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ABCD Skin Dermatoscopy

Covid Testing

We’ve seen many “patients” who aren’t ill – and haven’t been ill at any time – with Coronovirus symptoms but need a Coronovirus test for “non-clinical” reasons. The commonest situation is when people are travelling abroad but we’ve also done tests in other cases like health/care workers (before they were more widely available) or before people (usually the boss of a company or factory) return to work and meet co-workers again for the first time.

 

We’ve set up a special Package Price for non-clinical Covid Tests.

We can undertake the testing 6 days a week and can usually provide the result on the next working day*. Once the result is received we will provide the Lab Report and a formal Doctor’s Letter also known as a Medical Declaration Letter; of course if the result is positive then we make the required statutory notifications to Public Health England.

Blood Antibody Test

(have you “ever” had a Coronovirus infection)

£300

Swab PCR Antigen Test

(have you currently got a Coronovirus infection)

£200

These packages represent a saving of over £140 each compared to a routine appointment, test and Doctors letter. The packages are not suitable for patients who are currently unwell, who have had symptoms of Coronovirus, who think they might have had Coronovirus in the past or patients who need any other medical assessment/ advice – these patient’s should book a routine new patient appointment.

Where are the Tests Done?

The test are usually done in a face to face appointment with Dr Kumar-Beurg at one of our off-base clinic sites which are;

  • Sparkly Smile Dental Practice, SE3 0TA
  • Healthwise Natural Therapy Centre, SE3 8XA
  • Keats House, SE1 9RS

Provided the booking is made with enough notice: we can send a home self-test kit for you to do the Naso-pharyngeal Swab Antibody test yourself ar home

 

What’s the Turn-Around Time?

* The officially published turn-around time for routine tests is 48-72 hours from the labs receiving the samples. Therefore we can’t guarantee anything else. However when there is a specific time consideration we make special arrangements for transport as well as fast lab processing and we usually receive (so far we’ve always received) results the next working day.

This means that we can meet the needs of people who are travelling abroad and have to have a swab test within a strict window, usually 48 hr or 72 hr, before departure – or run the risk of 14 days quarantine on arrival.

In fact 2 of first 3 patients we saw for pre-Travel Dr’s Letters were ones who’d been turned away from the airport because their results from elsewhere weren’t adequate and they absolutely had to have a Dr’s Letter within 20 hours (approx) for them to catch the next flight.

One important factor if considering home self-testing is about sample delivery to the Lab. TDL (The Doctors Laboratory) is in the Harley Street area of West London and for time sensitive tests we use a courier to transport the sample within hours. If a test is done at home then the sample can be posted in fact the home test kit is provided with a pre-paid mailing envelop but if the result is time sensitive then we suggest – strongly suggest – that the sample is either delivered by hand or sent by courier to the lab and that we are notified by phone immediately so that we can alert the Sample Reception Desk.

Test Specific Further Information

Details about each of the tests can be found at the links below.

Covid Swab Test Leaflet

Covid Blood Test Leaflet

 

How to Proceed

  • If you’d like to proceed with one of the Coronovirus tests then please call us on 02084347028 or email enquiries@cld.ht.
  • The next step will be for you/ every person needing the test to complete an online Health Questionnaire which will be directly sent to the Dr.
  • Then a firm appointment time & place will be arranged and full payment taken in advance.

 

Covid Blood Test FAQ

Coronovirus Antibody Blood Test FAQ Leaflet

This leaflet is intended for patients of Dr Kumar-Beurg who have already discussed and decided to go ahead with Covid-19 antibody blood test and it serves as a reminder about advice that is usually given to patients during consultation. If you do not understand the following or feel it doesn’t apply to you then please ignore it or contact us for clarification.

 

What Test is Done?

We offer both the nasopharyngeal PCR swab and the the antibody blood test to detect if a patient is “currently suffering from” or has “ever been exposed to” Coronovirus Covid-19. This test is the Antibody Blood Test which tells if a patient has been exposed to Coronovirus more than 14-21 days ago. The test detects the presence of immunoglobulins in the blood (IgG); these are the molecules that are made by the immune system to fight an infection when it is first encountered. The presence of Coronovirus specific IgG indicates that the patient has been exposed to the infection (1).

 

Who Should Do the Test?

The antibody test is best done 14-21 days after the first symptom(s) of Coronovirus. These include fever, cough, loss of taste/ smell, diarrhoea/ abdominal pain/ loss of appetite and fatigue/ “brain-fog”. However there is clear evidence that some people (possibly many people) can have the Coronovirus infection without suffering any symptoms (2) so it’s almost impossible to judge by a person’s symptoms alone.

 

Is the Test Accurate and Reliable?

The one word answer is – Yes.

