PORTLAND, Ore. — Nearly a full month into Oregon’s coronavirus outbreak, many residents remain confused about whether they’re eligible for testing.
The Oregon Health Authority on Wednesday updated its testing guidance for health care providers and laboratories.
State officials say providers should have access to expanded testing from private labs, and they can determine whether a patient should be tested based on clinical judgment. But officials also made it clear that testing people who are asymptomatic, or have only mild symptoms, is discouraged.
Here’s a look at what the health authority says:
"Asymptomatic persons and those with symptoms that do not necessitate medical evaluation are not recommended for testing. Individuals with mild symptoms that do not necessitate medical evaluation should remain at home until 72 hours after any fever or cough resolve.
Persons with mild or moderate COVID-19-like illness who seek testing risk exposing others in healthcare settings, including members of the public, other patients, and healthcare workers. Evaluation and testing of such persons in a healthcare setting consumes resources that may become extremely limited, including personal protective equipment (PPE), swabs and viral transport media used to collect diagnostic specimens, and ties up clinical resources, including healthcare staff and rooms."
Testing through commercial laboratories:
Clinicians can order coronavirus testing at their discretion through laboratories, including some Oregon hospital laboratories or commercial reference labs, such as LabCorp and Quest Diagnostics. A flu test should be ordered first, during flu season, unless the person would not be eligible for antiviral medicine to battle the flu.
The state identified people with fever, cough or shortness of breath as the suggested group for COVID-19 testing:
- Health care workers
- Patients with worsening symptoms
- Patients older than 60
- Patients with underlying medical conditions, including, but not limited to hypertension, diabetes, cardiovascular disease, lung disease, and immunocompromising conditions
- Pregnant women
- Patients who had contact with a suspect or lab-confirmed COVID-19 patient, or who had travel from an affected geographic area, within 14 days of their symptom onset
Patients who do not have a clinical need to be sent to an emergency department or a hospital should not be sent there, the state said.
Patients with respiratory symptoms should be advised by physicians to self-isolate at home until 72 hours after both fever and cough (if present) resolve. Physicians should discuss a plan with a patient to seek appropriate medical care if symptoms get worse.
Testing at the Oregon State Public Health Laboratory, which is operated by the state:
A patient who meets all of the following criteria will be approved for testing, according to the state:
- Clinical need for admission to a hospital
- Evidence of viral lower respiratory infection
- Flu test ordered during flu season
A clinician seeking testing from the state lab “must submit an electronic request” to the state health authority, but for such patients, the physician does not need to call seeking approval.
People who don’t meet the above criteria “may be considered” for coronavirus testing at the state lab if they are:
- Symptomatic with fever, cough, or shortness of breath and in a facility or group setting, such as a healthcare facility, residential care facility, school or jail.
The state lab says it will test one to five specimens per facility, and potentially more, “if there are persons requiring hospitalization.”
-- Brad Schmidt; bschmidt@oregonian.com; 503-294-7628; @_brad_schmidt
This article was originally published by The Oregonian/OregonLive, one of more than a dozen news organizations throughout the state sharing their coverage of the novel coronavirus outbreak to help inform Oregonians about this evolving heath issue.