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COVID-19 Testing criteria change
With the changing epidemiological landscape in Missouri, new COVID-19 testing criteria are being implemented today.
“We are very much responding to the request from clinicians and our first responders about their need to make rapid diagnoses in certain cases,” said Williams. “Our new criteria reflects CDC’s new recommendations to ensure that we have testing available for high-risk groups and to help clinicians and first responders safely provide service to the people of Missouri.”
Testing for COVID-19 is available through the Missouri State Public Health Laboratory as well as commercial clinical laboratories. Clinicians who wish to submit specimens to the state laboratory must submit proper documentation and be approved by contacting the DHSS Emergency Response Center. Providers do not need to seek approval from DHSS to submit specimens for testing to commercial laboratories.
Clinicians should determine if a patient has signs and symptoms compatible with COVID-19 and whether the patient should be tested. Most patients with confirmed COVID-19 have developed fever and/or symptoms of acute respiratory illness (e.g., cough, difficulty breathing).
Priorities for testing may include:
- Hospitalized patients who have signs and symptoms compatible with COVID-19 in order to inform decisions related to infection control.
- Symptomatic residents of congregate living facilities that house adults ages 65 or older and individuals with chronic medical conditions and/or an immunocompromised state that may put them at higher risk for poor outcomes (e.g., diabetes, chronic heart disease, such as heart failure, receiving immunosuppressive medications, chronic lung disease, chronic kidney disease).
- Any persons including health care personnel, who within 14 days of symptom onset had close contact with a suspect COVID-19 patient with pending laboratory testing or laboratory-confirmed COVID-19 patient.
Change in guidance for those with COVID-19
Guidance is also changing for those with COVID-19 under home isolation regarding when they may discontinue home isolation. This decision should be made in the context of local circumstances.
In addition to the test-based strategy, an additional option now includes a time-since-illness-onset and time-since-recovery (non-test-based) strategy.
People can discontinue home isolation under the following conditions:
- At least 3 days (72 hours) have passed since recovery defined as resolution of fever without the use of fever-reducing medications and improvement in respiratory symptoms (e.g., cough, shortness of breath); and,
- At least 7 days have passed since symptoms first appeared.
Previous recommendations for a test-based strategy remain applicable (two negative test results from specimens collected at least 24 hours apart); however, a test-based strategy is contingent on the availability of ample testing supplies and laboratory capacity as well as convenient access to testing. Additional information related to the new guidance can be found on the DHSS website.
Individuals with laboratory-confirmed COVID-19 who have not had any symptoms may discontinue home isolation when at least 7 days have passed since the date of their first positive COVID-19 diagnostic test and have had no subsequent illness.