South Africa's COVID-19 testing backlog is making healthcare workers wait weeks for their own results, leading them to fear for themselves and patients. (GCIS)

A resource summary of the updated COVID-19 testing and management guidelines from South Africa’s National Department of Health and National Institute for Communicable Diseases.

Resource details:

Publication title: Clinical management of suspected or confirmed COVID-19 disease (Version 4)

Author(s): National Department of Health and National Institute for Communicable Diseases.

Publication date: 18 May 2020

What the guidelines are about:

These are updated guidelines on the care and management of COVID-19 cases in and outside of healthcare facilities. A previous version of the guidelines was issued on March 27. This latest edition includes a new section on the care and management of COVID-19 cases in children, pregnant and breastfeeding women, and people living with HIV.

Key take-aways from the guidelines:

  • Acute cases of COVID-19 should be tested by polymerase chain reaction (PCR). These tests can produce false negatives, the guidelines warn. Repeat tests are thus recommended for suspected cases of COVID-19 infection despite a prior negative test. Repeat confirmatory tests aren’t necessary, however.
  • Serological, or antibody, tests are currently not recommended to diagnose acute cases of COVID-19 as these are considered “insufficiently sensitive”.
  • People with suspected cases of COVID-19 waiting for their test results can self-isolate at home if they are medically well. Individuals who have been diagnosed with a mild case of COVID-19 and are medically well can also self-isolate at home. If the condition of suspected or diagnosed patients deteriorates while self-isolating at home, they should return to a healthcare facility immediately.
  • Individuals with suspected or confirmed cases will be admitted into an isolation facility if they are unable to self-isolate themselves safely. This includes individuals who are unable to “stay in a separate room, maintain physical distancing, maintain good hand hygiene, and return timeously to a healthcare facility in case of deterioration”.
  • Patients with mild COVID-19 and who are potentially at risk of developing a more severe case needn’t necessarily be hospitalised. These patients can be managed from home if they are able to safely self-isolate. Home-managed patients should be given the contact details of their doctor or healthcare facility in case of deterioration.
  • Asymptomatic COVID-19 patients can come out of isolation 14 days after their positive test. Patients with mild cases of COVID-19 can de-isolate 14 days after their symptoms begin. Those with severe cases of the disease can come out of isolation 14 days after they are in a stable condition.
  • Paracetamol is recommended as the first option for fever and pain relief.
  • Patients with low oxygen saturation levels should immediately receive supplemental oxygen therapy.

You can find and download the guidelines here.

[Please note: Information on the new coronavirus is rapidly changing. Please refer to the National Institute for Communicable Diseases’ website for the latest information. Visit for updates on South Africa’s coronavirus response.]

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Gopolang Makou was the impact and engagement officer at Bhekisisa.