Four-tier approach prioritizes ICU patients, those with symptoms and contact with a patient or travel history
TUESDAY, March 24, 2020 (HealthDay News) — In a statement published online March 19 by the Infectious Diseases Society of America (IDSA), recommendations are presented for public health and health care professionals to prioritize coronavirus disease 2019 (COVID-19) testing.
The IDSA developed recommendations for prioritization of diagnostic testing. As testing becomes more widely available or as new information becomes available, these recommendations are likely to change.
The IDSA recommends a four-tier approach to testing. Tier 1 includes critically ill patients with unexplained viral pneumonia or respiratory failure receiving intensive care unit-level care, regardless of travel history or close contact with suspected or confirmed COVID-19 patients. In addition, tier 1 includes anyone with fever or signs/symptoms of lower respiratory tract illness and close contact with a confirmed COVID-19 patient within 14 days of symptom onset; anyone with a history of travel within 14 days of symptom onset to regions with sustained community transmission; anyone who is immunosuppressed or elderly or has chronic health conditions; and those who are critical to the pandemic response.
Tier 2 includes hospitalized patients and long-term care residents with unexplained fever and signs/symptoms of a lower respiratory tract illness; routine testing of hospitalized patients may be important for infection prevention as testing becomes more widely available. Tier 3 includes patients in outpatient settings who meet the criteria for influenza testing and those with specific comorbidities; given limited available data, testing of pregnant women and symptomatic children with risk factors is recommended. Tier 4 includes community surveillance as directed by public health and/or infectious disease authorities.
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