COVID-19 Advisory for Healthcare Providers

COVID-19 Testing Guidance Updates for Outpatient, Inpatient (Hospital) and Educational Settings

Posted Sept. 10, 2021. Past health advisories and alerts are archived for historical purposes and are not maintained or updated.

The purpose of this advisory is to share current guidance from the Washington State Department of Health (WA DOH) and SRHD on testing patients for COVID-19. This is in response to questions from healthcare providers and patients regarding who and when to test for COVID-19 during this current phase of the pandemic.

Testing individual patients presenting at outpatient clinics:

Please continue to offer testing to any patients who meet these criteria (regardless of vaccination status):

  • Suspected COVID-19 infection based on symptoms, with or without known exposure
  • Asymptomatic persons exposed to a COVID case (please collect specimens no earlier than 5 days after exposure date).

If test kits are in short supply, please prioritize patients with symptoms and/or known exposures in high-risk work settings like healthcare, long term care, congregate living, or childcare services. More information about testing guidance and resources is available on the SRHD website, Testing | Spokane Regional Health District (

Testing during outbreaks in inpatient (hospital) settings:

The CDC recommends expanded viral testing of healthcare personnel and patients when hospital-associated transmission is suspected (Responding to SARS-CoV-2 Infections in Acute Care Facilities | CDC)

Based on this CDC guidance, during most outbreak situations in hospitals (as defined in Interim COVID-19 Outbreak Definition for Healthcare Settings (, SRHD recommends testing all staff and patients in the affected clinic(s) or unit(s). This is a standard epidemiological approach to investigating outbreaks to detect any mildly ill, pre-symptomatic or asymptomatic cases in the population at risk of exposure. If possible, repeat testing every 3-7 days until no new cases are identified for at least 14 days.

Testing in educational settings (higher education, K-12, childcare, etc.):

Testing is an effective tool for allowing schools to stay open safely for full-time, in-person learning by identifying cases of COVID-19 in schools and preventing the spread of the disease. For a screening strategy to be effective, tests need to be conducted frequently (at least once per week) and require high participation. An additional benefit of frequent in-school testing is that students/staff who test positive and complete their isolation period can be exempted from quarantine and testing protocols for 90 days. This can save resources and reduce absenteeism in childcare and K-12 settings where reduced physical distancing causes frequent close contact exposures in a population largely ineligible for vaccines.

While many K-12 schools have testing onsite, these resources are generally not available to childcare providers/children in daycare settings. With full attendance this fall, extracurricular activities, increased community activity outside of school, and travel, testing is an important tool to mitigate the potential rise in transmission in schools and childcare facilities.