The Pennsylvania Department of Health released the following guidelines on April 30, 2020:
The following specimens are acceptable to submit for COVID-19 testing:
- A nasophyaryngeal (NP) specimen,
- An oropharyngeal (OP) specimen, or
- A nasal mid-turbinate (NMT) swab, or
- An anterior nares specimen (NS), or
- Nasopharyngeal wash/aspirate or nasal wash/aspirate (NW).
- Consultation with the health department is required before testing at DOH. Please call 1-877-PA-HEALTH (1-877-724- 3258) or your local health department.
- Commercial and in-house laboratory tests do not require consultation with the health department. Please follow those laboratory specimen collection instructions.
- Positive test results should be reported through the Pennsylvania electronic reporting system, PA-NEDSS.
- Specimens for point-of-care tests should not be placed in media or saline prior to analysis.
The Centers for Disease Control and Prevention (CDC) issued updated interim guidelines for collecting, handling, and testing clinical specimens from persons for COVID-19 testing. The Pennsylvania Department of Health (DOH) is providing these updated guidelines with emphasis on the acceptable alternative specimens.
All testing for COVID-19 should be conducted in consultation with a healthcare provider. The guidance below addresses options for self-collection of specimens once a clinical determination has been made to pursue COVID-19 testing.
For initial diagnostic testing for COVID-19, CDC recommends collecting and testing an upper respiratory specimen. The following are acceptable specimens for testing:
- A nasopharyngeal (NP) specimen collected by a healthcare professional, OR
- An oropharyngeal (OP) specimen collected by a healthcare professional, OR
- An anterior nares specimen (nasal swab) collected by a healthcare professional or by onsite self-collection (using a flocked or spun polyester swab), OR
- Nasopharyngeal wash/aspirate or nasal wash/aspirate (NW) specimen collected by a healthcare professional.
Swabs should be placed immediately into a sterile transport tube containing 2-3mL of either viral transport medium (VTM), Amies transport medium, or sterile saline, unless using a test designed to analyze a specimen directly, (i.e., without placement in VTM), such as some point-of-care tests. If VTM is not available, see the standard operating procedure for public health labs to create viral transport medium in accordance with CDC’s protocol.
The NW specimen and the non-bacteriostatic saline used to collect the specimen should be placed immediately into a sterile transport tube.
In hospitalized patients only, CDC also recommends testing lower respiratory tract specimens, if available. For patients who develop a productive cough, sputum should be collected and tested for SARS-CoV-2. The induction of sputum is not recommended. When under certain clinical circumstances (e.g., those receiving invasive mechanical ventilation), a lower respiratory tract aspirate or bronchoalveolar lavage sample should be collected and tested as a lower respiratory tract specimen.
Specimens should be collected as soon as possible once a decision has been made to pursue COVID-19 testing, regardless of the time of symptom onset. For providers collecting specimens or within 6 feet of patients suspected to be infected with SARS-CoV-2, maintain proper infection control and use recommended personal protective equipment, which includes an N95 or higher-level respirator (or facemask if a respirator is not available), eye protection, gloves, and a gown according to PA-HAN-497 and CDC guidance.
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, follow Standard Precautions; laboratory coats or gowns, gloves, and eye protection are recommended.
For testing at DOH laboratories, consultation with public health is required. Please call 1-877-PA-HEALTH (1-877-724- 3258) or your local health department.