Important CDPH AFL of Sept 12 that Updates COVID Testing/Response Guidelines

The 9 page (AFL-20-53 ) update should be studied by management in the SNF and hospital setting since it sets expectations for testing during care transitions, dialysis care, and outbreaks.  In addition, it creates a new expectation that all HCP will be tested weekly, even when in surveillance mode.  The guidance allows for routine use of Antigen testing rather than exclusive use of RT-PCR testing.  This should allow facilities to have immediate test results.  The tracking and reporting requirements for testing results in symptomatic and asymptomatic persons are also addressed.  

Abbott labs have developed a second generation antigen test (BinaxNow COVID-19 Ag POC SARS-CoV-2 diagnostic test) that costs $ 5.00 per test.  This test has demonstrated 97.1% sensitivity and 98.5% specificity, which is a significant improvement for Ag POC testing.  One of my local SNF corporations has discovered CMS plans to send this machine even to SNFs which have received another machine.   With this machine and the other Ag testing machines, testing for other antigens like Influenza and RSV are possible, which may be something to add, since winter is approaching.  See CMS announcement of Aug 28,

These are welcome developments that should improve our COVID mitigation strategies.  I expect your local health departments will be adding further guidance contextualized to your local setting.

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