COVID-19 Testing information

Our dedicated colleagues across the state are a vital part of the NSW and international response to COVID-19 disease that is caused by the SARS-CoV-2 virus.  

 The COVID-19 clinics are listed here and private testing collection centres are here

All 60 of our labs are able to receive COVID-19 specimens collected from patients at public hospital emergency departments and COVID-19 fever clinics.    

NSWHP is constantly watching the market and assessing new assays and testing platforms once they have been approved by the Therapeutic Goods Association.

You can find a complete summary of the tests we currently use below with links to our most recent advice for more information.

Read our Clinical Update: Clinical pathology recommended for COVID positive patients (PDF 182KB) which provides advice regarding the range of tests and recommended ordering practices based on a review of evidence based practices. 

Visit here to understand more about sensitivity, specificity, positive and negative predictive values. 

You can also find out more about collection procedures here. 

 Clinical Situation  Test Summary Efficacy Collection Procedure
For all patients and all diagnostic scenarios including community spread

SARS-CoV-2 NAT 

(*the test looks for 3 different gene targets at the same time, so that you have good coverage of the genetic content of the virus should one or more of the genes be mutated or absent. Very highly unlikely that 2 or more gene targets will be absent using this strategy). 

Definitive Gold Standard Test 

High sensitivity and specificity with positive results most likely indicating infection – almost no occurrences of false positives  

Deep nose and throat Swabs.

 
For high risk patients where an urgent diagnosis is required (should only be considered where an urgent result is required within one to four hours) 

SARS-CoV-2 NAT Rapid

The devices and assays that are used in this setting are, usually, single patient assays and there are variable restrictions depending upon the global demand and supply of these test kits

Useful for ED patients with recent onset of respiratory symptoms/pneumonia (particularly if pregnant) OR patients with unexplained sepsis developed in hospital

Deep nose and throat Swabs.

 

To track and trace the outbreak of infections and to support contact tracing to control community spread. 

To detect new variants and mutations of concern

SARS-CoV-2 Whole Genomic Sequencing  Definitive Gold Standard Test

Low capacity, high cost and slower turnaround times limit the use of this test for clinical diagnosis

However, has proved invaluable in controlling the spread of outbreaks 
All positive specimens are sent to our Microbiology Genomics Lab at Westmead 

To identify known variants and mutations of concern which could cause more serious disease in communities with low prevalence of and low immunity to COVID 19, or where there is known imported source of infection, ie. returned travellers from countries where the VOC may be present.

SARS-CoV-2 VOC and MOC NAT

Under development by NSWHP, as an in-house assay or on various commercial NAT platforms, in limited sites, across the state

Currently in development

Deep nose and throat Swabs.

 

To detect presence of viable virus in patients with continuing positive NAT.

To support genomic test development

To provide material for molecular test validation

To provide material for quality assurance and control purposes

To construct IFA and other test platforms for serology

To confirm residual viable virions in long duration NAT positive cases

Viral Culture

Requires PC3/4 isolation laboratory service

Measures growth of virus

Assists in Creation of QA/QC material and IFA assays controls

Useful for research

Deep nose and throat Swabs.

 

To detect if someone has been infected by SARS-CoV-2 by identifying the presence of SARS-CoV-2-specific l antibodies in their blood

To detect the prevalence of the disease in a moment in time in a community

To establish the exposure to, or recovery from, COVID-19 in an individual

To assess recency of viral infection

To assist estimation of post exposure infectivity

To characterise the NAT findings in an individual as indicative of old/historical infection, especially in returned travellers.

SARS-CoV-2 Antibody Serology  To be used in conjunction with medical assessment and other diagnostics, such as NAT

While useful in identifying the presence of antibodies and the individual’s immune status, it is not recommended for diagnosis of acute infection

Blood test  
No clinical situation where this test is recommended for use  Rapid SARS-CoV-2-Antibody Serology  Not recommended for use  No use in acute COVID-19 infection  Blood test