SUMMARY

• The criteria for COVID-19 public health testing by the Virginia Department of Health (VDH) at the state lab (DCLS) have been updated. Please utilize the attached public health testing algorithm, which can also be found on FCHD’s COVID-19 provider webpage.
• FCHD does not assess patients or collect specimens for COVID-19 testing. Patients who have symptoms of COVID-19 may need a medical evaluation which is best performed by a primary care provider.
• COVID-19 testing is commercially available and health care providers should rely on commercial labs for patients who do not fall into a group where Health Department investigation and prioritization is being done.
  • Providers testing commercially will need to collect specimens as commercial labs will not collect specimens at this time. 
  • Healthcare providers who are unable to safely collect specimens (see updated guidance below) or do not have access to commercial labs currently offering testing are responsible for reaching out to their affiliated healthcare facilities to find an appropriate testing location for their patient.

SUGGESTED ACTIONS

• Providers should immediately triage and place mask on all patients with fever and cough.
• Providers should use their judgment to determine if a patient should be tested. CDC guidance for who to consider testing for can be found on their website.
  • Providers are strongly encouraged to test for other causes of respiratory illness, such as influenza, before testing for COVID-19.
• All providers should use the appropriate personal protective equipment (PPE) when evaluating and collecting specimens for potential COVID-19 patients. Providers should follow this PPE guidance to collect specimens (i.e., NP swabs) safely:
  • HCP in the room should wear an N-95 or higher-level respirator (or facemask if a respirator is not available), eye protection (face shield or goggles), gloves, and a gown.
  • The number of HCP present during the procedure should be limited to only those essential for patient care and procedure support. Visitors should not be present for specimen collection.
  • Specimen collection should be performed in a normal examination room with the door closed.
  • Clean and disinfect procedure room surfaces promptly as described in the section on environmental infection control below.
  • Do not perform any aerosolizing procedures (e.g. induced sputum) without the patient being in a negative pressure isolation room.
• VDH interim guidance on the use of personal protective equipment for suspected or confirmed COVID-19 cases in shortage situations is available here.
• All patients who are tested for COVID-19 (commercially and through public health) should be told to stay at home and away from others until they receive test results back. Further public health guidance will be provided if the lab result is positive. A patient guidance document can be found on FCHD’s COVID-19 provider webpage.
  • Household contacts to the tested patient should be advised to remain alert for subjective fever, cough, or difficulty breathing. If they feel feverish or develop cough or difficulty breathing during the self-observation period, they should take their temperature, self-isolate, limit contact with others, and seek advice by telephone from a healthcare provider or their local health department to determine whether medical evaluation is needed.
• Patients that are referred for commercial testing at another facility should call ahead to identify themselves as a suspect COVID-19 patient.
• COVID-19 is a rapidly reportable condition in Virginia. Healthcare providers are legally required to report all test positive cases to the local health department immediately. To report a positive result, immediately call the Fairfax County Health Department (FCHD) at 703-426-2433.