients who visit PathCare laboratories wear a cloth or surgical mask when coming to the laboratory. This will assist in
keeping you safe or keeping other patients safe if you have symptoms.
What symptoms will I have with COVID-19?
Most people who get this disease will have very mild symptoms, like having a cold.
People who develop COVID-19 generally have the following symptoms:
• Sore throat
• Muscle aches
• Loss of taste and smell.
In the minority of cases an individual may develop severe symptoms such as difficulty breathing or shortness of breath, persistent pain or pressure in the chest. If this happens, it is imperative that medical attention is sought and that you go to a hospital.
How does COVID-19 spread?
There are two ways of transmission
- Either via droplets when someone who has the virus coughs, sneezes, breathes, sings or laughs in close proximity. Generally, if you are more than 2 meters away, (called social distancing) the droplets won’t reach you, and should not be able to infect you. Masks also create an effective barrier against droplets.
- The second major transmission method is via aerosol particles. Those are about 1/100th the size of a human hair and are more difficult to defend against. Social distancing and staying outdoors, where there is more air flow, are helpful.
Droplets can land on surfaces, such as tables, door handles, or any other surface. If you touch that contaminated surface and then touch your face, especially your eyes, mouth or nose, you could become infected. It is thought that infection from surfaces or objects, is less common than direct infection via the respiratory route from someone else.
Can I have contracted the virus but have no symptoms?
Yes, you can. If you are infected but show no symptoms, you might still be infectious to other people and it is therefore very important to keep to recommendations on mask wearing, hand hygiene and social distancing.
What tests are done to diagnose COVID-19?
We will collect a throat and/or nose swab and send it to our laboratory for testing. Pathcare does a PCR test that detects the presence of the Covid-19 virus.
The test takes about 24 – 48 hours to process. If your test is negative you will receive a SMS with your result. If the virus is detected in your sample, we will contact your doctor who will contact you.
Please wait for your doctor to contact you.
How do I go about being tested?
Should you meet the criteria for a Person Under Investigation (PUI) as defined by the MoHSS, and you present with the symptoms mentioned previously, it’s essential that you contact your doctor.
Your doctor might not want you to physically come into the surgery, and might prefer a telephonic consultation. Your doctor will then furnish you with important documentation that you need to bring along to our branch for testing. We cannot test you without the documentation or a doctor’s referral. For asymptomatic persons needing COVID-19 testing for travelling purposes, the documentation requirements are different.
Are there any preventative measures I can take against contracting the virus?
Vaccines may be available in Namibia to prevent SARS-CoV-2 infection in the future. It also makes sense to be vaccinated against influenza to prevent co-infection and to be in good general health.
Risk of infection and transmission can be reduced by:
• Reducing personal contact (e.g. by no longer shaking hands).
• Keep your social distance (at least 2 meters)
• Avoid prolonged contact with people and in small closed areas – rather meet in open spaces with adequate air ow.
• Wear your mask when leaving home – it is the socially responsible thing to do.
• Cleaning your hands before touching your eyes, nose or mouth.
• Properly cleaning your hands after coughing or sneezing.
• Avoid using handkerchiefs and rather use a tissue and discard it.
Do I need to routinely use a face mask?
Research on face coverings shows that the risk of infection to the wearer is decreased by 65 percent (Dean Blumberg, chief of pediatric infectious diseases at UC Davis Children’s Hospital).
By wearing a mask, you are also reducing the risk of transmitting the virus to someone else, should you become infected. You’re now considered being an irresponsible member of the community if you’re not wearing a mask! The degree of protection varies depending on the mask type.
How is COVID-19 treated?
Symptomatic treatment may be given, for example to reduce fever, muscle aches and sore throat.
If symptoms are severe (e.g. if an individual requires oxygen due to difficulties breathing) treatment will need to take place in hospital.
What do I do if I’m concerned I have COVID-19?
Your doctor will evaluate you and may possibly recommend testing.
