Separate Fever Clinics Prevent the Spread of COVID-19 and Offload Emergency Resources: Analysis from a large tertiary hospital in China

Jiangshan Wang; Liang Zong; Jinghong Zhang; Han Sun; Walline Harold Joseph; Pengxia Sun; Shengyong Xu; Yan Li; Chunting Wang; Jihai Liu; Fan Li; Jun Xu; Yi Li; Xuezhong Yu; Huadong Zhu

Multiple testing methods were trialed to decrease false negatives. As COVID-19 has diverse manifestations, it was unreliable to identify this disease based on only one method. In our screening process, multiple methods, including blood cell analysis, chest CT [16] , SARS-COV-2 nucleic acid [17] and antibody tests [18] were used to screen for this disease. However, each method had its own false negative phenomena, therefore all patients suspected of any viral infection were recommended to receive another nucleic acid test once more in 24 hours, which helped guarantee that patients who didn't retest again and were transferred to the ED within 24 hours had an extremely low risk of COVID-19. Additionally, in order to avoid false negative results, patients with the following conditions were suggested to test for SARS-COV-2 nucleic acid once again one week later, even though previous RNA tests were negative twice: (1) confirmed COVID-19 contact history; (2) clinical manifestations and lab tests suggesting a viral infection unexplained by another disease; (3) chest CT strongly indicating a viral pneumonia. With these strict screening criteria, no COVID-19 cases were diagnosed in ED patients previously seen in the FC.