On October 6, 2020, the West Virginia Department of Health and Human Resources sent Health Advisory #171 to health care providers, hospitals and other health care facilities. The advisory covered the use of point-of-care antigen tests for SARS-CoV-2, the virus that causes COVID-19, in nursing homes.
Antigen tests give results quickly, so a facility can start infection control steps sooner. The state said the tests could add to other testing, mainly where lab PCR capacity was limited or results took more than 48 hours. The antigen tests were less sensitive than PCR tests but had similar specificity. The first tests had federal emergency authorization for people with symptoms. Because residents and staff without symptoms could spread the virus, the state also gave advice on testing people with no symptoms.
How the state said to read the results
- Residents or staff with symptoms: a positive antigen test needed no confirmation. The resident went into transmission-based precautions, or the staff member stayed off work, and the facility told the local health department at once. A negative antigen test needed a PCR test right away, within 48 hours and preferably within 24 hours.
- People with no symptoms during an outbreak: a positive test needed no confirmation. Exposed residents with a negative test went into transmission-based precautions. Staff with a negative test could keep working with symptom checks. The facility retested everyone who tested negative every 3 to 7 days until no new cases were found for 14 days.
- Routine testing with no outbreak: staff with a negative test could keep working. In counties with low or moderate spread, a positive test needed a PCR test within 48 hours, preferably within 24 hours. If the PCR test was negative, two negative PCR tests 24 hours apart were needed before a staff member could go back to work.
One positive resident or staff member started an outbreak response with testing of the whole facility. People who had recovered from COVID-19 in the past 3 months and had no symptoms were not to be tested again.
The advisory also explained how facilities had to report results. Under an April 16, 2020 executive order, all COVID-19 lab results had to go to the state electronically. Facilities could use an online form from the West Virginia Health Information Network, send results from their electronic records system, or send files to the state directly.
This guidance is from October 2020. It is kept here as a record and is not current advice. Check current guidance from the CDC or your doctor.