Currently the recommended period of time to stay at home is 10 days, as you could be infective for this amount of time. Keep practicing good hygiene at home and clean surfaces regularly.
Should I get tested for the virus?
Your doctor will decide if testing is needed. If your doctor refers you for a COVID-19 PCR test, once you have had your sample taken, you should go straight home and self-quarantine until you receive your results.
What do I do if I have been in contact with someone with a coronavirus infection?
If you have been in contact with somebody with confirmed or probable COVID-19, you should self-isolate for 10 days. Your doctor will be able to guide you on assessing the type of contact you had, and what further action is needed.
Get plenty of rest, and stay hydrated by drinking enough fluids.
If you develop any symptoms, contact your doctor and:
• Practice good cough etiquette when coughing or sneezing.
• Clean your hands after coughing or sneezing.
• Stay at home, unless you develop symptoms that warrants hospital admission.
If you feel short of breath, or have difficulty breathing, go to the nearest hospital. If possible, please try to phone ahead and inform the hospital/clinic/GP to tell them that you are coming.
Remember to wear a face mask to prevent transmission to other patients and healthcare workers!
What does it mean if I test negative for the COVID-19 PCR test?
A negative COVID-19 PCR result means that you are unlikely to have active COVID-19. However, it is possible that you are very early in your infection (in the window period), as the test only becomes positive after a few days (the incubation period).
It is also possible that you could have become infected with COVID-19 after the sample was taken. Due to intermittent viral shedding and sampling variability, and despite high sensitivity of the PCR test employed by PathCare, the PCR may be falsely
negative even though you have COVID-19.
Your doctor will help you to interpret your results in the context of the pre-test probability of whether or not you may have COVID-19 infection. In a minority of patients with negative PCR results where a false negative PCR result is suspected, your doctor might decide to recommend repeat testing on a fresh swab taken 24-48 hours after the first swab.
Why is my PCR positive when I do not have any symptoms and why could the PCR negative be negative when repeated within a few days?
The PCR which Pathcare performs is highly specific meaning false positives are unusual.
There are also other factors that may influence the result like:
• Quality of the specimen (broncho-alveolar lavage specimen is better than sputum which is better than a nasal swab which is
better than a throat swab or saliva)
• The viral load (an indication of viral load is given by the Ct value)
• Timing of sample where PCR turns positive about 48 hours before symptoms develop and then generally stays positive for a few weeks from time of symptom development. The PCR may remain positive for up to 3 months and possibly longer after COVID-19 infection, including patients who had asymptomatic infection. It is important to note that the PCR detects viral RNA and this does not equate to the production of infectious viral particles. This is not a false positive PCR result but it may reflect the presence of non-viable virus.
• intermittent viral shedding may cause results to fluctuate between positive and negative, especially after the initial period of infection has passed.
• Sampling variability
COVID-19 is generally transmissible for 48 hours before symptoms develop until about 8 days after symptoms developed. When screening asymptomatic patients and the result is positive, one does not know whether that is a true current infection or merely persistence of a positive PCR in a healthy patient that had previous asymptomatic or mild infection.
Our clinical advice is if you test positive, stay home for 10-13 days (following WHO and national de-isolation guidelines) and do not retest as the virus is generally not transmissible beyond D10. If you retest you will see persistent positive results in some patients, but that is only viral RNA fragment persistence and not viable virus. We generally only advise retesting in previously positive patients after 90-days, should such a patient again present with viral respiratory symptoms.
Asymptomatic infection is more common than symptomatic infection and it is not surprising to see that asymptomatic patients test positive with PCR. Follow the 10-day rule (WHO and national) of self-isolation if a patient tests positive, and do not retest as the second test does not alter decision making.
PathCare Namibia is dedicated to producing COVID-19 results of high quality within a reasonable turnaround time. Once the result is available, if you have questions, we encourage you to discuss the results with your doctor or with the MoHSS if needed, as it is important to interpret the results within your unique context at a specific time point.