Coronavirus symptoms, testing and care
COVID-19 is a new illness that can affect your lungs and airways. It's caused by a virus called coronavirus. This page tells you how to recognise symptoms and what you should do if you have symptoms. It also provides information about testing care workers and people who use care services for the virus.
Symptoms of Coronavirus§
New data suggests long COVID affects around 10% of 18 to 49 year olds who become unwell with COVID-19.
The most common symptoms of coronavirus (COVID-19) are recent onset of any of the following:
- a new continuous cough
- a high temperature
- a loss of, or change in, your normal sense of taste or smell (anosmia)
For most people, coronavirus (COVID-19) will be a mild illness. However, if you have any of the symptoms above you should self-isolate at home.
If you have these symptoms, however mild, stay at home and do not leave your house for at least 7 days from when your symptoms started (if you live alone), or 14 days (if you live with someone who has symptoms). You do not need to call NHS 111 to go into self-isolation. If your symptoms worsen during home isolation or are no better after 7 days, contact NHS 111 online. If you have no internet access, you should call NHS 111. For a medical emergency dial 999.
Two criteria that must both be met for Extra Care and Supported Living providers to be eligible for testing. These criteria are:
- A closed community with substantial facilities shared between multiple people, such as shared livings spaces, kitchens, lounges etc. even where these have been closed during national and local lockdowns, and
- Where most residents receive the kind of personal care that is CQC regulated (rather than help with cooking, cleaning and shopping).
DHSC has asked LAs to consider this when identifying eligible settings.
DHSC say they are on track to begin allocating testing to priority locations (20% of settings identified by each Local Authority) in the week commencing the 12th October
They will then prioritise high prevalence areas in particular, and for every setting where councils have provided their completed returns on time, they aim to allocate tests to all eligible settings in October.
Extra Care and Supported Living testing webinars have been arranged. They will cover:
- Ordering tests
- Preparing for testing
- Test kit delivery
- The testing process itself
- Testing certain care groups
- Registering completed test kits
- How to send test kits back to labs
- Results and what they mean for organisations.
The session will include a Q&A with representatives from the national testing team, who will be able to answer your questions and address any concerns in the session.
Findings show 1 in 170 people in England had the virus between 18 September and 5 October, with 45,000 new infections every day.
An overview of NHS Test and Trace, including what happens if you test positive for coronavirus (COVID-19) or have had close contact with someone who has tested positive. Updated to reflect that the requirement to self-isolate if you test positive or are contacted by NHS Test and Trace and asked to self-isolate has changed from guidance to law.
Guidance on coronavirus testing, including who is eligible for a test and how to get tested. Added ‘students on clinical placements’ to list of essential workers and those prioritised for testing (England only).
NHS Test and Trace has now reached almost half a million people, including those testing positive and their contacts, to slow the transmission of coronavirus in England.
NHS COVID-19 app launches to help control coronavirus (COVID-19) transmission. Download the app at https://covid19.nhs.uk/
Privacy notice and data protection impact assessment for the NHS COVID-19 mobile app. Added new and updated privacy notices for national launch of the app, including an updated data protection impact assessment.
DHSC is engaging directly with organisations in the adult social care sector. People who are eligible to request a test will be given details on how to register. Tests are prioritised and even if you’re eligible, you will not get a test immediately. It can take several weeks to be invited to order a test and another 5 days for the test kit to be delivered to your address.
All care home staff are eligible for antibody tests. Care home staff in England and Wales should be tested at an NHS test site where possible. Talk to your care home manager to find your nearest test site.
Stuart Miller has written to care providers to highlight rising infection rates and request action on testing and PPE in all care settings. Key points from the letter incluide:
- portal is now open for care homes for working age adults to register for repeat testing. Care homes that have not yet registered for repeat testing are encouraged to do so
- each care home needs to reorder kits towards the end of each round of testing. Care homes are able to reapply 21 days after their last order
- ensure staff are following the PHE guidance relating to PPE:
- for all care settings: Personal Protective Equipment (PPE) illustrated guide for community and social care settings
- for care homes: COVID-19: how to work safely in care homes
- for domiciliary care: COVID-19: how to work safely in domiciliary care in England
- care home and home care providers can use the PPE Portal to order and receive critical coronavirus (COVID-19) personal protective equipment (PPE).
