ST. LOUIS — Missouri health officials loosened the criteria for getting tested for COVID-19 this week after weeks of complaints that tight guidelines meant few sick people were eligible.
The Missouri Department of Health and Senior Services announced the guidelines Monday, saying health care professionals should use their judgment in deciding who to test.
Previously, Missouri set narrow parameters to ration test kits: A patient had to have symptoms severe enough to be hospitalized, or have symptoms plus known contact with someone who already tested positive for COVID-19. Patients could also get tested if they had symptoms and had recently traveled to an area with a documented widespread outbreak.
The loosened restrictions this week bring Missouri in line with the federal Centers for Disease Control and Prevention, which updated its guidelines for testing March 5 to defer to physicians.
With the new rules in Missouri and efforts to increase capacity in Illinois, officials in both states say totals of those testing positive for the virus are likely to increase.
As of Tuesday, 255 people in Missouri and 1,535 people in Illinois have tested positive. Illinois also reported four new COVID-19 deaths Tuesday for a total of 16, along with the 250 new cases.
Despite the new rules, lack of supplies may continue to prevent widespread testing. For weeks, items such as swabs and reagents used in the analysis of samples have been in high demand nationally.
The shortage and earlier criteria for testing in Missouri led to many sick people around St. Louis unable to get tested, including an internal medicine doctor who couldn’t order tests for herself or her patients. Meanwhile, several high-risk people shared stories in the Post-Dispatch about navigating a series of hotlines and doctor calls before being denied testing.
As of Monday evening there were 28 mobile sample-collection sites in Missouri, and at least nine sites in the St. Louis metro area. A list of providers with sites can be found on the DHSS website. All of the large hospital systems around St. Louis have set up the sites where people can get tested in their cars to limit exposure to others.
In Illinois on Tuesday, Gov. J.B Pritzker emphasized the state’s efforts to expand testing. Illinois now has capacity for 2,000 tests per day, including about 600 tests a day from state health department labs. Pritzker said he hopes to increase that through more labs and hospital-based testing so that more than 4,000 people will soon be tested for the virus each day.
“Testing helps demonstrate the actual reach of COVID-19 and informs us how we can potentially isolate the outbreak,” Pritzker said.
The total number of COVID-19 tests completed each day for Missouri patients remains unclear as private labs including LabCorp and Quest Diagnostics are now handling most of the state’s testing and, before this week, only reported positive results to the state.
That is set to change. Dr. Randall Williams, director of DHSS, changed protocol Saturday to require all private labs to report the total number of both negative and positive tests to his department, rather than only to local health officials.
The state’s lab, the Missouri State Public Health Laboratory, conducts less than 100 tests a day, with 660 tests completed so far.
Both the CDC and the new Missouri testing guidelines still advise that health care professionals should still prioritize certain groups for testing, including:
• Hospitalized patients with COVID-19 symptoms, including fever and respiratory illness.
• People with symptoms living in nursing homes or other living facilities that house older adults or those with medical conditions that make them higher risk.
• People who have had close contact with a suspected COVID-19 patient, including health care professionals.
A letter from Williams also said factors such as high numbers of confirmed COVID-19 cases in a certain community could guide health care providers when deciding who to test.
On Monday, DHSS also announced new directions for people who do test positive for COVID-19 in line with advice from the CDC.
People can discontinue home isolation after three days pass with no symptoms, including showing no fever — without the use of fever-reducing drugs — and showing no signs of respiratory illness. People should wait at least seven days since their symptoms first appeared, according to the guidelines.
Previous recommendations advised people could end isolation after two negative test results from samples collected at least 24 hours apart. The guidelines were widened to account for the limited number of tests.