Central District Health Announces Additional COVID-19 Testing Information and Infection Prevention Guidelines

Testing Criteria
Criteria to guide testing of patients for COVID-19 have been expanded to a wider group of symptomatic patients. See https://www.cdc.gov/coronavirus/2019-nCoV/hcp/clinical- criteria.html. 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. A checklist for evaluating persons with respiratory symptoms for COVID-19 is available here: https://healthandwelfare.idaho.gov/Portals/0/Health/Epi/COVID- 19%20assessment%20guidance_DPH.pdf. This checklist is an optional tool for clinicians and is not required for specimen submission at IBL.

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, asking them to call before arriving. 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.

Commercial Lab Testing
As of 3/10/2020, LabCorp, Quest Diagnostics, and UW Medicine are accepting samples from Idaho for COVID-19 testing. ARUP Laboratories started COVID-19 testing on 3/12/2020. Refer to the commercial laboratory for guidance on specimen collection and submission procedures. The Healthcare Common Procedure Coding System code for COVID-19 laboratory tests is U0002. See the Medicare fact sheet for further detail: https://www.cms.gov/files/document/03052020-medicare-covid-19-fact-sheet.pdf. Specimens may be collected and shipped to commercial laboratories without prior public health notification.

Testing at Idaho Bureau of Laboratories
For COVID-19 testing at IBL, oropharyngeal and nasopharyngeal swabs can be combined at the time of collection into the same vial. Combining these specimens will conserve consumables and increase testing capacity. See https://www.cdc.gov/coronavirus/2019-nCoV/lab/guidelines-clinical specimens.html for additional information.

To test specimens for 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 or the Division of Public Health Epidemiology Section at (208) 334-5939.

Testing at IBL is not offered for asymptomatic people.

Specimens from patients with mild respiratory symptoms and no known exposures will have standard testing priority. High priority will be given to specimens from symptomatic people who meet one or more of the following criteria:

• had close contact with a person with a confirmed COVID-19 infection
• recently traveled to an area with widespread community transmission of COVID-
  19
• have severe respiratory illness of no known cause
• are health care workers
• are long-term care facility residents or residents of other congregate living
  facilities with respiratory disease and negative influenza testing.

Contact IBL at 208-334-2235 or see the IBL website (https://statelab.idaho.gov) for instructions on specimen collection and submission. After notifying public health, submitters can use the IBL Clinical Test Request Form, select the Other option under Virology, and write in “COVID-19”.

Turnaround time for results will be variable based on daily number of specimens received. Results will be sent to the provider listed on the clinical test request form. Please do not call for test results.

Infection Prevention Considerations
CDC has updated its COVID-19 infection prevention guidance to include PPE considerations during times of supply chain shortages. See https://www.cdc.gov/coronavirus/2019-nCoV/infection-control.html for detailed infection prevention and control recommendations and updates.

Patients presenting with respiratory illness should be instructed to take steps to minimize the spread of illness in the community. Specific steps include staying home and avoiding close contact with others while ill, covering coughs and sneezes with a tissue, washing hands often, and disinfecting frequently touched surfaces.

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