It should be noted that the subject of antibody testing is controversial in the UK because the Government, NHS and PHE have not agreed and approved any of the antibody tests for use by the NHS.

Bedside testing kits – similar to pregnancy test kits – have claimed to give instant results (based on IgM and IgG antibodies), however, there are questions about the accuracy of these tests. Therefore, we recommend using a lab-based test.

The blood is processed by The Doctors Laboratory (TDL) which is a very well established service just off Harley Street in London that we have used for several years  – it’s the largest Private Practice lab in the UK and also does extensive testing for the NHS including ones for Coronovirus.

The actual lab machinery is made by Abbott which is again based in the UK and is one of the leading global brands for medical equipment and it’s the same machine that’s been used regularly for years for similar tests. The Abbott test has been in use around the world including the USA (3) since the start of the Covid pandemic and was awarded a CE mark and approved for European-wide use on 29th April (4) & (5).

The test is described as having a 100% sensitivity (which means that it will detect the antibody in all the blood samples that have it) and 99.5 specificity (it will give the correct answer, negative in 99.5% of the blood samples that are free of antibody). This means that the lab technique has a negligible/ zero false negative rate (ie if there are antibodies in the sample then they’ll be detected).

In the real world there are also other factors that can affect the accuracy of lab tests (such as immonusuppresive disease or medications) and one of the major sources of controversy at Governmental level seems to be the impact of false positives when the actual prevalence of infection in the population is relatively low (6).

 

How Do I Take the Sample From Myself?         << Self Test Antibody Blood Tests Not Currently Available >>

The test is a fingerprick blood sample that uses a self-administered, spring-loaded lancet rather than a needle & syringe phlebotomy sample to draw the blood.

Before you take the sample it’s helpful (but not necessarily essential) to;

  • Make sure you’re well hydrated, have had plenty of water to drink beforehand
  • Make sure you’re warm and relaxed
  • Hold your hand(s) in a bowl or sink full of warm water for 5-6 minutes and
  • Wash your hands with soap & dry them before doing taking the sample.

When you use the lancet it’s preferable to apply it to the side of your finger, not the main fingerpad.

If you can stand up while taking the sample and keep the bottle on a low table while you milk the finger for blood then that’s usually easier – but – if you feel even slightly faint or unsteady then please make sure you’re seated to do the test.

 

How Do I Return the Sample to the Lab?

To prepare the sample for return;

  • Make sure that your sample bottle has been labelled with your name, date of birth and the test date
  • Put the sample bottle back into the folding plastic bottle holder and put the bottle holder back into the clear plastic bag. 
  • If possible then please write the date of collection on the request form and …
  • Make sure the request form is inside the yellow-white plastic mailing bag.
  • Put the clear sample bag with the specimen into mailing bag and seal it shut.
  • The mailing mag already has the lab’s address and postage paid stamp on it.

To dispatch the bag you can either;

  1. Send it using the pre-paid Royal Mail service. Because of service disruptions since the UK went into lock-down I think it’s better to use an alternative but if you decide to post the sample then I strongly recommend taking the sample to a post office in the morning and sending it as guaranteed next-day delivery. 
  2. Use a courier such as www.gophr.com or https://apc-overnight.com/ 0800 373737. 
  3. Use a taxi service (if they agree) such as Uber or a local minicab firm. 

 

How Long Does it Take to Get the Result?

The sample takes 2-3 days to process and the result will be sent to you by email.

What Does a Negative Result (“Anti-SARS CoV 2 IgG Result: NOT Detected”) Mean?  

A negative test result completed in the correct time frame would suggest you have not previously suffered from COVID-19 – there are very few exceptions to that. This means that if you’re exposed to the Covid virus in future then you may develop the infection. 

What Does a Positive Result (“Anti-SARS CoV 2 IgG Result: IgG Detected”) Mean?  

If the result says “2019-nCoV IgG Detected ” then that means that you have had the Coronovirus infection.  

The national guidance and instructions are being frequently updated so please make sure to read the up-to-date information on the links below which are available in multiple languages (7,8,9). The main points you need to know are;

  1. A positive test result indicates you have had the virus.
  2. It is not yet known whether this grants any future immunity to the virus which means you may be able to get the virus more than once.
  3. Whether or not previous exposure confers immunity, we don’t know how long the antibodies will remain in your system. Other coronavirus antibodies, such as ones that cause the common cold, usually stay in the body for 1-2 years. 
  4. If you get worse then you should seek further medical attention. You can contact us but please be aware that Cloud Health only offers routine booked appointments and does not offer an unscheduled or Out Of Hours Service. If you need more urgent care than we can provide then please telephone 111 or 999 as appropriate. Please do not go to a GP surgery, a Walk-in Centre or an A&E Department unless you’ve been given special instructions over the phone and told exactly where to go.
  5. There is no requirement or recommendation to do contact tracing or testing at this time but your household members should seek medical advice if they start to show any symptoms of Coronovirus.
  6. Covid-19 is a “notifiable disease” and all Doctors making a diagnosis are legally required to inform Public Health England (PHE). We will also send a copy of positive results to your registered NHS practice and recommend that you contact them (by phone/ online) to discuss the result with them.

