SELDOC Healthcare is piloting the use of FebriDx, a rapid point-of-care test system that, if successful, will enable our clinicians to distinguish more easily between viral [possibly COVID-19] and bacterial infections, and provide patients with suitable diagnostics at home. 
SELDOC will run the pilot scheme from the Tessa Jowell Health Centre and initiate an HCA home-visiting service across the weekends of 28-29 November and 5-6 December across south east London. 
Identifying viral and bacterial infections 
The symptoms of viral and bacterial infections can be very similar and hard to differentiate, and acute respiratory infections (ARIs) are among the most common reason for outpatient office visits and unnecessary antibiotic prescriptions. 
FebriDx Near Patient Testing identifies clinically significant ARIs, and so SELDOC plans to use the pilot scheme to evaluate its benefits over a four-day period. 
The criteria to measure its effectiveness include the number of patients with upper or lower Respiratory tract symptoms visited by our HCAs, and the number of patients treated without base visits and face-to-face GP appointments. We will examine the acceptability of both clinicians and patients to use the device, and its overall reliability. 
We will also consider the cost of this near-patient testing service against any cost avoidance in saving GP time, and the potential of commissioning FebriDx in both core hours and out of hours. 
Moreover, we will focus on the impact on patients throughout, as well as any utilization of antibiotics, the number of patients referred to emergency departments, and any incidents due to the proposed process. 
How it works 
The process of the FebriDx pilot is simple: first, an online assessment determines whether or not a patient is displaying potential COVID symptoms. If so, and if that patient is unable to manage those symptoms, a GP will request a FebriDx Pilot HCA to make a home visit – ­wearing full PPE – to perform a series of observations and, if necessary, administer a finger prick blood test, which takes a matter of minutes. The results are just as efficient, taking as little as 10 minutes in some cases, after which a GP can make any further recommendations. 
The full planned process of FebriDx can be found on this video: 
FebriDx will reveal the cause of each patient’s upper/lower respiratory tract symptoms and, thanks to its 99% predictive value when it comes to ruling out a bacterial infection, should enable SELDOC clinicians to administer more effective advice. 
FebriDx works by looking for the myxovirus resistant A (MxA) protein, which is only elevated in the presence of acute viral infections. In such cases, but not during this pilot, the HCA would follow the FebriDx test with a COVID swab, before deciding whether or not hospitalization or home isolation are required. For the purposes of this pilot, our HCAs will discuss the findings with a GP and recommend appropriate action. 
FebriDx also recognises raised levels of the C-reactive protein (CRP), the cause of bacterial infections. If found, our HCAs can assess with a GP and conduct an exploratory check for symptoms of sepsis. If sepsis is ruled out, a GP can then consider the use of antibiotics or further treatment. 
In advance of the pilot scheme, SELDOC will train HCAs how to take observations and spot signs of a sick/septic patient, and how to use the system itself and interpret the results. GPs will also learn how to interpret the results of FebriDx, and the associated nuances around any sensitivities and specifics. 
SELDOC will publish the outcome of the pilot scheme afterward. 
For more information of FebriDx, please visit 
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