Triage
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Criteria for Testing
Testing capacity has been in flux (see for updates), with resultant changes in testing eligibility protocols. The Massachusetts Department of Public Health (MA DPH) publishes updated guidelines with criteria for COVID-19 testing (see below for version as of 4/2/2020). It differentiates between populations recommended to be tested at state versus commercial laboratories.
Thought question:
For a low-risk patient who may not fall under the recommendations to get tested for COVID-19, but who does want to get tested, how might a healthcare worker navigate the conversation about the utility of testing amongst those at highest risk?
Screening can occur remotely through a telephone/virtual visit by guidelines similar to above. Drive-through testing sites are expanding across the country, , and often require that patients fill out to determine eligibility. With in-house testing increasing at hospitals, institutions are developing their own testing eligibility protocols (see below). The Cleveland Clinic has produced allowing patients to self-assess for infection risk, with care recommendations based on risk level.
Testing: Hospitals have generally been outlining testing criteria for ambulatory vs emergency department or inpatient settings. Partners-specific guidelines are available (note: requires Partners credentials). BILH Cambridge Health Alliance guidelines are available (note: requires CHA credentials). Of note, most protocols are initially symptom-based (except for select populations such as transplant patients or requiring urgent airway surgery), followed by a prioritization list for symptomatic patients or staff. These reflect a balance of clinical/operational needs for testing and resource availability.
Clinical Triage: For a discussion of clinical triage guidelines, see