 

References

(1) https://www.corelaboratory.abbott/int/en/offerings/segments/infectious-disease/sars-cov-2

(2) https://jamanetwork.com/journals/jama/fullarticle/2762028?guestAccessKey=9e4e116a-7ab4-4a98-97b7-9b0bbedb5c6f

(3) https://www.evaluate.com/vantage/articles/analysis/spotlight/covid-19-antibody-tests-face-very-specific-problem

(4) https://www.abbott.co.uk/media-center/news/CE-mark-and-immediate-availability-of-its-COVID-19-laboratory-based-antibody-test.html

(5) https://www.independent.co.uk/news/health/coronavirus-antibody-test-approval-news-europe-uk-accuracy-abbot-a9490026.html

(6)  https://soundcloud.com/bmjpodcasts/talk-evidence-covid-19-update-lack-of-testing-transparency-how-to-give-good-debate at 15.01 minutes

(7) https://www.nhs.uk/conditions/coronavirus-covid-19/

(8) https://www.gov.uk/coronavirus 

(9) https://www.gov.uk/government/publications/covid-19-stay-at-home-guidance/stay-at-home-guidance-for-households-with-possible-coronavirus-covid-19-infection

END

Covid Swab Test FAQ

Coronovirus PCR Antigen Swab Test FAQ Leaflet

This leaflet is intended for patients of Dr Kumar-Beurg who have already discussed and decided to go ahead with Covid-19 swab testing and it serves as a reminder about advice that is usually given to patients during consultation. If you do not understand the following or feel it doesn’t apply to you then please ignore it or contact us for clarification.

 

What Test is Done?

We offer both the nasopharyngeal PCR swab and the the antibody blood test to detect if a patient is “currently suffering from” or has “ever been exposed to” Coronovirus Covid-19. This test is the Naso-Pharyngeal Swab which tells if the patient has active Coronovirus infection at the time of taking the swab.

 

Who Should Do the Test?

The test can be done to make a diagnosis in people who have current symptoms – at the time of testing – that are suggestive of Coronovirus. These include fever, cough, loss of taste/ smell, diarrhoea/ abdominal pain/ loss of appetite and fatigue/ “brain-fog”. It should not be done by people who think that they might have had the infection and already recovered. However there is clear evidence that some people (possibly many people) can have the Coronovirus infection without suffering any symptoms so it’s almost impossible to judge by a person’s symptoms alone.

 

Is the Test Accurate and Reliable?

The one word answer is – Yes.

The swab is processed by The Doctors Laboratory (TDL) which is a very well established service just off Harley Street in London that we have used for several years – it’s the largest Private Practice lab in the UK and also does extensive testing for the NHS including these PCR swab tests for Coronovirus.

The assays used at TDL show a minimum sensitivity of 98% (which means that if there’s any virus present on the swab then there’s less than a 2% chance of it being missed) and a specificity of 100%, with no cross-reactivity with other viruses (which means that it never gives a false positive result). These are the tests currently used by the NHS and are approved by Public Health England. They are fully compliant with government guidelines.

However no test is perfect and there will be some “false negatives” which is when the test says a person is free of a disease even though they do actually have it. With the Covid swab test the biggest reason for false negatives seems to be either (a) the person wasn’t shedding virus when the swab was taken or (b) the swab didn’t sample – didn’t touch – the area where the virus was present.

 

How Do I Take the Sample from Myself?

There are instructions in the kit; my personal guidance is to try to do the sample first thing in the morning on a Monday – Thursday and;

  • It’s easier to have someone help/ do it for you.
  • Only touch the outside of the collection tube and the red swab handle. Be very careful not touch the white cotton bud or the white stick of the swab.
  • Moisten the cotton bud with a few drops of tap water.
  • Pu the stick into your mouth as far as possible on the left hand side till it touches the left tonsil or the back of your throat … then … move it around and twist it around at least four times to ensure it makes good contact with a large area of the inside of your mouth/ throat.
  • Do the same on the right side of your tonsils/ throat.
  • Insert the swab up your left nostril as far as it will comfortably go … then … move it around and twist it around at least four times.
  • Do the same with your right nostril.
  • Put the swab back into the collection tube and press to click it closed.

There is a helpful video (although it is intended for health professionals) available at 2.27 minutes at https://www.youtube.com/watch?v=qPRuKEzzz40&t=201s.

