TITLE:
Normal Body Temperature and Negative Covid 19 Questionnaire Sufficient Prior to Diagnostic Neurological Testing to Prevent Covid 19 Transmission to Health Personnel
AUTHORS:
Narayan Verma
KEYWORDS:
Covid 19, Questionnaire, Neuro-Diagnostic Testing
JOURNAL NAME:
Open Journal of Preventive Medicine,
Vol.11 No.5,
May
31,
2021
ABSTRACT: The aim of this study was to find a simple and effective way to screen patients for Covid 19, prior to them being submitted to neurophysiological or neuro-psycholoigical testing in order to protect employees from being infected during the pandemic from patient contact. On May 18, 2020 when Michigan, a critically affected pandemic area, reopened for medical business after lockdown declared by the Governor on March 23, 2020, medical personnel in our office-which is an academic neurology practice-EEG and sleep technicians, medical Assistants, physician assistants and myself fretted about potential Covid 19 transmission during neuro-diagnostic procedures-EEG, video-EEG, ambulatory EEG, PSG, MSLT, CPAP titration, neuropsychological testing, EMG/NCV, VNG/Balance test and autonomic testing including the tilt table test, which require an intimate patient contact and risk of exposure. We screened all unselected and consecutive patients who were scheduled for neuro-diagnostic testing in our facility by infrared thermometer, a standard Covid 19 questionnaire and a single Covid 19 PCR nasal/throat swab prior to these tests. 542 consecutive unselected neurological or sleep/wake disorder patients aged 18 - 90, 65% males, 35% females were tested over six months as a part of this project. A total of 1109 diagnostic tests were performed. No test was limited in scope or duration. Standard PPE precautions were still taken despite the negative screening, room door left open and relatives’ presence limited during the test procedure. All were afebrile and negative on questionnaire and only 3 were found to be positive for Covid 19 PCR, indicating that a negative infrared temperature reading and a standard Covid 19 questionnaire is over 99 percent effective in prescreening for intimate neurological diagnostic testing. The technician, administering most of these tests, never contracted the virus. The technician collecting the nasal/throat swab never contracted the virus. One PA, two sleep technicians and one medical assistant came down with Covid 19 but were all felt to have contracted that from domestic exposure from family members or friends and not when at the job. All had mild disease and rapidly recovered. Infrared temperature testing and standard Covid 19 questionnaire are sufficient prior to intimate neuro-diagnostic testing when combined with standard PPE precautions to limit exposure to Covid 19 in medical personnel in a neurology office with on-site diagnostic testing.