The Centers for Disease Control and Prevention (CDC) has updated the guidance for evaluation of persons under investigation for coronavirus disease 2019 (COVID-19), expanding the criteria to a wider group of symptomatic patients. As more diagnostic testing becomes available, the CDC recommends the following:

  • Clinicians should use their judgement to determine if a patient has signs/symptoms compatible with COVID-19 and whether the patient should be tested.
  • Decisions for testing should be made on local epidemiology of COVID-19, as well as the clinical course of illness (most patients with confirmed COVID-19 have developed fever and/or symptoms of acute respiratory illness).
  • Clinicians are strongly encouraged to test for other causes of respiratory illness (eg, influenza).
  • Priorities for COVID-19 testing may include: 
    • Hospitalized patients who have signs/symptoms compatible with COVID-19 in order to inform decisions related to infection control.
    • Other symptomatic individuals such as, older adults (≥ 65 years) and individuals with chronic medical conditions and/or an immunocompromised state that may put them at higher risk for poor outcomes (eg, diabetes, heart disease, receiving immunosuppressive medications, chronic lung disease, chronic kidney disease).
    • any persons, including healthcare workers, who have had close contact with a laboratory-confirmed COVID-19 patient within 14 days of symptom onset, or a history of travel from affected geographic areas (China, Iran, Italy, Japan, South Korea) within 14 days of symptom onset.  

In a recent press statement, FDA Commissioner Stephen M. Hahn, MD provided an update on the current state of diagnostic testing for COVID-19. As of March 7th, the CDC has shipped tests to public health laboratories sufficient to test roughly 75,000 people, with labs in areas of highest need receiving additional tests. In addition, 1.1 million tests, manufactured by Integrated DNA Technologies, have been shipped to nonpublic health labs and another 400,000 are expected this week. According to Hahn, other manufacturers are also scaling up production which could mean an additional 4 million tests by the end of next week. 

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“A very important point I want to make here is about the reporting of numbers,” said Hahn. “The actual number of tests that have shipped is larger than the number of patients that can be tested. With current estimates (and this could change), 2.1 million tests would roughly translate to 850,000 Americans being able to undergo testing.” Hahn noted that once the tests are received, labs will need to verify the tests and train staff; the number of tests that can be run will also vary based on the size of the lab.  

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This article originally appeared on MPR