Posted March 6, 2020. Past health advisories and alerts are archived for historical purposes and are not maintained or updated.
New Washington state cases of COVID-19 continue to be reported primarily in King and Snohomish Counties. As of March 6, 79 cases have been reported in with the state with11 deaths. Most cases have been reported in King and Snohomish Counties; however, one case each have been reported in Jefferson and Grant Counties. Many cases have been linked to Life Care, a skilled nursing facility in Kirkland. As of March 6, there are no confirmed cases in Spokane County residents.
NEW Airborne precautions are no longer strictly recommended by the Washington Department of Health (DOH). Standard, contact, and droplet precautions should be used for suspect COVID-19 cases. However, healthcare workers should wear gloves, gowns, a fit-tested N95 mask, and eye protection for any potentially aerosolizing procedures, including the collection of nasopharyngeal specimens. Rooms should be left vacant for one hour after a patient leaves.
NEW Please do not advise patients with no known exposure to call the Spokane Regional Health District for consultation. Please advise patients according to the documents below:
Two new commercial laboratories have started testing for COVID-19, greatly expanding testing options across the country. The University of Washington Medicine Laboratory began testing on Monday March 2 and NEW LabCorp began testing on Thursday March 5. These tests are open to all patients at the clinician’s discretion with no restrictions; no public health notification or approval is required. These options should be used for patients who do not meet the strict criteria for testing at the Washington State Public Health Laboratory (WA PHL) as indicated below, but do meet symptom criteria consistent with a COVID-19 illness while other respiratory pathogens are being simultaneously ruled out. NEW We expect other commercial laboratories, including Quest, ARUP and Mayo Clinic Laboratories, to begin testing as soon as next week.
NEW DOH has expanded criteria for testing at the Washington Public Health Lab (WA PHL) to include persons for which public health action is of upmost importance. See below.
As the outbreak expands, emergency departments are likely to become quickly overwhelmed. Outpatient settings need to have appropriate PPE and plans in place to safely collect appropriate specimens and management of suspect COVID-19 patients. Standard, contact and droplet precautions are recommended (no longer airborne).
WHEN TO USE WA PHL (SRHD approval required)
WA PHL testing is primarily reserved at this time for persons with:
Patients who meet the criteria below OR NEW criteria of significant public health importance as described above need to have testing approved by Spokane Regional Health District (SRHD) Epidemiology (if sending specimens to WA PHL) by calling 509-324-1442 during business hours or 509-869-3133 after hours. Please also conduct a respiratory pathogen panel to rule out other etiologies.
WA PHL Specimen Submission Form and instructions are here: https://www.doh.wa.gov/ForPublicHealthandHealthcareProviders/PublicHealthLaboratories/MicrobiologyLabTestMenu. Nasopharyngeal (NP) swabs and sputum are preferred, but oropharyngeal (OP) swabs can replace sputum if sputum cannot be obtained.
WHEN TO USE UNIVERSITY OF WASHINGTON LAB (UW LAB) or LABCORP (SRHD approval not required)
There are no restrictions or inclusive criteria to use the UW Lab or LabCorp for COVID-19 testing; however, testing of asymptomatic persons is not recommended. If someone does not meet the criteria listed above for testing at the WA PHL, the clinician may order that testing through UW Lab or LabCorp as they would any other commercial testing at their discretion.
Due to resource constraints, there is no need to notify SRHD Epidemiology in advance about tests sent to UW Lab or LabCorp, with the exception of suspect cases who are healthcare workers or suspect cases that may be connected to a facility outbreak. However, if any person tests positive for COVID-19, those results should be immediately reported to 509-869-3133.
If COVID-19 is suspected:
Washington State Department of Health and CDC have compiled additional guidance for healthcare providers, which is available on their website (this is a rapidly evolving situation and you should continue to check for updates to these documents): https://www.doh.wa.gov/Emergencies/Coronavirus/Resources