 

How Do I Return the Sample to the Lab?

To prepare the sample for return;

  • Put the collection tube back into the clear plastic sample bag.
  • If possible then please write the date of collection on the request form and …
  • Make sure the request form is in the clear sample bag.
  • Press to close the clear sample bag.
  • Put the clear sample bag into the yellow-white plastic mailing bag and seal it shut.
  • The mailing mag already has the lab’s address and postage paid stamp on it.

To dispatch the bag you can either;

  1. Send it using the pre-paid Royal Mail service. Because of service disruptions since the UK went into lock-down I think it’s better to use an alternative but if you decide to post the sample then I strongly recommend taking the sample to a post office in the morning and sending it as guaranteed next-day delivery but if the test is time sensitive then I recommend …
  2. Use a courier such as www.gophr.com or https://apc-overnight.com/ 0800 373737 … or …
  3. Use a taxi service (if they agree) such as Uber or a local minicab firm .. or …
  4. Delivery the sample to the lab yourself by hand as soon as it’s been done.

 

How Long Does it Take to Get the Result?

The official turn-around time for the samples is 2-3 days however we take steps to speed that up and usually have a result within 2 days of it getting to the lab and for very time sensitive tests we have always received the result the next working day (or sooner). As soon as we receive the result it will be sent to you by email, you will also receive a formal Dr’s Letter or Medical Declaration Letter and a hardcopy will be sent by post.

 

What Happens if Coronovirus is Detected? 

If the result says ” 2019-nCoV PCR Detected ” then that means that you do have the Coronovirus infection.  

The national guidance and instructions are being frequently updated so please make sure to read the up-to-date information on the links below (multiple languages). The main points you need to know are;

  1. Coronovirus is a “notifiable infection” which means that Doctors are obliged by law to inform Public Health England about every patient diagnosed with it. We will do that and PHE might make contact with you. We will also notify your registered NHS GP/ Practice with a copy of the test result. We recommend that you telephone or email your NHS GP/ Practice to make sure they know that you’ve been diagnosed with Coronvirus – do not go to the surgery in person. You don’t have to tell 111 that you’ve been diagnosed with coronovirus however it might be helpful to you especially if you need local help to isolate.
  2. You should self-isolate for 7 days – that means avoiding contact even with other people in your own household, please see the bullet points below.
  3. Your whole household should self-isolate for 14 days – that’s even more strict than the normal “social distancing” and “lock-down” rules and means none of your household going out of the house at all, not even for shopping, essential work or exercise. There are many local charities, social and church groups that are helping people who are staying indoors and some of them are listed below.
  4. If you get worse then you should seek further medical attention. You can contact us but please be aware that Cloud Health only offers routine booked appointments and does not offer an unscheduled or Out Of Hours Service. If you need more urgent care than we can provide then please telephone 111 or 999 as appropriate. Please do not go to a GP surgery, a Walk-in Centre or an A&E Department unless you’ve been given special instructions over the phone and told exactly where to go.
  5. There is no requirement or recommendation to do contact tracing or testing at this time but your household members should seek medical advice if they start to show any symptoms of Coronovirus.
  6. You may want to consider contacting people you have been in contact with in the two weeks prior to the test.

 

Self-Isolation Tips

  • You should try to use rooms that other household members don’t go into, keep the door of your room closed and open the windows as much as possible. If you do have to use the same rooms (eg bathroom) then …
  • you should try to go into the room after everyone else has finished using it … 
  • before you leave you should wipe down all surfaces with a disinfectant and …
  • keep any “contaminated” tissues/ wipes/ rags etc away from other people.
  • You should try to avoid eating with household members, ask them to leave food on a table/ tray outside your room and take it inside to eat. If possible use disposable plates/ cutlery, if not then they should wear long washing up gloves to handle any dirty crockery and not use those gloves for anything else.
  • Your clothes and bed-sheets can be cleaned with a normal or hot cycle in the washing machine – they don’t need to be boiled or destroyed.

 

References:

https://www.randox.com/coronavirus-randox/

https://www.randox.com/statement-covid19-testing/

https://www.nhs.uk/conditions/coronavirus-covid-19/

https://www.gov.uk/coronavirus

https://www.gov.uk/government/publications/covid-19-stay-at-home-guidance/stay-at-home-guidance-for-households-with-possible-coronavirus-covid-19-infection

https://nextdoor.co.uk/

https://www.nationalcareforce.co.uk/

https://www.home-start.org.uk/news/support-for-families-who-are-self-isolating-during-the-coronavirus

https://jamanetwork.com/journals/jama/fullarticle/2762028?guestAccessKey=9e4e116a-7ab4-4a98-97b7-9b0bbedb5c6f

END

Information Leaflet 2016

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