COVID-19 PHL Laboratory Testing

MEMO RUHS PH Laboratory COVID-19 Specimen Submission Guidance
Novel Coronavirus 2019 Lab Test Request Form

The RUHS Public Health (PH) Laboratory is accepting specimens for COVID-19 testing for any Persons Under Investigation (PUI) who are approved by the Public Health Disease Control program.

All testing requests must go through RUHS-PH. Please call 951 358 5107 during business hours, or after hours 951 782 2974 for on-call if urgent or emergent.

Determining Who Should Be Tested
The CDC no longer has specific requirements for Persons Under Investigation (PUIs). However, Public Health may require a risk assessment, and testing for COVID-19 is not recommended as routine or panel testing. When obtaining the history of a suspected case of COVID-19, be prepared to present to the Department of Public Health the following information to evaluate the case:

· Symptoms (fever, cough, other lower respiratory symptoms)
· Date of onset
· Travel dates (including specific cities or regions visited and when). For many countries the specific region is vital to determining exact risk.
· Individuals this person was exposed to who may have COVID-19, and information on why you suspect them to be meaningful exposures. The highest level of concern involves household contacts.
· Other testing. Influenza should be ruled out: flu and COVID-19 disease are difficult to distinguish clinically, and influenza B activity in the county remains elevated. The Department also strongly advises obtaining a respiratory viral panel and considering a rapid strep test if pharyngitis is noted. You may be required to complete other initial testing before specimens are accepted.

Ordering the COVID-19 Real Time RT-PCR test:
For submitters that are not interfaced with the PHL, please complete a CLI.CSR.FRM.013 V2 - Novel Coronavirus 2019 Lab Test Request Form.

For internal RUHS submitters:
· Once available, please order the test via EPIC or Novius.
· Additional guidance will follow this memo with instructions of how to order the test electronically.
· The PH laboratory will provide collection supplies. Please submit a CLI.CSR.FRM.014 V1 PH LAB COVID-19 SUPPLY REQUEST FORM.
Please note: that collection supplies will be provided on a case by case basis for external submitters sending specimens to the public health laboratory.

Collection by Nasopharyngeal swab AND oropharyngeal swab (NP/OP swab):
Use a synthetic fiber swab with plastic shaft. Do not use calcium alginate swabs or swabs with wooden shafts. Place swab immediately into a sterile tube with 2-3 ml of viral transport media (VTM).

NP and OP swabs can now be combined into a single tube with 2-3 ml of VTM. Please still collect both an NP and OP swab, if possible, however the PHL will accept a single NP swab. Single OP swabs will be rejected. THE PREFERRED SPECIMEN FOR THE MOST ACCURATE RESULTS IS THE NP/OP COMBINATION!

Storage and Transport of Specimens:
Specimens must be stored at 2-8°C and shipped on cold/ice packs. Specimens must be tested within 72 hours of collection.
For transport, wrap specimen cap in parafilm to prevent leakage and place each specimen into a separate biohazard bag containing an absorbent sheet. Specimen must be accompanied by the appropriate LTR or electronic request form. Test request must include a PUI # or the specimen will not be tested.

Please contact the laboratory with any questions.