Coordinating Our Response
Vermont needs health care providers and facilities across the state to collaborate in the COVID-19 testing effort. The Vermont Department of Health alone cannot meet the need for testing. By building capacity for prioritized testing everywhere in the state, we are also building capacity to respond to changing needs.
Primary care providers play a vital role in COVID-19 testing and referral in Vermont. Having reliable local access to testing is essential for both symptomatic and asymptomatic patients. We encourage providers to test patients in their own facilities. Using the guidance below, providers can test patients quickly and safely.
Who should be tested?
- Anyone with symptoms of COVID-19.
- People without symptoms who have had close contact (within 6 feet for a total of 15 minutes or more over a 24-hour period) with someone who tested positive for COVID-19.
- People without symptoms who will be attending or recently attended a gathering of people from more than one household.
- People who often gather socially with other people from outside their household.
- People without symptoms in quarantine due to exposure to someone who has tested positive for COVID-19, or people who have traveled and wish to end quarantine early with a negative test. In both cases, the test should be done on or after day 7.
- College students returning to Vermont from out-of-state colleges should be tested on or after day 7 of their quarantine.
- People working in health care or congregate care settings may need to be tested at regular intervals per Health Department guidance.
- Patients scheduled for a procedure or surgery involving airway management may need to be tested prior to the procedure (see Inpatient/Outpatient Medical Services for details). These patients should be referred by their provider to the hospital or health care setting for testing to ensure timely reporting of results.
- Patients being referred to congregate psychiatric settings from a hospital emergency department must be tested and receive a negative result before they are transported.
- Patients for whom a provider determines a test is warranted.
If someone does not fit in these categories and the provider does not see a clinical, health, or exposure-related reason to test, the person should only be tested if there is the capacity for that testing.
Who should not be tested?
- People who tested positive previously and had symptoms of COVID-19, unless determined necessary by a health care provider.
- People who tested positive previously and did not have symptoms of COVID-19, except in special cases.
Providers may offer less invasive collection methods with nasal swabs. Self-administered nasal swab testing is similar to a nasopharyngeal swab at detecting coronavirus. Collecting nasal swab specimens is less technically complex, so can reduce the risk of the spread of infection to healthcare providers.
Guidance on Infection Control During the Collection
For both indoor and outdoor environments and drive-through/drive-up clinics that maintain a distance of:
Less than 6 feet from the patient during collection. Maintain proper infection control. Recommended PPE includes an N95 filtering facepiece or higher-level respirator, eye protection (face shield or goggles), gloves and a gown.
Greater than 6 feet from the patient during collection: Follow standard precautions. Recommended PPE includes gloves. Health care personnel must wear a form of source control (facemask or cloth face covering) at all times while in the health care facility. PPE use can be minimized through patient self-collection while the health care provider maintains at least 6 feet of separation.
- More Guidance on Specimen Collection (CDC)
- More Guidance for COVID-19 Personal Protective Equipment (Vermont Department of Health)
- Request COVID-19 PPE Resources
Other Testing Options
Providers may refer patients to centralized testing sites such as local Federally Qualified Health Centers, hospitals, and associated test centers. See the list of COVID-19 Specimen Collection Sites
The Health Department offers pop-up testing clinics to serve people with no symptoms who are unable to get a test elsewhere.
Polymerase Chain Reaction (PCR)
The PCR test is the standard test for detecting SARS-CoV-2, the virus that causes COVID-19. Health care professionals are encouraged to use PCR tests. Nasal swab kits, used for anterior nares specimen collection are available to certain health care providers in Vermont
SARSCoV-2 antigen testing should only be used when PCR testing is not available, or when very rapid turn-around is required (especially for symptomatic patients), for example in the following circumstances:
- Symptomatic patients in a primary care setting
- Patients being admitted to hospitals with limited availability of PCR testing
Antigen tests could be used for screening asymptomatic residents and staff at a long-term care facility if the tests were performed at least weekly. If used this way, positive antigen tests would be considered presumptive positive and would need confirmation by PCR. Infection and control measures should be implemented pending confirmation.
The Vermont Department of Health Lab and the University of Vermont Medical Center have partnered to provide COVID-19 test kits, free of charge, to certain health care providers in Vermont. Get more information about ordering test kits.
Other providers should order test kits through commercial channels.
Send samples to the University of Vermont Medical Center (UVMMC) Laboratory. Specimens from certain groups will be prioritized, including health care workers who are symptomatic, patients who are hospitalized, long-term care facility residents, people who are incarcerated, and those who are immunocompromised, require dialysis or are deceased. All other non-priority samples will be tested as quickly as resources allow.
All specimens must include a Clinical Test Request Form for COVID-19. Label all specimens with the patient's name and the collection date. If you have questions, call UVMMC Laboratory Customer Service at 800-991-2799.
Hospital labs that have daily courier pickup for UVMMC, please include your sample in that pickup. Otherwise, send your samples to your nearest clinical laboratory for pickup.
The timeline for receiving results is typically:
- 24 hours for priority specimens
- 1-3 days for non-priority specimens
Test results are reported to the hospital or clinical laboratory where the test was collected, which in turn notifies the ordering health care provider. Test results are sent using the fax, email, or phone number that was provided on the clinical test requisition form or through the Lab Web Portal.
The health care provider notifies the patient of the results. However, in the event of a positive result, the Health Department will also reach out to the patient to convey public health recommendations and collect information on contacts. It’s possible that Health Department notification may occur prior to the provider’s conversation with their patient. Patients awaiting lab results should contact their provider with questions.
Health care providers can access COVID-19 test result reports through our Lab Web Portal.
With the Lab Web Portal:
- Reports are delivered securely and in a timely and efficient manner.
- Authorized users can view, print, and download patient reports in a PDF document soon after they are released by the Health Department Laboratory.
- Positive result reports are flagged so that users can prioritize those as needed, and reports can be printed as a batch.
- Users can set up notifications to be emailed when reports have been uploaded to the portal.
At this time, the Lab Web Portal can only be used for COVID-19 results reporting. Test requests must still be made using our Clinical Test Request form.
If you would like more information about the Health Department Laboratory’s Lab Web Portal, please email us at AHS.VDHVTLWPSupport@vermont.gov
False positives are considered very rare. Therefore, the Health Department considers all FDA-approved PCR COVID-19 positive results to be true positives unless there is concern about contamination from the performing laboratory. Not having any known exposures to COVID-19 or being asymptomatic should not change the interpretation of a positive PCR lab result.
Asymptomatic patients typically have lower viral loads than symptomatic patients, which means they are more likely to be closer to the threshold of detection for PCR tests. Because of this, retesting of the same sample is not generally recommended. Similarly, subsequent testing with a negative result may mean there was viral clearance, but this does not change the interpretation of a previous positive result, isolation recommendations for the case, or quarantine recommendations for close contacts. Because of this, additional testing is not recommended following a positive PCR result.
Instructions for Collection and Packaging of Specimens for Novel Coronavirus (COVID-19)
Clinical Test Request Form - Leave the insurance portion of the form blank.
Guidance for Inpatient and Outpatient Procedures
COVID-19 Specimen Collection Sites
Waiting for test results (information sheet for patients)
Information sheets for patients
Considerations for Implementation of SARS-CoV-2 Rapid Antigen Testing (Association of Public Health Laboratories)
UVMMC Laboratory Customer Service for providers: (802) 847-5121 or (800) 991-2799
UVMMC has a COVID-19 Hotline for providers to call if they have questions regarding screening patients for COVID-19 testing: (802) 847-2700