Coronavirus Disease 2019 (COVID-19) Outbreak, Update # 9 Updated Guidance on Clinician Testing

NH DPHS Health AlertOn March 18, 2020, NH DHHS issued health alert update #9 regarding the COVID-19 outbreak with updated guidance on clinician testing.

Key Points and Recommendations:

  • New Hampshire Division of Public Health Services (DPHS) has identified 39 total cases of COVID-19 in New Hampshire, including in the counties of Rockingham (17),  Hillsborough (8), Grafton (7), Carroll (4), Belknap (2), and Merrimack (1). Several individuals who tested positive in multiple areas of the State have no identified risk factors for COVID-19 indicating community-based transmission. 
  • This prompts an important change as you take calls from patients who are concerned that they might have COVID-19. Most people with mild symptoms of COVID-19 can be managed at home without testing, much as providers can empirically manage patients who might have flu. We advise against testing everybody with mild fever or respiratory symptoms because: 
    • Presenting for testing potentially exposes the public, healthcare workers, and vulnerable persons to COVID-19.
    • We must preserve our limited personal protective equipment (PPE) and specimen collection supplies for our healthcare system to be able to care for patients who will develop severe COVID-19 illness over the coming months of this pandemic. 
    • Confirming infection for every person does not change how most people’s illness is managed. 
  • Any person with COVID-19 compatible symptoms who is not tested and can be managed at home (i.e., does not require hospitalization) should be instructed to self-isolate until: 
    • At least 7 days have passed since symptoms first appeared, 
      AND
    • At least 72 hours (3 days) have passed since recovery – which is defined as resolution of fever without the use of fever-reducing medications and improvement in respiratory symptoms. 
  • We have updated our guidance (Figure below) for which symptomatic persons should be prioritized for COVID-19 testing. 
  • Asymptomatic persons should not be tested for COVID-19, regardless of exposure, because it depletes PPE and testing resources and does not change the need for an exposed person to self-quarantine. 
  • All asymptomatic close contacts of a person with COVID-19 or persons who are being presumptively managed as COVID-19 (without testing) should stay home (self-quarantine) for 14 days from the last day of exposure.
  • Although international travel is no longer the only risk factor for COVID-19, persons who have traveled from countries with widespread sustained transmission must also stay home (self-quarantine) for 14 days from the last day of travel.
  • We will continue to host weekly calls to answer healthcare provider and local partner questions about COVID-19. The next discussion will be held on Thursday March 19th from 12:00 – 1:00 pm (noon hour), and calls will recur weekly. Call-in information for the Q&A session is: (833) 709-6685; this is an operator assisted call so no conference code is needed.

Read the Full DHHS Alert