Central District Health Announces Additional COVID-19 Testing Information

Situation Update

Positive COVID-19 results have been reported for 3 Health District 4 residents and 7 people statewide. At this time, there is not indication of community spread in Idaho.

Testing Criteria

Healthcare providers should use their judgment to determine if a patient has signs and symptoms compatible with COVID-19 and whether the patient should be tested. Healthcare providers are strongly encouraged to first test for other causes of respiratory illness, including influenza.

If a healthcare provider feels that testing is indicated but is not offering COVID-19 testing due to infection prevention concerns, Central District Health strongly urges providers to refer patients to other locations such as urgent care clinics. Central District Health does not maintain a list of clinics who perform testing and cannot provide detailed recommendations at this time regarding where patients may seek testing.

Central District Health’s Investigation Role

Currently, any patient with a positive test result for SARS-CoV-2 will be contacted by local public health and advised on monitoring and movement restrictions after they have been notified by the provider of their result. Central District Health will not notify patients of positive or negative results.

This is a rapidly evolving situation and this could change as needed to focus public health resources on protecting the most vulnerable populations.

Testing at Idaho Bureau of Laboratories

To test specimens for SARS-CoV-2 (the virus that causes COVID-19) at the Idaho Bureau of Laboratories (IBL), notify public health officials prior to specimen submission. Failure to notify public health will lead to delays in testing. Call Central District Health at (208) 327-8625, fax specimen submission reporting form to 208-327-7100 or call the Division of Public Health Epidemiology Section at (208) 334-5939.

Only nasopharyngeal (NP) swab specimens will be tested at IBL. Specimens must be accompanied by a completed IBL clinical test request form found at https://healthandwelfare.idaho.gov/Portals/0/Health/Labs/Clinical_Test_Request_Form.pdf select the Other option under Virology, and write in “COVID-19”. Incomplete forms will delay processing of specimens and receipt of test results.

The priority of the Idaho Bureau of Laboratories (IBL) is to maintain a 24-hour turnaround time for SARS-CoV-2 testing of hospitalized patients.

To ensure this capability, beginning Tuesday March 17, IBL will only accept specimens for testing for SARS-CoV-2 on:

• Hospitalized patients
• Specimens determined by local public health districts to be high priority for public health purposes. Central District Health prioritizes the following groups of patients:
• Close contact with a person with a confirmed COVID-19 infection
• Recently traveled to an area with widespread community transmission of COVID-19
• Health care workers
• Long-term care facility residents or residents of other congregate living facilities with respiratory disease and negative influenza testing.

Specimens collected on patients not falling into the above categories must be sent to commercial laboratories for testing. Testing is not recommended in people who have no symptoms.

Please do not call IBL or Central District Health to ask when results will be Please do not ask your patients to call Central District Health to ask for their results. IBL will call the ordering provider listed on the clinical test request form if the result is positive, and all results will be provided via normal channels.

Please be sure after hours contact information is included on the form to avoid delay in communicating positive results and appropriate public health response. IBL is currently experiencing difficulty with reporting software and temporarily will be faxing all results to providers. Please be sure to include a secure fax line number on the clinical test request form.

Guidance for Discontinuation of Home Isolation

CDC has developed updated guidance for discontinuation of home isolation of persons with COVID 19. In most instances, using the non-test-based strategy is recommended. Under this strategy, persons with COVID-19 who have symptoms and were directed to care for themselves at home may discontinue home isolation under the following conditions:

• At least 3 days (72 hours) have passed since resolution of fever without use of fever-reducing medications and improvement in respiratory symptoms (e.g., cough, shortness of breath); AND
• At least 7 days have passed since symptoms first appeared.

Viral Transport Media Alternatives

Some facilities are reporting difficulty obtaining viral transport media /universal transport media to collect and transport patient samples. Alternative transport media for the CDC 2019-nCoV Real-Time RT-PCR Diagnostic Panel used by IBL are described at https://www.fda.gov/medical-devices/emergency situations-medical-devices/faqs- diagnostic-testing-sars-cov-2. The most likely alternative for Idaho facilities is: Dry swab in saline. Do NOT use calcium alginate swabs or swabs with wooden shafts.

• Supplies:
  • Puritan: 25-3317-H, 25-3316-U, 25-3316-H, 25-3317-U, 25-3318-U,25-3318-H, 25-3319-H, 25-3320-U, 25-3320-U EMB 100MM, 25-3320- U EMB 80MM, 25-3320-H and 25-3320-H EMB 80MM
  • Copan: 501CS01, 503CS01, 516CS01, 518CS01 and 534CS01
• Storage: Up to 72 hours at 4℃, or frozen for longer storage

Contact your commercial laboratory to learn what specimen collection and transport materials are acceptable for their SARS-CoV-2 assay.

Additional resources

• CDC COVID-19 for healthcare: https://www.cdc.gov/coronavirus/2019- ncov/hcp/index.html
• Central District Health: https://cdh.idaho.gov/dac-coronavirus.php
• Idaho Coronavirus Page: https://coronavirus.idaho.gov