- the Adult Social Care Winter Plan will set out the support and resources we will make available nationally, as well as describing the actions for local areas
The third report from the country’s largest study on coronavirus rates of infection has been published today showing that cases are increasing steadily across the country.
An overview of the NHS Test and Trace service, including what happens if someone tests positive for coronavirus (COVID-19) or have had close contact with someone who has tested positive. Updated to add references about local contact tracers with info on how and when they may contact people.
Guidance on coronavirus testing, including who is eligible for a test and how to get tested. Updated following attachments to reflect updates to the registration portal: ‘guidance on non-Randox testing (England)’ and ‘how to use non-Randox test kits’.
Guidance and spreadsheet to record the details of up to 50 people who you've tested for coronavirus on that day. When registering test kits online, you will now be able to upload up to 50 test kits at once and you will be assigned a unique organisation number to use when using the national testing programme services. This document covers what these changes will look like and what these mean for you, and then walk you through the multiple registration upload portal.
DHSC is encouraging care homes to access testing on weekends when labs are less busy.
A summary of explanatory information to support users of DHSC coronavirus (COVID-19) testing and tracing statistics. Updated to reflect that daily testing statistics will no longer be updated on GOV.UK, and clarifying who gets transferred to contact tracing.
NICE is seeking specialists to join the Diagnostics Advisory Committee for the evaluation of ‘Exploratory economic modelling of SARS-CoV-2 viral detection point of care tests and serology tests’.
This group will explore:
- a viral detection test can be used to confirm the presence of SARS-CoV-2, the causative agent of COVID-19
- a serology test can be used to determine if someone has previously been exposed to SARS-CoV-2 and now has antibodies against the virus.
As outlined in the final scope, the assessment will explore the parameters that are most influential on cost-effectiveness modelling results in different settings.
For full information and details about how to apply, please see the NICE website
The closing date 14 September 2020
A summary of explanatory information to support users of DHSC coronavirus (COVID-19) testing and tracing statistics. Updated to correct an error in how the number of people tested relates to the number of positive cases.
The second monthly REACT-1 report from Imperial College London and Ipsos MORI has been published, showing how the virus has spread in England.
National monitoring tool that brings together metrics to assess the wider impacts of coronavirus (COVID-19) on health. Updated with new data release.
The COVID-19 pandemic has made the experience of bereavement much harder than previously and presents additional challenges when seeking to support bereaved people.
The University of Cambridge Palliative and End of Life Care Research Group is undertaking a national survey of a wide range of people who are supporting bereaved people during the pandemic. We would be very grateful if you could complete the anonymous survey which takes less than five minutes to complete.
Closing date 4 September 2020.
Letter from DHSC to Directors of Public Health, copied to Directors of Adult Social Services, Local Authority Chief Executives, Regional NHS Testing Leads and Care Providers. The letter includes an update on the use of Randox test kits and DHSC plans to roll out re-testing to care homes for older people and people with dementia, and all other adult care homes.
Matrix showing how to access tests for staff and clients in adult social care in England. Distributed with DHSC letter issued on 31 July 2020.
The Department of Health and Social Care launched the next stages in its Adult Social Care Testing Strategy on the 3 July. This document outlines the key testing provision within that strategy for residents and staff in care homes. This testing approach applies in England only. This document was updated on 27 July, and distributed with the DHSC letter on 31 July 2020 (see above).
NHS Test and Trace will launch the new campaign alongside a new business plan to expand testing capacity and prepare the nation for winter.
Sets out the next steps in the development of the NHS Test and Trace service and priorities for the next 3 to 6 months.
Coronavirus NHS Test and Trace service in the workplace – updated 22 July – GOV.UK
Government guidance on the NHS Test and Trace service for employers, businesses and workers. The guidance has been redrafted for clarity. In addition, there is a new section on collecting customer and visitor data for NHS Test and Trace. The following information has been added to the section headed ‘If a worker develops symptoms and orders a test’: Where an interaction between 2 people has taken place through a Perspex (or equivalent) screen, this would not be considered sufficient contact. Contact tracers will not consider the wearing of personal protective equipment (PPE) as a mitigation when assessing whether a recent contact is likely to have risked transmitting the virus.
