Note: Clinicians should use their judgment to determine if a patient has signs and symptoms compatible with COVID-19 and whether the patient should be tested.

COVID-19 Case Report Form

Evaluation Criteria

Most patients with confirmed COVID-19 have developed fever (subjective or confirmed) and/or symptoms of acute respiratory illness (e.g., cough, difficulty breathing). Additional symptoms of COVID-19 include:

• Fatigue
• Anorexia
• Chills
• Rigors
• Myalgias
• Headache
• New loss of taste or smell
• Vomiting
• Sore throat
• Rhinorrhea

The following exposure criteria may be considered for increasing the index of suspicion:

• Has the patient had close contact with a person with laboratory confirmed COVID-19 infection?
• Has the person traveled outside of Hawaii?

Testing Criteria

The Centers for Disease Control and Prevention (CDC) has updated priorities for testing patients with suspected COVID-19 infection. The diagnostic test of choice for acute COVID-19 is RT-PCR.

High priority

• Hospitalized patients
• Healthcare workers, workers in congregate living settings, first responders with symptoms
• Residents in long-term care facilities or other congregate settings, including prisons and shelters, with symptoms
• Persons identified through public health cluster and selected contact investigations

Priority

• Persons with symptoms of potential COVID-19 infection, including fever, cough, shortness of breath, chills, muscle pain, new loss of taste or smell, vomiting or diarrhea and/or sore throat
• Other groups or persons prioritized for testing as part of public health investigation or surveillance activities

Collect one (1) nasopharyngeal (NP) swab as soon as possible (wearing appropriate PPE).  When sending specimens to the clinical laboratories, clearly indicate the priority group on the laboratory request form sent with the specimen (e.g., symptomatic healthcare worker).

Serologic tests should NOT be used for acute COVID-19 diagnosis.  

Testing at State Laboratories Division (SLD) supports public health investigations and surveillance activities with emphasis on vulnerable populations, including:

• Residents or employees of congregate settings that serve vulnerable populations (e.g., long-term care facilities, assisted living facilities, residential care homes, homeless shelters, residential treatment facilities)
• Persons involved in front-line COVID-19 response efforts (e.g., emergency medical services, law enforcement, firefighters, public safety workers)
• Close contacts of a confirmed case (Note:  Not all close contacts of confirmed cases require testing if results will not alter clinical or public health actions)
• Persons identified through COVID-19 cluster investigations
• Persons with suspect COVID-19 identified through airport screening
• Hospitalized patients with suspect COVID-19, if clinical laboratory testing is not readily available.

Submit a Case Report Form via facsimile to the Disease Outbreak Control Division at (808) 586-4595 to request testing at SLD. 

Medical Advisories

• Update #14 – Coronavirus Disease 2019 (COVID-19) – (HDOH) (July 22, 2020)
• Previous medical advisories