COVID-19 Update for Virginia
May 7, 2020
Dear Colleague:
COVID-19 continues to evolve. Please visit the Virginia Department of Health (VDH) website for clinical guidance and epidemiologic data. I want to highlight the following updates:
Testing
Testing capacity at commercial, private and hospital laboratories performing SARS-CoV-2 testing continues to increase in Virginia. As a result, in May, testing at Virginia’s state laboratory, the Division of Consolidated Laboratory Services (DCLS), will transition to supporting public health surveillance and investigation activities. Until May 31, 2020, if testing in the private sector is not available, clinicians may request testing for patients at DCLS by submitting the online COVID-19 Testing Request Form.
- For providers who are handling specimens, but are not directly involved in collection (e.g. self-collection) and not working within 6 feet of the patient, updated CDC guidance recommends following Standard Precautions; laboratory coats or gowns, gloves, and eye protection are recommended. Healthcare personnel are recommended to wear a form of source control (facemask or cloth face covering) at all times while in the healthcare facility.
- Healthcare providers who have conducted COVID-19 testing or provided COVID-19 treatment for uninsured persons on or after February 4, 2020 may submit claims for reimbursement to the COVID-19 Uninsured Program Portal.
VDH recommends using tests that have been evaluated by the FDA. Providers should understand the type of test performed and the limitations of the test prior to interpreting the results.
- Serologic testing results should not be used as the sole basis of diagnosis, but supplemented with testing results from a molecular detection method and clinical evaluation.
- The performance of most available serology tests has not been reviewed by the FDA.
- VDH has updated our COVID-19 testing website and test sampling site map to provide additional resources.
Updated CDC Guidance for Discontinuation of Transmission-Based Precautions for Patients with COVID-19 in Healthcare Settings and Return-to Work Criteria
The symptom-based strategy (previously called the non-test-based strategy) was extended from at least 7 days after symptom onset to at least 10 days after symptom onset. For return to work criteria for healthcare providers, the preference about using a test-based strategy was removed. CDC’s Discontinuation of Isolation for Persons with COVID -19 Not in Healthcare Settings was also updated to extend the symptom-based strategy to at least 10 days.
Enhanced Morbidity Reporting Portal
VDH has enhanced the online morbidity reporting portal to report suspected or confirmed cases of COVID-19 (and other reportable diseases or conditions) to VDH. Electronic reporting, rather than paper- or fax-based methods, allows VDH to process reports more quickly and meet the demands of timely reporting to the public and the CDC. Please include signs and symptoms, other critical epidemiologic fields (e.g., race and ethnicity), and if testing is being pursued. Because VDH receives COVID-19 test results directly from laboratories, VDH can match suspected cases reported through the portal with laboratory reports. Therefore, clinicians should provide only one report per patient, at the earliest point COVID-19 is suspected.
Fatalities
Please promptly certify the cause of death in the Electronic Death Record when a patient dies. Delays in certifying death not only hinder respectful and proper processing of the decedent, they necessitate storage of the decedent, often exceeding the capacity of health care facilities, resulting in a need for temporary emergency storage facilities. If clinicians are unsure of the cause of death in cases where COVID-19 is suspected but not lab-confirmed, ‘presumed’ or ‘probable’ COVID-19 may be used in the cause of death statement (see Dear Colleague letter on April 20, 2020).
VDH strongly encourages all hospitals, nursing facilities or nursing homes, assisted living facilities, and correctional facilities to notify funeral service providers upon the transfer of a decedent with suspected or known COVID-19. The intent of section 32.1-37.1 of the Code of Virginia is to provide advance notice to persons practicing funeral services so they can prepare and take any additional infection control precautions.
Thank you for all that you are doing every day to protect Virginians. Please consider joining or promoting the Virginia Medical Reserve Corps: www.vamrc.org/vvhs or vamrc@vdh.virginia.gov. For all other questions, contact your local health department.
Sincerely,
M. Norman Oliver, MD, MA
State Health Commissioner