Guidance on coronavirus testing, including who is eligible for a test and how to get tested. Updated 2 documents in section ‘Documents for care homes using the online application portal’: ‘guidance on Randox testing’ and ‘guidance on non-Randox testing’. These have been updated to reflect changes to clinical guidelines that people testing positive will need to be retested after 6 weeks. The ‘guidance on Randox testing’ document also includes a note to say that Randox test kits should not be used for testing until further notice.
How the DHSC puts together the contact tracing data in its weekly reports. Updated to include more information on how NHS Test and Trace classifies complex and non-complex cases and contacts, and how local test sites are included in turnaround statistics.
NHS Test and Trace has been notified that some test kits produced by Randox laboratories may not meet required safety standards for coronavirus testing. As a precautionary measure and while the issue is investigated further, NHS Test and Trace are requesting that all settings pause the use of Randox test kits with immediate effect and until further notice.
Over 120,000 volunteers tested across England between 1 May and 1 June as part of the country’s largest study into coronavirus. Imperial College London’s research shows the rates of infection fell during May, the last month of lockdown, halving every 8 to 9 days. There were on average 13 positive cases for every 10,000 people, with an overall reproduction number of 0.57 – lower than previously reported. The key findings include: young adults aged 18 to 24 were more likely to test positive; people of Asian ethnicity were more likely to test positive than those of white ethnicity; and care home staff and healthcare workers were more likely to be infected with COVID-19 during lockdown than the general population.
Guidance on the different types of coronavirus test available. Includes information on: Information on: the different types of coronavirus test; which type of test to use and when; what you should do when you receive a test result; and testing in the future.
Staff and residents in care homes for over 65s and those with dementia will receive regular coronavirus tests as part of a new social care testing strategy.
LGA press release says councils have received reports of fraudsters attempting to exploit the system through bogus phone calls, emails and text messages which ask for bank card details to cover the cost of the testing kit. The genuine NHS service is free. Anyone asked these types of questions should report the incident to Action Fraud.
From 7 June 2020 all adult care homes will be able to access whole care home testing for all residents and asymptomatic staff through the digital portal. This includes adult care homes catering for adults with learning disabilities or mental health issues, physical disabilities, acquired brain injuries and other categories for younger adults under 65 years. The Department of Health and Social care are continuing to explore how they can support other parts of the sector such as those in supported living settings, extra care settings and domiciliary care. Anyone with suspected coronavirus symptoms in these settings can still access testing by self-refer on gov.uk/coronavirus .
Care homes can apply for coronavirus testing kits to test the residents and staff. They can apply whether or not any residents or staff have coronavirus symptoms. There are 2 types of test kits delivered to care homes:
- Randox test kits
- all other types, known as Kingfisher test kits
The test kits look similar and test for whether someone currently has coronavirus in the same way.
Letter from Department of Health to care providers providing preliminary information for care providers – formal guidance will be issued shortly. Under the Test and Trace system anybody who has had a specific “close contact” with somebody who tests positive for COVID19 will be expected to isolate themselves for 14 days, or for seven days from developing symptoms of COVID19. Broadly a “close contact” is spending 15 minutes or more within 2 metres of an infected person, very close specified personal interaction for a shorter period of time or someone who has lived within the same household during a period of potential risk transmission. The letter outlines scenarios relating to care workers and close contact, and what employers should consider..
The Department of Health and Social Care aims to reach all care homes whose residents are over 65 or have dementia by the 6th June. There are still some care homes across England, who are eligible to register via the online portal who have not yet done so. Eligible care homes can access the online portal.
The Department is also hosting a series of webinars each weekday, in the morning and afternoon on the whole home swab testing process. The target audience is care homes. The Department strongly recommends them for care homes about to receive their test kits, but anyone from an eligible care home yet to carry out whole care home testing can attend one. More dates/times are added all the time.
The main objectives of the webinar series are to: outline the end to end whole home testing process, share top tips and provide an opportunity to ask questions. Register online.
Anyone who tests positive for coronavirus will be contacted by NHS Test and Trace and will need to share information about their recent interactions. This could include household members, people with whom they have been in direct contact, or within 2 metres for more than 15 minutes.
People identified as having been in close contact with someone who has a positive test must stay at home for 14 days, even if they do not have symptoms, to stop unknowingly spreading the virus.
