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Posted on: May 1, 2020

COVID-19 Update for Clinicians, May 1, 2020

SUMMARY: See this health alert for 

  • Updated Guidelines for SARS-CoV2 Testing 
  • SARS-CoV2 Testing Survey 
  • Health District Not a Venue for SARS-CoV2 Serology 
  • HRSA Launches COVID-19 Uninsured Program 
  • COVID-19 in 2020 & the Way Forward 
  • Education Opportunity—Sexually Transmitted Diseases during COVID-19 
  • COVID-19 Data  

 Updated Guidelines for SARS-CoV2 Testing 

 The Washington State Department of Health (DOH) has updated it’s guidance for SARS-CoV2 testing. Secretary Wiesman’s letter regarding testing can be viewed as an attachment at the end of this document.

What has changed from the previous edition? 

  • New promotion of testing for all patients with new onset of symptoms suggestive of viral respiratory tract infection, regardless of age or health status. 
  • Addition of chills, rigors, myalgia, headache, sore throat, anosmia, and ageusia to the list of COVID-19-compatible symptoms.   
  • Inclusion of young, healthy and mildly ill patients as candidates for testing.   
  • Expansion of specimen collection sites to include nasal and nasal mid-turbinate. 
  • Precautionary statements about limited sensitivity in point-of-care diagnostic tests and discouragement of use of serology for diagnosis or for detection of prior infection.   

What has not changed? 

  • In general, please submit specimens for testing through commercial laboratories.   
    • The Washington State Public Health Laboratory’s testing capacity remains reserved for: 
      • Workers in healthcare facilities, congregate living settings, critical infrastructure and public safety/first responders 
      • Residents in long-term care facilities or other congregate living settings, including prisons and shelters  
      • Persons identified through public health cluster and selected contact investigations  
      • Patients with no health insurance 
  • With some exceptions, testing of asymptomatic people is discouraged.  

 Please take a moment to review the updated guidance

SARS-CoV2 Testing Survey 

DOH is asking healthcare providers to complete a survey to better understand access and barriers to SARS-CoV-2 testing in the community. This survey is meant only for licensed practicing professionals who might order SARS-CoV-2 PCR testing for their patients. Please click on the attached link to complete the survey: Hcwsurvey. The survey takes approximately 5 minutes to complete.   

Please note that this survey by DOH targeting individual health care providers is distinct and separate from the Health District’s recently released survey addressing health care facilities and systems about SARS-CoV2 testing capacity.  

 Health District Not a Venue for SARS-CoV2 Serology 

The Health District has received several calls in the past week from patients whose health care provider referred them to us for serologic testing.  The Health District does not collect or submit specimens for SARS-CoV2 serologic testing at this time.  Please refer to our update on SARS-CoV2 serology in last week’s update and, if you deem it appropriate, collect and submit serum specimens through a trusted commercial laboratory providing serologic testing.    

HRSA Launches COVID-19 Uninsured Program  

The Health Resources and Services Administration (HRSA) has launched a new COVID-19 Uninsured Program Portal, allowing health care providers who have conducted COVID-19 testing or provided treatment for uninsured COVID-19 patients on or after February 4, 2020, to request claims reimbursement. Health care providers can electronically request claims reimbursement through the program and will be reimbursed generally at Medicare rates, subject to available funding. Steps will involve: enrolling as a provider participant, checking patient eligibility, submitting patient information, submitting claims electronically, and receiving payment via direct deposit. Please visit the site for additional instructions and other details. 

COVID-19 in 2020 & the Way Forward 

As case reports have declined substantially since their peak just over a month ago and hospital surge capacity is also restored, the question arises about when to modify social distancing rules and norms in order to permit some resumption of economic, educational, and social activity. The Health District is working closely with the Snohomish County Department of Emergency Management, DOH and local public health jurisdictions to plan a path forward.  Although plan details are still under development, key elements of the plan include the following: 

  • Adequate acute care facility capacity to provide COVID-19 and non-COVID care without resorting to crisis standards. 
  • Adequate personal protective equipment for acute care facilities, emergency medical services, and other critical elements of the COVID-19 response. 
  • Testing capacity (adequate supplies, analytic capacity, and turnaround times) to permit patients to be tested within one day of onset of symptoms and results on the same or next day. 
  • Case and contact investigation and control capacity for suppression 
  • Accounting for vulnerable populations (e.g., long-term care, chronic conditions, racial-ethnic minorities, unsheltered). 

Aside from seemingly adequate acute capacity, current conditions across-the-board are not conducive to a successful widespread resumption of normal activity at this time. Social distancing recommendations and activity restrictions remain largely in place.  However, as we better define and see further progress in meeting these criteria, you should anticipate a slow, layered return to some activities with public health implementing intensified efforts at case finding, contact tracing, and quarantine of close contacts. The hope is that these disease control efforts will keep a resurgence of disease and ensuing surge of acute and intensive care demand at bay. However, it also seems prudent to remain prepared for the possibility that future rounds of social distancing may become necessary on one or more occasions if reported incidence or acute care demand exceed thresholds for action.   

 The timeline for complete resumption of pre-COVID-19 activity to include large gatherings and like endeavors is probably somewhere along the 12-24 month horizon as we wait for arrival at herd immunity through a vaccine or via cumulative infection of a critical proportion of the population sufficient to inhibit sustained transmission. 

 For additional information on the dashboard of criteria for modification of social distancing and resumption of activities, please visit Governor Inslee’s COVID-19 website.   

Education Opportunity—Sexually Transmitted Diseases during COVID-19 

The University of Washington’s STD Prevention Training Center is sponsoring a 1- hour webinar hosted by the National Network of STD Clinical Prevention Training Centers. This webinar will provide guidance to the STD field with respect to disruptions in clinical care resulting from public health measures necessitated for COVID-19. Registration is required for this event.  To register, please use this link: https://globalmeetwebinar.webcasts.com/starthere.jsp?ei=1307645&tp_key=ac038673e 7.  For additional background on this topic, please see the April 13 Health District update

COVID-19 Data (through April 30, 2020) 

 April 29 marked 100 days since the first reported case of COVID-19 was confirmed in Snohomish County. A video is available about the first 100 days of the response. 

 chart 1 may 1 alert

chart 2 may 1 alert

SEE FULL ALERT WITH ALL ATTACHMENTS HERE

 

 

 

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