2019 Novel Coronavirus: Orange County Updates
March 9, 2020
Clinical laboratories have announced that COVID-19 testing is now or will soon be available. The CDC has also recently liberalized its guidance for potential testing to a wider group of symptomatic patients. Providers should anticipate transitioning to using commercial laboratories for clinical testing.
Recommendations for Providers
  • Begin transitioning to working with clinical laboratories for COVID-19 testing
  • Report all laboratory-confirmed COVID-19 cases immediately to the Orange County Health Care Agency at 714-834-8180 (after hours 714-628-7008)
  • Report suspect COVID-19 cases with specific risk factors (see below)
  • This situation continues to evolve rapidly; providers should consistently monitor CDC recommendations at https://www.cdc.gov/coronavirus/2019-ncov/index.html.
COVID-19 Public Health Reporting Mandates
OCHCA does not need to be informed of every suspect case who is tested for COVID-19 infection using a commercial laboratory. But to assist with investigation and potential patient isolation, OCHCA should be informed of any symptomatic patient who fits any of the following criteria:

  • Develops symptoms within 14 days of returning from a country of risk (including China, Italy, Iran, South Korea, and Japan)
  • Is a contact of a confirmed case (including health care workers)
  • Resides at a skilled nursing facility

Per Title 17 of the California Code of Regulations Section 2500, a novel virus infection with pandemic potential such as COVID-19 requires immediate reporting. Accordingly, all patients who test laboratory positive for COVID-19 should be reported immediately to OCHCA by clinicians and laboratories.
OCHCA Public Health Laboratory Testing Capacity
As commercial laboratories’ testing becomes available, the OCHCA Public Health Laboratory will continue to provide testing for patients with fever and acute respiratory illness who:

  • Have had close contact with a confirmed COVID-19 case
  • Develop symptoms within 14 days of returning from affected geographic areas with widespread or sustained community transmission including China, Iran, Italy, South Korea, and Japan
  • Have severe acute lower respiratory illness (e.g., pneumonia, ARDS) requiring hospitalization and without alternative explanatory diagnosis (e.g., influenza), regardless of travel or exposure history
  • Reside at a skilled nursing facility
Testing Recommendations
CDC’s updated guidance can be found at https://www.cdc.gov/coronavirus/2019-nCoV/hcp/clinical-criteria.html . Providers should instruct any patient tested for COVID-19 to self-isolate at home until results are available.

Diagnosis is confirmed by PCR testing of appropriate clinical specimens. CDC recommends the collection of:

  • Upper respiratory (nasopharyngeal AND oropharyngeal swabs)
  • Lower respiratory if available (tracheal aspirate, bronchoalveolar lavage specimens, or sputum)

If a lower respiratory tract specimen is not obtainable, upper respiratory may be submitted alone for testing. Specimens should be stored at 2-8°C and sent by courier to Orange County Public Health Laboratory prior to shipment to the CDC.

More detailed guidance on specimen collection and laboratory biosafety can be found at:

Contact Information
For questions or concerns please contact the Communicable Disease Control Division at 714-834-8180.
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