California Department of Public Health
March 20, 2020
TO: Health Care Providers and Laboratories
SUBJECT: CDPH Guidance for Prioritization of Patients for Laboratory Testing for COVID-19
Testing for Coronavirus Disease 2019 (COVID-19) is now available in a number of public health, commercial and hospital laboratories in California, however broad scale testing is not available. This guidance is intended to support health care providers and laboratories in determining testing prioritization. Testing for COVID-19 is a medical test and should be done if a licensed health care provider determines that it is necessary based on the signs, symptoms, and history of a patient. There are many reasons why testing should be based on medical indications and a health care provider decision. A health care provider can provide results to the patient and help the patient understand the results and provide appropriate care. Also, testing based on medical need will ensure that people who most need testing can get results rapidly and reduce strain on the health care system. Persons who may be considered for testing depending on clinical severity and community health relevance
- 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.
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.
Asymptomatic persons should not be tested for COVID-19. Current testing for COVID-19 cannot detect prior infection. Testing a person without symptoms does not rule out the possibility that person may become ill in the future.