COVID-19 Health Alert # 9:
Bureau of Communicable Diseases, May 18, 2020
Summary
- The next phase in Wisconsin’s COVID-19 pandemic response will require a massive scale up of testing (a health care activity) and contact tracing (a local public health activity). For these intensified activities to succeed, a new and stronger commitment to collecting and reporting patient-level data is needed.
- To enable collaboration between health care partners and state and local public health, DHS is requiring collection of a standard set of data elements for all patients at the time of testing, and will be supporting numerous strategies for submitting these data to public health.
- As more labs develop testing capacity, Wisconsin’s public health labs are able to accept a broader range of patients for fee-exempt testing. The expanded priority list for public health testing is available on the DHS website.
Dear Colleagues,
Required Data Reporting at the Time of COVID-19 Sample Collection
COVID-19 is a Category 1 Reportable Condition in Wisconsin. Confirmed and suspected cases must be reported to local public health agencies through the Wisconsin Electronic Disease Reporting System (WEDSS). Suspected cases should be reported via WEDSS within 24 hours of sample collection for a nucleic acid (e.g. PCR) or antigen test even if the patient is asymptomatic. Timely and complete reporting of patient information will play an increasingly important role in the next phase of Wisconsin’s pandemic response, as systems for contact tracing and case investigation are scaled up.
A rapid public health response and initiation of case investigations and contact tracing depends on the support of providers, laboratories and other reporting agencies. DHS has identified a standardized set of data elements to be reported for all patients receiving a nucleic acid or antigen COVID-19 test. These elements allow for rapid identification and location of patients, and they also include critical clinical and risk factor criteria. These elements are listed below and are included on the revised Patient Information Form (PIF). It is preferred that these data elements are reported electronically via WEDSS or through configuration of the electronic health record used in clinical settings. If electronic reporting is not feasible, the PIF can be downloaded and submitted via fax to the patient’s local health department.
Required data elements include:
- Patient Demographics (Name, DOB, Gender, Race/Ethnicity, Preferred Language)
- Contact Information (Mobile Phone Number, Secondary Phone Number, Address)
- Reason For Testing (Symptoms, Pre-procedure Screening, Public Health Investigation)
- Hospitalization Status
- Occupation
- Link (if any) to outbreak investigation or community testing initiative
- Specimen type
Fee-exempt Testing at Public Health Laboratories
Guidance about which patient specimens may be submitted for fee exempt testing to Wisconsin’s two public health laboratories, the Wisconsin State Laboratory of Hygiene (WSLH) and the Milwaukee Health Department Laboratory (MHDL) has been expanded to include underserved populations. Health care providers are encouraged to submit most specimens for testing using existing laboratory partnerships (i.e., clinical and commercial laboratories). Public health laboratories should be used preferentially for patients without access to timely testing in other laboratories. Patient specimens should be sent to public health laboratories in the following situations:
- Public Health Investigations as directed by state or local public health
- Hospitalized patients with COVID-19 symptoms
- Patients with COVID-19 symptoms for whom rapid diagnosis is needed to inform infection control practices (e.g. labor and delivery, dialysis, aerosol-generating procedures, etc.)
- Resident of a long-term care facility with COVID-19 symptoms
- Resident in a jail, prison, or other congregate setting with COVID-19 symptoms
- Health care worker or first responders (e.g. fire, EMS, police) with COVID-19 symptoms
- Essential staff in high consequence congregate settings (e.g. prisons or jails) with COVID-19 symptoms
- Utility workers (water, sewer, gas, electric, power, distribution of raw materials, oil and biofuel refining) with COVID-19 symptoms
- Underserved populations with poor access to testing in other settings (e.g., underinsured, patients at Federally Qualified Health Centers, homeless patients, migrant workers, etc.) with COVID-19 symptoms
- Post-mortem testing for a person with COVID-19 symptoms prior to death who died of unknown causes AND where results would influence infection control interventions at a facility or inform a public health response
It is no longer necessary to submit a Patient Information Form with specimens submitted to public health laboratories. Rather, the required data elements should be reported directly to public health via WEDSS. Specimens sent to public health laboratories should be accompanied by the appropriate laboratory requisition forms (WSLH: CDD Requisition Form A (#4105) / MHDL: Microbiology Requisition H-455)
Thank you for your commitment to patient care and public health in Wisconsin.
Sincerely,
Ryan Westergaard, MD, PhD, MPH
Chief Medical Officer and State Epidemiologist for Communicable Diseases
Wisconsin Department of Health Services
