Testing: A message from the CDPHE

March 3rd, 2020
(Message from the CDPHE, dated March 3, 2020)

The Colorado State Public Health Laboratory is planning a laboratory call for our clinical laboratory partners, date and agenda forthcoming. The State Laboratory at the Colorado Department of Public Health and Environment is now operating seven days a week, testing for COVID-19. The lab will perform two testing runs daily, at 10 am and 4 pm. All test requests and required information must be at the lab and approved one hour prior to the scheduled run.

coronavirus or COVId-19 in Colorado
Coronaviruses, also called COVID-19. Photo: UCHealth.

With current staffing and equipment resources, the state lab has the capacity to test up to 160 samples per day, assuming test kits from Centers for Disease Control and Prevention are continuously available. Turnaround time for results is expected to be within 24 hours of specimen receipt at the State Laboratory. Confirmatory testing on positive specimens will be performed at CDC but will not delay reporting or our public health response. Specimen test requests must be submitted through the LabOnLine electronic test request portal at https://labonline.cdphe.state.co.us/Account/SignIn and include all required specimen, patient and epidemiological information (symptoms, travel dates & locations, hospitalization).

LabOnLine user access assistance: cdphe_labonline@state.co.us, 303-692-3399 or https://sites.google.com/state.co.us/lsd-horizon-lims/labonline

The preferred method for specimen transport to the State Laboratory is through the routine courier shipping methods. On-demand courier service is available if the routine system will not allow samples to arrive at the laboratory prior to cut-off times by calling 303-815-7220.

Currently acceptable sample types include nasopharyngeal (NP) or oropharyngeal (OP) swabs in viral transport media. Please do not place more than one swab in each collection tube. Additional sample types may be requested by CDPHE on a case-by-case basis (including lower respiratory specimens for patients with more severe illness).

At this time, there is no cost associated with COVID-19 testing at the State Laboratory.

In Colorado, there are three circumstances where public health may decide that a patient needs to be tested:

  1. The patient has a fever OR signs/symptoms of lower respiratory illness, such as cough or shortness of breath, AND the patient has been in close contact with someone confirmed with COVID-19, within 14 days of when symptoms started.
  2. The patient has a fever and signs/symptoms of lower respiratory illness (and other diagnoses such as influenza have been ruled out), AND the patient recently traveled to parts of the world where infection rates are high or community spread is occurring, within 14 days of when your symptoms started.
    1. Please note this guidance varies slightly from Centers of Disease Control and Prevention. As we have capacity, Colorado will continue to consider testing for individuals who are not hospitalized in order to identify patients who have traveled to affected areas who have less severe disease.
  3. The patient has a fever with severe lower respiratory illness that requires hospitalization AND other diagnoses such as influenza have been ruled out.

Additional points from CDPHE HAN sent on 02/28/2020

  • There is currently no commercially available testing for COVID-19. Commercial multiplex respiratory panels that include coronaviruses are unable to detect the virus that causes COVID-19 (SARS-CoV-2).
  • Testing for other respiratory pathogens may support decision-making but should not delay specimen submission for COVID-19 testing; consider collecting two separate samples if you are also running a respiratory panel when the PUI has a known exposure or has traveled to an affected country. If a PUI tests positive for another respiratory pathogen, after clinical evaluation and consultation with public health authorities, they may no longer be considered a PUI, especially if their exposure is considered low risk. This may evolve as more information becomes available on the frequency of COVID-19 co-infections.
  • As a precautionary measure, based on previous CDC guidance from MERS-CoV, facilities may want to consider hand-carrying specimens from patients being evaluated for COVID-19 to the lab instead of using pneumatic tube systems.
  • Specimens should be collected as soon as possible once a PUI is identified, regardless of time of symptom onset. Additional guidance for collection, handling, and testing of clinical specimens is available at https://www.cdc.gov/coronavirus/2019-nCoV. For biosafety reasons, it is not recommended to perform virus isolation in cell culture or initial characterization of viral agents recovered in cultures of specimens from a PUI for COVID-19.

 

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About the author

UCHealth is an innovative, nonprofit health system that delivers the highest quality medical care with an excellent patient experience. With 24,000 employees, UCHealth includes 12 acute-care full-service hospitals and hundreds of physicians across Colorado, southern Wyoming and western Nebraska. With University of Colorado Hospital on the Anschutz Medical Campus as its academic anchor and the only adult academic medical center in the region, UCHealth pushes the boundaries of medicine, providing advanced treatments and clinical trials and improving health through innovation.