Coronavirus Testing - March 31, 2020
Testing for the novel Coronavirus (SARS-CoV-2/COVID-19) is now live at RML core lab.
Testing for the novel Coronavirus (SARS-CoV-2/COVID-19) is now live at RML core lab. All specimens are being tested as quickly as possible. Patients are being prioritized based on inpatient/outpatient status and Tier designations (below). Please call client services if there is a critical need for testing (918-744-2500 or x18842 or x18843) or send an email to RMLCovid19@ascension.org. Due to the need to quickly test the most critical patient populations, the shortage of specimen collection and testing supplies, RML will only be accepting specimens from Tier 1 and Tier 2 patients at this time.
The updated CDC guidance lays out four priority levels for testing:
- Any hospitalized patients who are critically ill and receiving ICU-level care with unexplained viral pneumonia or respiratory failure.
- Anyone with fever and signs of a lower respiratory tract illness who has had close contact with a confirmed COVID-19 patient within 14 days of symptom onset.
- Anyone with fever and signs of a lower respiratory tract illness who has traveled within 14 days of symptom onset to countries or areas of the United States that have experienced sustained community transmission of novel coronavirus.
- Anyone with fever and signs of a lower respiratory tract illness who is immunosuppressed, elderly, or has underlying chronic health conditions.
- Individuals who are critical to pandemic response such as health workers and public health officials who have fever and signs of a lower respiratory tract illness.
People at the second highest priority for testing are hospitalized patients and long-term care residents who have unexplained fever and signs of lower respiratory illness. "The number of confirmed COVID-19 cases in the community should be considered. As testing becomes more widely available, routine testing of hospitalized patients may be important for infection prevention and management at discharge," the recommendations say.
Patients in outpatient settings who meet influenza testing criteria, including people with co-morbid conditions such as diabetes and congestive heart failure as well as individuals over age 50. "Given limited available data, testing of pregnant women and symptomatic children with similar risk factors for complications is encouraged. The number of confirmed COVID-19 cases in the community should be considered," the recommendations say.
People targeted for community surveillance by public health or infectious disease officials.
- Acceptable swabs have synthetic tips (NO cotton or calcium alginate) and plastic shafts (NO wooden shafts).
- Collect a single nasopharyngeal specimen. Oropharyngeal specimens have reduced sensitivity and should NOT be collected. Nasal (nares specimens) are NOT acceptable.
- Place swab in a transport tube containing 1-3 mL VTM, UTM, M6, M4 or sterile saline; eSwabs may also be used for collection, but due to the low volume, repeat testing cannot be performed in cases of specimen failure.
- Place specimen within a biohazard bag, one patient specimen per bag. Swabs in media or saline should be refrigerated until picked up.
- COVID-19 testing order is: SARS-CoV-2 by PCR, SARS-CoV2 (6907557).
- RML will pick up all specimens from RML pick up sites and deliver them to the core lab.
Testing of both COVID-19 and other respiratory viruses (mini VRESP panel) may be performed from a single swab if there is at least 1.5 mL of collection media. If both tests are desired, order both the SARS-CoV-2 by PCR (6907557) and Mini VRESP PCR (6907567). When both orders are placed, RML will perform the SARS-CoV-2 test, followed by the mini VRESP panel if specimen is sufficient. If only the SARS-CoV2 test is truly needed, please do not order the VRESP panel. Effective immediately, due to new CDC guidelines, no viral cultures of respiratory specimens will be performed. Order the mini VRESP panel by PCR if testing for respiratory viruses is necessary.
All orders for the viral respiratory panel (VRESP PCR) will be converted to an abbreviated virus panel, the Mini VRESP PCR (6907567) with testing limited to those viruses that have been identified in our patient population this season including influenza A and B, RSV and metapneumovirus. This is required to optimally utilize testing resources and personnel during this pandemic. To help streamline this process, please order the mini VRESP panel instead of the VRESP Panel. If testing of other viruses such as Adenovirus or Parainfluenza viruses 1-3 is required, please order these tests separately (order names ADENOV PCR or PARA FLU P). Please avoid screening with rapid testing for Influenza and RSV to conserve collection supplies and avoid duplicate testing.
Useful Links and Guidelines for Clinicians, Laboratorians, Infection Preventionists, and Emergency Management Professionals:
Oklahoma State Department of Health Coronavirus Disease Information
Kansas State Department of Health COVID-19 Resource Center
Wisconsin State Department of Health Services COVID-19 Information
Current CDC Guidelines for Specimen Collection
Current CDC COVID-19 Situation Summary
CDC Clinical and Epidemiologic Criteria for COVID-19
CDC Biosafety Guidelines
CDC UN 3773 Biological Substance, Category B Shipping and Packaging Training
COVID-19 - Navigating the Uncharted [Article by Drs. Fauci (NIH-NIAID), Lane (NIH-NIAID), and Redfield(CDC)]
If you have any questions or need additional information contact:
Dr. Gerald Miller at 918-744-2553 x15543 or email: email@example.com; or contact
Kendra Thompson at 918-744-3131 x18355 or email Kendra.firstname.lastname@example.org.