Coronavirus Disease 2019
Public Health
Laboratory

Before you begin... Page Updated 3-21-2020
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Please read these instructions carefully as issues with specimens, forms, and labeling can lead to specimen rejection or testing delays. DO NOT collect or send specimens to the Public Health Lab (PHL) until instructed to by DPH. When contacting DPH, please be prepared to provide a call-back number and to wait for 10-15 minutes for a call-back. Once approved by DPH, follow all instructions below under Public Health Lab Specimen Collection and Transport.

PHL aims to result tests within 2 business days of receipt of specimen, but delays could occur based on volume and capacity.

APPROPRIATE TESTS
  • For all patients: Collect TWO upper respiratory specimens - one oropharyngeal (OP) swab and one nasal specimen (either nasopharyngeal (NP) swab, nasopharyngeal wash/aspirate or nasal aspirate swab,)
  • For patients with a productive cough: collect one lower respiratory specimen (sputum, bronchoalveolar lavage or tracheal aspirate) in addition to the upper respiratory specimens.
  • Outpatient settings should only collect an NP and an OP swab.
SPECIMEN COLLECTION
Image of a Swab Kit

Note About NP and OP swabs

  • Use synthetic fiber swabs with plastic shafts such as ones used to collect specimen NP swabs for influenza testing (see figure).
  • Do not use calcium alginate swabs or swabs with wooden shafts - Use sterile tubes with at least 1ml of viral transport media.
  • Each swab must be placed into a separate vial.
  • Oropharyngeal Swab - Swab the posterior pharynx, avoiding the tongue. Immediately place swab in transport media.
  • Nasopharyngeal (NP) swab - Insert a swab into the nostril parallel to the palate. Leave the swab in place for a few seconds to absorb secretions. Immediately place swab in transport media.
  • Nasopharyngeal wash/aspirate or nasal aspirate - Collect 2-3 mL into a sterile, leak-proof, screw-cap sputum collection cup or sterile dry container.
  • Sputum: Have the patient rinse the mouth with water and then expectorate deep cough sputum directly into a sterile, leak-proof, screw-cap sputum collection cup or sterile dry container.
  • Bronchoalveolar lavage or tracheal aspirate: Collect 2-3 mL in a sterile, leak- proof, screw-cap sputum collection cup or sterile dry container.
FORMS AND SPECIMEN LABELING
  • Complete a COVID-19 PHL H-3021 Test Requisition form for each specimen. The following information must be in the "other" field of the test request form:
    • For NP swabs - novel coronavirus 2019 PCR and Biofire RP panel
    • For OP swabs, sputum, BAL, and endotracheal aspirates - novel coronavirus 2019 PCR
  • Test request forms MUST include full patient name, date of birth, medical record number, sex, date/time collected, specimen source, and the hospital or clinic where the specimen was collected.
  • The specimen source on the tube MUST match the source on the form.
SPECIMEN STORAGE AND TRANSPORT
  • Refrigerate specimens at 2-8C and transport on cold pack, preferably as Category B.
  • Ship specimens by courier to: Los Angeles County Public Health Laboratory, Attn: Molecular Epidemiology Unit, 12750 Erickson Avenue, Downey, CA 90242
  • Public Health will provide a courier only to facilities with no other alternate means of specimen transport.
  • Upon approval by LAC DPH, the PHL will contact your laboratory to discuss specimen transfer. Specimens that arrive at PHL without prior DPH approval may experience significant delays in testing
LAC DPH Public Health Lab (PHL) COVID-19 Testing Criteria
3-24-20
COVID-19 diagnostic testing through the DPH Public Health Lab (PHL) will be accepted for patients admitted to intensive care units if your facility is experiencing substantial delays in obtaining a test result from a commercial clinical laboratory. PHL aims to maintain a turnaround time of ~1-2 business days after receiving specimen. Therefore, this recommendation will be regularly reassessed based on the volume of test requests through PHL and on the availability of COVID-19 commercial clinical laboratory capacity
Clinical Features and Epidemiologic Risk
Fever or signs/symptoms of lower respiratory illness (e.g. cough or shortness of breath) AND Any healthcare worker (defined as a person providing direct clinical care to patients) who worked while symptomatic in an acute or long-term care facility1
-or-
A resident of a long-term care facility
-or-
Paramedic personnel and Emergency Medicine Technicians (EMTs)
Part of a cluster of 2 or more cases of a presumed infectious acute respiratory illness within a 72-hour period AND Any congregate living setting (e.g. senior assisted-living facility, homeless shelters)
IF patient meets criteria for COVID-19 Testing at PHL, then call LAC DPH and an on-call physician will advise on the next steps.
  • Call 213-240-7941 from 8:00am-5:00pm Monday to Friday and 213-974-1234 (After Hours Emergency Operator)
  • DO NOT collect or send specimens to PHL until the case is discussed and testing is approved by DPH


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  • Public Health has made reasonable efforts to provide accurate translation. However, no computerized translation is perfect and is not intended to replace traditional translation methods. If questions arise concerning the accuracy of the information, please refer to the English edition of the website, which is the official version.

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