The West Virginia Department of Health and Human Resources (DHHR) is working to ensure that the public and medical providers understand the current Coronavirus Disease 2019 (COVID-19) testing criteria and the fact that supplies for such are not unlimited. Currently, COVID-19 testing is used in accordance with guidelines from the U.S. Centers for Disease Control and Prevention (CDC).
The state’s public health lab, West Virginia Office of Laboratory Services (OLS), is the primary facility for COVID-19 testing until commercial laboratories and hospitals develop testing capacity for COVID-19. The state public health lab has remained available 7 days a week to provide testing for any healthcare or public health provider submitting specimens. At present, all tests submitted to OLS are being processed within a 2-3-day timeframe, often earlier. Most states are seeing turnaround time increase as testing submissions rise and supplies remain on backorder.
Since early March, two groups have been and remain prioritized for COVID-19 testing through OLS. These groupings prioritize the likelihood of finding disease (testing those who are most likely to have been exposed), support care for those most at risk, and support proper infection control in the healthcare setting. Individuals prioritized for testing by OLS include the following:
Seriously ill individuals hospitalized or otherwise at high risk of complications: This includes seriously ill individuals with symptoms of COVID-19 who are hospitalized, near hospitalization or otherwise at highest risk of poor health outcomes (e.g., those who are elderly or have serious underlying chronic diseases, nursing home residents, etc.) AND who do not have another identified cause for their illness (e.g., flu, other respiratory viruses). No history of potential exposure is needed for these patients.
Individuals at medium to high risk of having been infected: This includes any individual with symptoms of lower respiratory illness (fever, cough, shortness of breath) AND a history of likely exposure to COVID-19 within 14 days of symptom onset (e.g., close contact with an individual confirmed to have COVID-19 or recent travel history from or living in areas with widespread community transmission) AND do not have another identified cause for their illness (e.g., flu, or other respiratory viruses).
These are slight modifications of CDC Guidelines, focusing on those most ill in criteria one above, given that supplies are limited, and some products remain on backorder in West Virginia and nationally. They are subject to change. For current testing criteria, visit coronavirus.wv.gov.
“DHHR continues to actively work with providers to assure they are knowledgeable about specimen collection and submission protocols, and to adjust to changing supplies and supply chains,” said Dr. Cathy Slemp, State Health Officer and Commissioner of DHHR’s Bureau for Public Health. “We are also working with local and federal partners to build novel testing systems as supplies and resources are made available federally.”
All providers seeing patients meeting the above criteria and requesting testing through the state’s public health lab are asked to first obtain a public health consult in order to provide applicable patient information and coordinate specimen submission.
Most individuals who are seriously ill have testing arranged by their healthcare provider. Individuals with a likely history of medium or high-risk exposure (as per above) may contact their healthcare provider by phone or call the Coronavirus Hotline, 1-800-887-4304, to help determine their need for testing.
“Testing for COVID-19 may not be appropriate for everyone,” added Dr. Slemp. “A provider’s decision to order COVID-19 testing is based on several factors, including clinical judgment and the availability of testing supplies and lab resources.”
With any respiratory illness, individuals who are sick with fever, cough, and other respiratory symptoms should stay home and self-isolate until fully well and cleared by a physician. During this time of anticipated large demand on the healthcare delivery system, individuals are asked to avoid unscheduled visits to healthcare providers. People who are mildly ill should not go to provider offices or be sent to emergency departments. Mildly ill people should stay home, follow CDC guidance, and contact their healthcare provider if needed.
Providers who contract with LabCorp for COVID-19 testing should contact their representative to assure supplies and service. Several state hospital systems are working to implement newly emerging commercial products. Commercial and hospital labs may establish their own testing criteria in conjunction with the submitting provider and typically do so in ways to best utilize available supplies needed for testing.
“Providers and facilities are encouraged to stay abreast of emerging technologies to assure they are ready to implement rapid tests and other products as they emerge on the market,” concluded Dr. Slemp.
An information hotline to address public and medical provider questions and concerns regarding COVID-19 has been established. Operators are available 24/7, toll-free at 1-800-887-4304 to provide accurate information about COVID-19 and the risk to the public.
A daily update is posted by DHHR regarding the number of cases of COVID-19 at www.coronavirus.wv.gov. For additional information, please visit http://www.cdc.gov/COVID19.