IDAHO HEALTH ALERT NETWORK


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Message ID:   1813      Public Message
Subject:   Test Covid sample update
Sent By:   PHD7 Date Sent:   3/27/2020 2:14:32 PM
Priority:   Advisory Status:   Sent (Delivered)
PHIN Specific Data:
Severity:   Severe Delivery Time:   15 Minutes
PHIN Status:   Test Message Type:   Alert
Sensitivity:   Non Sensitive Acknowledgement:   No
Attachments:
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Message Text:

Guidance for Novel Coronavirus Disease (COVID-19) Specimen Collection and Testing — update 3/27/2020

On 3/24, the Centers for Disease Control and Prevention (CDC) updated guidance for clinicians on evaluating and testing persons for COVID-19 to include prioritization of groups for testing, and guidance on collecting specimens for COVID-19 testing to allow for use of nasal swabs and self-collection of nasal swabs. We describe below how these guidelines integrate with testing at the Idaho Bureau of Laboratories (IBL), https://statelab.idaho.gov. IBL's priority is to maintain a 24-hour turnaround time for SARS-CoV-2 testing of hospitalized patients.


Prioritization of Specimens for Testing at IBL
IBL will accept specimens for testing for SARS-CoV-2 based on CDC priority categories. IBL prioritization may differ slightly from CDC priority guidelines in order to maintain turnaround time for hospitalized patients. Notify Eastern Idaho Public Health within 24 hours of shipment so they can correctly identify high priority specimens for IBL. This prioritization may be revised if turnaround time for hospitalized patients cannot be maintained.

IBL High Priority Specimen
• Hospitalized patients
• Symptomatic healthcare workers
• Symptomatic patients in long-term care facilities
• Symptomatic staff or inmate in correctional facility in the absence of an identified COVID-19 outbreak in the facility
• Severe respiratory illness of no known cause
IBL Routine Priority Specimen
• Symptomatic patients = 65 years of age
• Symptomatic patients who are at high risk of severe disease because of underlying medical conditions
CDC Priority 3 (not listed above for IBL):
     Specimens should be sent to commercial laboratories

Asymptomatic persons should not be tested.

See https://www.cdc.gov/coronavirus/2019-nCoV/hcp/clinical-criteria.html.

Specimen Collection and Submission
Either nasopharyngeal (NP) swab specimens or nasal swab (NS) specimens may be tested at IBL.
NP swabs are preferred.
Nasal Swabs: Do not use cotton swabs, swabs with wood shafts, or swabs with calcium alginate. Use only synthetic fiber swabs to sample both anterior nares. Specimens may be collected by healthcare professional or self-collected. Oral swabs may be used; NP swab shaft length and flexibility are not desirable. See https://www.youtube.com/watch?v=2cd4gg975ao from the Joint Commission and CDC for nasal swab collection video.
Transport Media: The volume of transport media required is 1 to 3 mls. Laboratories may aliquot media as needed. For specimens submitted to IBL, viral transport medium, Amies transport medium, or sterile saline may be used.
Clinical Test Request Form: Specimens must be accompanied by a completed IBL clinical test request form (https://healthandwelfare.idaho.gov/Portals/0/Health/Labs/Clinical_Test_Request_Form.pdf). Many forms are being submitted with blank Onset Date and Collection Date fields. Both dates are being used to prioritize samples. Samples without these dates completed are processed last. To ensure timely and appropriate notification, the patient city or county must be provided. Without complete information, laboratorians, epidemiologists, and infection preventionists are losing valuable time tracking down the appropriate jurisdiction for public health intervention. Please help your colleagues by completing all the requested information on the clinical test request form for specimen submissions to IBL.
https://www.cdc.gov/coronavirus/2019-nCoV/lab/guidelines-clinical-specimens.html