COVID-19: Updated Testing Guidance, Return to Work Guidance, and Isolation Facility Information

Posted July 8, 2020. Past health advisories and alerts are archived for historical purposes and are not maintained or updated.

Community transmission of COVID-19 continues to increase in Spokane County. The median age has shifted in recent weeks from the mid-50s to 34 years of age. Nearly 30% of cases reported to date are young adults ages 20-29 yet they only represent 15% of the total population. Sixteen percent of cases reported to date are in people ages 30-39. Non-Hispanic whites make up nearly 52% of total cases reported to date, followed by 22% in Native Hawaiian/Pacific Islander (reflecting significant and disproportionate disease burden in Marshallese individuals reported in May and June).  

Washington State Department of Health (DOH) is maintaining current case counts by county. Spokane Regional Health District (SRHD) is maintaining a COVID-19 website specifically for healthcare providers, including a link to Spokane-specific data which are updated Monday through Friday.


DOH Updated Testing Guidance for Healthcare Providers:
  • Revised language to stress the importance of testing people who are mildly symptomatic along with asymptomatic close contacts.
    • Healthcare providers should test all patients with new onset of symptom(s) consistent with COVID-19, regardless of their age or health status. Patients should be tested as soon as possible after seeking care, ideally within 24 hours, and provided information to self-isolate until receipt of test results If healthcare providers are unable to provide testing within this timeframe, patients should be referred to another testing site. Broad testing is strongly encouraged at this time.
  • Added recommendation to test all newborns born to parents who are suspected of having or who have tested positive for COVID-19.
  • Removed preference of specimen type.
  • Clarified language around consenting minors.
  • Full guidance available here: https://www.doh.wa.gov/Portals/1/Documents/1600/coronavirus/Interim-2019NovelCoronavirusQuicksheetProviders.pdf 


SRHD Updated Guidance For Non-Healthcare Worker Return to Work:
  • SRHD recommends a time-based strategy for return to work and does NOT recommend a test-based strategy. More information here: https://www.cdc.gov/coronaviru...
  • Symptomatic persons with confirmed or suspected COVID-19 can return to work after:
    • At least 72 hours have passed since the resolution of fever without the use of fever-reducing medications and improvement in respiratory symptoms; AND
    • At least 10 days have passed since symptoms first appeared.
  • Asymptomatic persons with confirmed COVID-19 can return to work after:
    • At least 10 days have passed since the positive laboratory test AND the person remains asymptomatic.
    • Asymptomatic persons who test positive and later develop symptoms should follow the guidance for symptomatic persons above.
  • Asymptomatic persons with a known exposure to a COVID-19 positive case without appropriate PPE (and neither work in critical infrastructure nor are healthcare workers) should not return to work and should self-quarantine for 14 days.  If a person is tested during the 14-day quarantine period, a negative test would not change nor decrease the time a person is in quarantine.
  • Asymptomatic persons who are not healthcare personnel but work in critical infrastructure and have had a known exposure to a person with COVID-19 are recommended to self-quarantine for 14 days unless a replacement cannot be found.  If someone in this category is unable to quarantine, the individuals and the employer should follow CDC guidance for return to work to include wearing a face covering, distancing, adherence to hand hygiene, and monitoring for symptoms: https://www.cdc.gov/coronavirus/2019-ncov/community/critical-workers/implementing-safety-practices.html.
    • Critical infrastructure employees include personnel in law enforcement, first responders, workers in food packing/distribution and agriculture, critical manufacturing, informational technology, transportation, energy, government facilities, and janitorial/custodial staff. Full guidelines can be found here: https://srhd.org/media/documents/COVID-19_ReturntoWorkGuidance.pdf


Pre-Procedure Testing Recommendations

If testing a patient for COVID-19 prior to any procedure, please wait for the results. If you opt not to wait for results, assume the patient is infected with COVID-19 and use appropriate personal protective equipment. SRHD has received reports of testing occurring prior to a procedure for which medical staff have not waited for the patient’s results, resulting in unnecessary COVID-19 exposures amongst medical staff performing or involved in the patient’s procedure.

 

SRHD-Sponsored Isolation Facility

An SRHD-sponsored isolation facility is available for patients who cannot safely isolate or quarantine in their current living environment including in their own homes due to at-risk family members or other situations making isolation or quarantine logistically difficult.  This facility is only for self-sufficient patients who are medically stable (no healthcare is provided on site).  

SRHD can assist with accessing language services and should be involved in discharge planning when a patient is still infectious and is a candidate for the SRHD-sponsored isolation facility. For consultation and to refer a patient to the facility, please call SRHD Epidemiology at 509-324-1442 during business hours or 509-324-1500 after hours.

 

Additional Resources

DOH COVID-19 Healthcare Provider Resources and Recommendations: https://www.doh.wa.gov/Emergen...

CDC COVID-19 Information for Healthcare Professionals: https://www.cdc.gov/coronaviru...