Last updated March 23, 2022
Testing is an essential part of the overall response to COVID-19. Testing helps stop the spread of COVID-19 by:
- identifying those who are infected or have been exposed to the virus; and
- using results to respond quickly.
Here is a summary of the Washington State Department of Health’s COVID-19 testing strategy, which was first released in June 2020. It includes the state’s testing strategy principles and the impacts of testing on the community.
DOH-led testing work has centered on:
- Equitable and widespread access to testing
- Quick turnaround times for results
- Availability of testing supplies
- Using in-state lab capacity as much as possible
- Ensuring local health jurisdictions and other facilities have support to operate testing efforts
- Prioritizing people with symptoms for testing, along with close contacts of people who are infected, and people in congregate settings where there are positive cases
The Department of Health (DOH) continues to work with local health jurisdictions, tribal partners, health care systems, and congregate settings, including schools, to make sure testing recommendations are current and follow the best scientific evidence available and that it is reducing barriers to accessing needed testing supplies to support local testing strategies.
- A successful public health testing strategy ensures the ability to test populations most at risk of COVID-19 infection.
- Providing access to testing for the most vulnerable and marginalized populations is critical to effective pandemic management by ensuring all populations will have equitable access to testing.
- Active engagement of trusted community leaders is necessary to understand local needs, cultural perspectives, build trust, and reduce barriers to testing in groups that experience health disparities or are at greater risk of severe health outcomes.
- The timing of testing is important. For people with symptoms, the CDC recommends testing as soon as possible. For people who are contacts of someone with COVID-19 infection and who do not have any symptoms, testing 5 days after contact with someone who has a positive case of COVID is recommended.
- Using regional laboratories with the ability to do high volumes of tests with rapid turnaround times and electronic reporting is more efficient than using many smaller labs.
- DOH will provide clear guidance on the use of available and future testing resources in Washington state. Local health jurisdictions, health care providers, schools, and businesses should use this guidance to optimize the mitigation strategies we have. Recommendations for testing are available at DOH Resources and Recommendations.
- COVID-19 must be continuously and carefully monitored because it is expected ongoing periodic changes in the prevalence of infection and the degree of transmission will occur. This will inform how DOH prioritizes testing efforts.
- DOH will use science to determine the role of different types of COVID-19 tests in COVID-19 diagnosis, and to develop best practices in public health monitoring and promotion activities.
Impacts of Testing on the Community
- 1. Testing capacity - It is neither feasible nor in the interests of public health to test the entire population for either active or past infection. The CDC provides guidance on the types of tests and information these tests yield.
- Point-of-care tests, to include molecular and antigen tests, allow faster turnaround times and are easier to perform that laboratory-based tests, allowing for expanded testing capacity and access.
- While rapid antigen tests are less accurate than laboratory-based tests, their turn around time may lead to earlier detection and isolation of infected and/or contagious individuals.
- 2. Testing priorities - We can help stop the spread by prioritizing testing and follow-up services for people who are at highest risk for transmitting COVID-19 in the following scenarios:
- People with symptoms and their close contacts are the priority populations for testing.
- Congregate settings are at increased risk of outbreaks. Congregate living settings (such as nursing homes, correctional facilities, shelters, or schools) and places where social distancing is not possible (such as worker housing or food packing plants) have been prioritized for testing.
- Outbreaks across the state require a prompt response. Outbreaks have occurred in places like correctional facilities, food and fruit processing plants, temporary worker housing, skilled nursing facilities, shipping vessels, and hospitals.
- 3. Equity - Because the COVID-19 pandemic has disproportionately affected people with lower incomes, the elderly, people of color, and immigrant/refugee communities, people who are incarcerated, people with disabilities, and people experiencing homelessness. These populations will continue to be prioritized in the following ways:
- DOH collaborates with multiple vendors to support local health jurisdictions as they facilitate testing partnerships and design and launch free, low-barrier, and sustainable community testing sites.
