(March 23, 2020, 7:55 p.m.) -- The LB Health Dept.'s March 22 recommendation to LB doctors (detailed below) follows a guidance issued by California's Department of Public Health on March 20. The guidance titled "Guidance for Prioritization of Patients for Laboratory Testing for COVID-19" states in pertinent part:
Persons who may be considered for testing depending on clinical severity and community health relevance include:
Hospitalized patients who have signs and symptoms compatible with COVID-19 in order to inform decisions related to infection control or medical management.
Residents and staff of long-term care facilities with signs and symptoms compatible with COVID-19.
Other persons who are at higher risk for severe infection with signs and symptoms compatible with COVID-19. These persons include older adults (age >65 years) and individuals with chronic medical conditions.
Residents and staff of correctional facilities and other congregate settings with signs and symptoms compatible with COVID-19.
Healthcare personnel with signs and symptoms compatible with COVID-19.
Persons in these categories with mild illness should contact their health care provider by phone to discuss the need for testing.
[Relevant to LB Health Dept. recommendation below] Persons with mild respiratory symptoms who do not otherwise need medical care and who are not in one of the above groups should not be routinely tested for COVID-19. These persons should care for themselves at home as they normally would for a mild illness.
In addition, ill persons should stay home and away from others until there has been no fever without the use of fever-reducing medications, there has been improvement in respiratory symptoms (e.g., cough, shortness of breath) for at least 3 days; AND it is at least 7 days since symptoms first appeared, i.e., the minimum length of time will be 7 days.
(March 23, 2020, 5:20 p.m.) -- If you (or your familymembers) begin showing symptoms compatible with COVID-19, the LB Health Dept.has told your LB doctor that it recommends that he/she not test you for COVID-19 if you show "mild" fever respiratory illness that "can be safely managed" at home unless it would change how your doctor manages you as a patient or would inform public health response.
In a "Provider Health Alert" (salient text below) emailed March 22 at 6:50 p;m., LB's Dept. of Health and Human Services says a nationwide shortage of COVID-19 tests and laboratory supplies requires that "testing should be carried out judiciously."
Consistent with recommendations elsewhere, the LB Health Dept. recommends against testing asymptomatic persons "because available tests have not been approved and validated for testing of those without symptoms. If patients know they have been exposed, they should be counseled to self-quarantine."
[Salient text of LB Health Dept. "Provider Health Alert" Mar. 22, 6:50 p.m.]
Currently, there is a nationwide shortage on COVID-19 tests and laboratories supplies needed to run the test. As a result, testing should be carried out judiciously.
Unless confirming a diagnosis of COVID-19 will impact patient management COVID-19 diagnostic testing is not recommended for persons with mild febrile respiratory illness who can be safely managed at home. This will minimize possible exposures to healthcare workers, patients, and the public and will reduce the demand for personal protective equipment.
It is recommended that providers test only persons with symptoms compatible with COVID-19 where a diagnostic result will change clinical management or inform public health response.
Testing of asymptomatic persons is not recommended because the available tests have not been approved and validated for testing of those without symptoms. If patients know they have been exposed, they should be counseled to self-quarantine.
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