If those in isolation develop symptoms, they can book a test at nhs.uk/coronavirus or by calling 119. If they test positive, they must continue to stay at home for 7 days or until their symptoms have passed. If they test negative, they must complete the 14-day isolation period.
Flow chart on how to get access to COVID-19 tests for care staff, residents and clients. This includes links across to relevant information based on whether or not someone has symptoms and where they work or are receiving care.
If a care home suspects a resident has coronavirus symptoms
You should contact your local Health Protection Team (HPT) if:
- you suspect your care home has a new coronavirus outbreak
- it has been 28 days or longer since your last case and you have new cases
Your HPT will provide advice and arrange the first tests.
For testing in other situations, you should apply for testing kits.
You can apply for coronavirus testing kits to test the residents and staff of your care home. You can apply whether or not any of your residents or staff have coronavirus symptoms.
This testing is currently only available in England. At the moment, you can only get tests if your care home looks after older people or people with dementia.
Related resources on whole care home testing:
- DHSC letter on roll out of whole care home testing – 13 May 2020
- Testing referral form: downloadable Excel form
- Digital portal for care home testing
You can apply for a test if you are:
- an essential worker with coronavirus symptoms
- aged 65 or over with coronavirus symptoms
- someone who cannot work from home and has coronavirus symptoms (for example, construction workers or delivery drivers)
Apply for coronavirus testing kits to test the residents and staff of care homes for older people or those with dementia.
Registered managers can apply whether or not any residents or staff have coronavirus symptoms.
Letter from Helen Whately on plans to ensure staff and residents in care settings is more joined up and that available national capacity is targeted to areas and care homes with the greatest need.
The letter follows on from the Secretary of State for Health and Social Care commitment (28 April) to offer a coronavirus test to every staff member and resident in every care home in England, whether symptomatic or not.
In the coming days, the Government will launch a digital portal for adult social care coronavirus testing, to make arranging tests for care homes as easy as possible. They will also make digital and clinically approved guidance available.
Anyone with a new continuous cough, a high temperature or the loss or change of sense of taste or smell can book a test by visiting nhs.uk/coronavirus.
If you’re eligible for a test and you don’t have internet access you can call 119 in England and Wales or in Scotland and Northern Ireland, 0300 303 2713.
Tests for NHS and social care, patients, residents and staff will continue to be prioritised.
Care, including medicines§
The Minister for Equalities’ Oral Statement to the House, on the first quarterly report to the Prime Minister and Health Secretary on progress to understand and tackle COVID-19 disparities experienced by individuals from an ethnic minority background.
Clinically extremely vulnerable people in England will receive new guidance to help them reduce their risk from coronavirus, tailored to where they live.
Guidance and information for industry, healthcare professionals and patients covering the coronavirus (COVID-19) outbreak. Added guidance on Warfarin
Researchers are calling on more people from Black, Asian and minority ethnic backgrounds and the over 65s to volunteer for clinical studies through the NHS Vaccine Registry.
Interim advice from the Joint Committee on Vaccination and Immunisation (JCVI) on the groups that should be prioritised for vaccination, if and when a vaccine is available.
Paper prepared by Mark Woolhouse, Bram van Bunnik and Aziz Sheikh.
Information on COVID-19, including guidance on the assessment and management of suspected UK cases. Added COVID-19: long-term health effects to the Management of possible or confirmed cases section.
The government is seeking views on proposed changes to the Human Medicine Regulations 2012. The consultation covers:
- authorising temporary supply of an unlicensed product
- civil liability and immunity
- expanding the workforce eligible to administer vaccinations
- promoting vaccines
- making provisions for wholesale dealing of vaccines
Closing date: 18 September 2020.
Government press release says millions could be vaccinated against COVID-19 as UK secures strong portfolio of promising vaccines. The UK has secured early access to 90 million doses of promising coronavirus vaccine candidates.
The government has launched the NHS COVID-19 vaccine research registry. This new website will enable people in the UK to play their part by volunteering for future vaccine studies.
The government has immediately authorised the NHS to use the world’s first coronavirus treatment proven to reduce the risk of death. Dexamethasone, an anti-inflammatory drug, has been immediately approved to treat all UK hospitalised COVID-19 patients requiring oxygen, including those on ventilators
Clinicians have the authority to remove patients from the shielded list if, after review, if they feel that he/she is not ‘clinically extremely vulnerable’.