- DOH partners with Medical Teams International (MTI) to deploy mobile testing capacity to communities with inadequate access in Central Washington, including temporary farmworkers preparing to return to their home countries after the growing season.
- DOH partners with multiple testing companies to procure and distribute tests used for screening testing for employees who are at high-risk, such as staff in skilled nursing facilities.
- In 2022, DOH made at-home testing widely available across the state through the Say Yes! COVID Test program.
- DOH equips local health jurisdictions, Tribal partners, critical access hospitals, and federally qualified health centers with rapid diagnostic tests, also called point-of-care tests.
- 4. Quick results - It is critical to have a quick turnaround time for test results after symptoms are recognized to slow community transmission.
Rapid turnaround times -- from the point of collection to notification and the public health reporting of results -- remain a priority to limit community spread of COVID-19. DOH monitors turnaround times for nucleic acid amplification test (NAAT) testing across the state and has partnered with several Washington labs to increase access and reduce turnaround time.
- 5. Testing as a tool - Testing for COVID-19 is an important way to inform mitigation efforts which can help Washington residents stay safe and healthy.
- Testing remains an important tool to demonstrate how effective mitigation efforts are at containing community spread.
- Testing helps understand community level transmission, which, in turn, helps inform the need for other mitigation strategies, including masking. It also highlights where there is a need for more targeted testing efforts. This information is shared with local health jurisdictions and Tribal partners.
- 6. Regularly updated guidance - DOH will continue to provide guidance on testing in different settings as one of the tools needed to minimize ongoing community spread. Specific guidance is available for:
- Local health jurisdictions
- Health care providers (inpatient and outpatient)
- Congregate settings
- Schools and childcare facilities
- Healthcare settings
For current guidance see:
- Health Care Providers
- Resources and Recommendations
- Testing for COVID-19
- K-12 and childcare guidance
- 7. Regional laboratories - DOH works with laboratories located throughout Washington state.
- DOH contracts with in-state labs to expand outbreak response and screening capacity to support public health and clinical testing efforts across the state. Using in-state labs can help provide test results more quickly when national labs are experiencing delays.
- The availability of rapid point-of-care testing may reduce the need for lab capacity to support lab-based testing but will not eliminate it.
- 8. Monitoring infection rates - Increased access to COVID-19 diagnosis should be supplemented with regular surveillance to determine prevalence of undiagnosed active infection and inform ongoing mitigation strategies.
Roles for Key Stakeholders
- Local health jurisdictions (LHJs)
LHJs are responsible for coordinating testing within their jurisdiction, including when outbreaks occur. If LHJs cannot support the outreach teams or need assistance in scaling up routine testing, DOH can provide additional resources and guidance.
- Public, private, and Tribal health care providers
Public, private, and tribal health care providers give molecular and rapid point-of-care antigen testing to their populations in the inpatient, outpatient, drive-thru testing, and home-based self-collection settings.
- LHJs should reinforce public health messaging at the time of specimen collection and result notification.
- Skilled nursing facilities and memory care units conduct regular staff testing and reporting per HHS guidelines.
- Schools and childcare networks
Schools and childcare networks play a major role in controlling the pandemic by implementing measures that keep schools open for in-person learning while keeping students and staff safe.
- The Learn to Return program, a DOH partnership with Health Commons Project, enables K-12 schools to conduct diagnostic and screening testing, allowing schools to catch cases quickly and prevent spread.
- Learn more about K-12 testing on the DOH school testing page.
- Expand access and create demand for testing
- Work with community stakeholders and government agency communications to frame testing as a positive activity that informs where to direct additional public health support.
- Continue to reduce barriers to testing by providing multilingual resources, support for persons living with disabilities and more walk-up and low-barrier testing sites.
- Continue to support and work directly with local health jurisdictions to develop individual testing strategies unique to their region and resources.
- Elevate discussions around financing and the use of public/private/philanthropic partners to support community testing sites.
- Continue to emphasize the need for worker and wage protections for people concerned about income or job loss if they develop symptoms.
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