Evaluating and Testing: COVID-19 - Minnesota Dept. of Health

Evaluating and Testing: COVID-19

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Collecting Specimens
Home Care Instructions

Guidance for evaluating, testing, and reporting COVID-19 in Minnesota.

Updated 7/30/20

Current guidance for testing

In consideration of the testing priorities outlined below, evaluate how your staff resources and laboratory capacity can be used to ensure testing access for these priority groups. Individuals being tested for surveillance purposes (e.g., those tested prior to employment, for sports team or camp participation, enrollment in an academic institution) should not be prioritized for testing given nationwide reagent shortages and a lack of evidence to support the usefulness of a broad testing approach.

Testing Priorities

  1. Symptomatic people
    Symptomatic people in any setting. If PCR testing for SARS-CoV-2 is negative, symptomatic people should continue to self-isolate and follow setting-specific public health recommendations.

  2. Asymptomatic people with either a known COVID-19 exposure or requiring medical care

    1. Asymptomatic people requiring medical care
      This includes patients where the procedure creates a high-risk for SARS-CoV-2 transmission (e.g., aerosol-generating procedures) or the procedure is high risk to the patient due to SARS-CoV-2 infection. Examples include: aerosol-generating procedure (e.g., intubation, bronchoscopy, etc.), or patients undergoing other procedures that may be delayed based on testing results (e.g., chemotherapy, cardiac surgery, or other procedures in which COVID-19 may worsen outcome), or patients admitted to the hospital.

    2. Asymptomatic people linked to an ongoing public health investigation
      Situations where one or more COVID-19 cases have been identified in a shared setting (e.g., long-term care facility, workplace, schools or child care, correctional facility). This type of testing should be done in consultation with MDH.

    3. Asymptomatic people with a known COVID-19 exposure
      If resources are limited, providers may consider further prioritizing testing to those contacts who would pose a significant risk of spread if they were infected or who are at high risk of severe disease. The following groups are considered highest priority:
      • Individuals working or attending K-12 schools or child care.
      • Hospitalized patients.
      • Health care personnel.
      • First responders (e.g., EMS, law enforcement, firefighters).
      • Individuals living, working or visiting congregate settings.
      • Individuals with medical conditions including pregnancy.
      • Individuals 65 years of age and older.
      • Individuals who live in households with a higher risk individual or who provide care in a household with a higher risk individual
      • Member of a large household living in close quarters.

Exposure is defined as being within 6 feet for more than 15 minutes to persons with confirmed COVID-19. All close contacts should follow a 14-day quarantine period. Even if the result is negative, these contacts should continue to quarantine for a full 14 days after last exposure and monitor for symptoms; infection could develop at any time during the quarantine period. Repeat testing at the end of the quarantine period may be recommended for staff or residents of congregate settings (acute care, assisted living, skilled nursing, group homes, long-term care facilities, substance use disorder treatment centers, homeless shelters, and correctional facilities); refer to setting-specific testing guidance for additional information. Specific guidance is available for health care workers who have a health care exposure and these individuals should follow that guidance; it would apply if they have a community/household contact.

MDH Public Health Laboratory (PHL) testing priorities

Only send specimens to MDH-PHL for:

  • Symptomatic residents and staff in congregate living settings (long-term care facilities, prisons/jails, shelters for people experiencing homelessness, etc.).
  • Symptomatic dialysis patients.
  • Symptomatic patients that cannot be tested at an in-house lab, commercial lab, or through negotiated access to the University of Minnesota or Mayo Clinic labs.

Positive results from MDH will be communicated immediately to the provider. Negative and positive results will be faxed immediately to the submitting laboratory; please do not call us for the results. Results may not be available for up to 3 days. Please inform your patient of the result and do not have them call us for results.

People awaiting testing or results

People with undiagnosed fever and/or acute respiratory symptoms (cough, shortness of breath) who are awaiting testing or results should:

  • Self-isolate for 10 days after illness onset and 24 hours after resolution of fever without taking fever-reducing medications, and improvement of respiratory symptoms, whichever is longer.
  • Isolate from household and intimate contacts as much as possible.

Household and intimate contacts of these people should limit their activities in public for 14 days after incorporating precautions in the home, and monitor for symptoms.

Forms

Collecting Specimens

  • CDC: Specimen Collection
    Videos on collecting specimens. The page is specific to pertussis, but the specimen collection guidance is universal.

Home Care Instructions

Health care providers should review with their patients the following CDC recommendations for the home care of patients being evaluated for COVID-19 who do not need to be hospitalized.

Please assist patients and household members with accessing personal protective equipment (disposable face masks and gloves).

Updated Thursday, 30-Jul-2020 10:34:34 CDT