On 10 April, NHS England wrote to GPs requesting that they review the list for accuracy and identify any additional patients who they feel should be included. The decision to remove a patient from the list should always be a clinical decision. Clinicians have been advised to discuss these decisions with their patients and mark their decision on the IT system.
Where some of these people have been receiving direct support from Government, the DHSC has been following up via text to make it clear that they can still access forms of support including the NHS Volunteers network, and will retain their supermarket priority delivery slots. If a patient has received a text and is unsure of what it means for them, they should contact their clinician to discuss.
The Government has announced a review which will analyse different factors that impact health outcomes from COVID-19. These factors include ethnicity, gender, obesity and the impact of COVID-19 on vulnerable groups.
To complement the wider disparity review, a research call by the National Institute for Health Research (NIHR) and UK Research and Innovation (UKRI) has jointly called for research proposals to investigate emerging evidence of an association between ethnicity and COVID-19 incidence and adverse health outcomes..
Frontline experience both in the UK and in other countries suggests that many older people may present atypically. This blog outlines the atypical symptoms known so far.
Letter summarising arrangements for COVID-19 testing including:
- Residents at point of outbreak: contact local PHE Health Protection Team who will ensure swab kits are provided and tests are carried out.
- Residents post outbreak: Piloting approach that enables all residents in a care home that has an outbreak and need a test to have access to one. Further information to follow
- On admission from hospital to care home: Patients should be tested before admission. See guidance.
- Pre-admission from other settings: In development. In the interim use local testing arrangements.
- Ongoing surveillance: Some care settings will be invited to swab and test selected residents and staff as part of public health surveillance work
There are two routes through which your staff can be tested. Employers should either:
- use the online employer portal to upload details of those they know are self-isolating. In order to obtain a login, employers of essential workers should email firstname.lastname@example.org with two email addresses that will primarily be used to load frontline worker contact details.
- increase awareness of the employee portal amongst staff so that they can book a test directly for themselves or members of their household if they become symptomatic and are self-isolating. They can book a test through the self-referral service.
Mobile testing units, operated by the Armed Forces, will travel around the UK to increase access to coronavirus testing for frontline workers including care workers. Units will respond to areas of highest demand, travelling to test frontline workers and the most vulnerable at sites including care homes
The government has committed to provide a COVID-19 test to all care workers who need one. This commitment covers all social care staff, including staff and voluntary workers in residential care settings and providing home care support. Frontline care workers in England who would like to be tested should speak to their employer. Tests are currently carried out through a network of drive-through regional testing sites.
The government is also piloting mobile testing units which will travel to offer tests where they are needed, providing kits directly to care homes that have a particularly urgent or significant need.
The Government has commenced a major long-term study to track the spread of Covid-19 in general population. The study will include antibody testing to help understand levels of immunity. The aim is to involve up to 300,000 people to take part over 12 months.
Government announces that all symptomatic care residents will be tested for COVID-19 as testing capacity continues to increase. All patients discharged from hospital to be tested before going into care homes as a matter of course. All social care staff who need a test will now have access to one with the Care Quality Commission (CQC) to contact all 30,000 care providers in the coming days to offer tests.
First advert from the NHS on COVID-19, published 18 March 2020
New 5-pillar plan outlines national effort to increase testing to 100,000 a day across the UK this month. Includes increased commercial swab testing for critical key workers in the NHS, before then expanding to key workers in other sectors.
There is no evidence from clinical or epidemiological studies that treatment with ACE-I or ARBs might worsen COVID-19 infection.
Recent media reports have suggested that chloroquine can protect patients from coronavirus or treat COVID-19, the illness caused by a coronavirus. Chloroquine and hydroxychloroquine are not licensed to treat COVID-19 related symptoms or prevent infection. Clinical trials are ongoing.
FAQs for the public on what they can and can’t do, including exercise, visiting friends, care for pets and animals.
NICE is reviewing the evidence re the use of NSAIDs in treating of COVID-19. In the interim, use paracetamol. Those currently on NSAIDs for other medical reasons (e.g. arthritis) should not stop them.
See all related information on coronavirus.