Public labs test for COVID-19 as CDC updates testing criteria

Feb. 28, 2020

As many as 40 state public health labs could begin testing for the COVID-19 virus using parts of the test developed by the Centers for Disease Control and Prevention (CDC) as early as this week, according to the Association of Public Health Laboratories (APHL).

"As of now: @CDCgov & @US_FDA developed a new protocol using 2 of 3 components of original test kit. Many public health labs are able to use the original kit w/out problem component to begin testing as soon as this week," APHL said on its Twitter feed.

Earlier this month, the CDC's rollout of test kits was delayed after problems were found with some the kits' reagent. The APHL wrote a letter to the Food and Drug Administration (FDA) on February 24, asking the agency for enforcement discretion to allow state and local public health labs the ability to create a laboratory-developed test for the detection of the novel coronavirus.

On Twitter, the APHL said its scientists were in talks with the FDA and CDC to figure out a way to allow labs to use functioning tests.

Meanwhile, the CDC expanded its guidelines for when providers and public health officials should tests patients for COVID-19. The updated guidelines now also recommend testing patients who are hospitalized for fever and severe acute lower respiratory illness even when “no source of exposure has been identified” if there is no alternative diagnosis.

The CDC also now recommends testing patients who have respiratory symptoms and have recently returned from Iran, Italy, Japan and South Korea. This updates the agency’s earlier guidelines, which only included travel to China.

Testing capacity across the United States was called into doubt earlier this week when officials at the University of California Davis said the latest patient diagnosed in California was not tested for COVID-19 for several days because the person did not have a travel history to China or contact with a case-patient.

The patient may represent the first US case involving community spread of COVID-19.

According to a statement from UC Davis Medical Center, where the patient is being treated, the test was requested immediately upon the patient’s admittance on February 19.

"We requested COVID-19 testing by the CDC, since neither Sacramento County nor the California Department of Public Health is doing testing for coronavirus at this time. Since the patient did not fit the existing CDC criteria for COVID-19, a test was not immediately administered. UC Davis Health does not control the testing process," the hospital said.

"Sunday (Feb. 23), the CDC ordered COVID-19 testing of the patient, and the patient was put on airborne precautions and strict contact precautions, because of our concerns about the patient's condition."

But all California hospitals might not be prepared to protect their workers. According to a survey of the California Nurses Association and National Nurses United released earlier this week, only 31 percent of nurses said employers have made personal protective equipment available to them. And only 13 percent of the roughly 3,000 nurses asked said they had a patient isolation plan in place, and only 46 percent said they had been given COVID-19 information.

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