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Generic Plans for COVID-19 Specimen Testing and Management During a Hurricane

Guidance for state, county, and city public health laboratories

Doctor in personal protective equipment (PPE) performing a COVID-19 test on a masked patient.

During hurricane season, clinical laboratories testing for COVID-19 need to have plans for how they will ensure that testing continues if their laboratory operations are impaired. The following generic plan offers considerations for what to include in this plan.

Have a plan to maintain the testing facility’s infrastructure.

Plans must address how to maintain the testing facility’s infrastructure in the event of a power outage. A laboratory that is in the direct path of a storm could require additional power supplies, additional fuel for power supplies, or alternate fuel supply chain sources. Testing facilities should assess components necessary for liquid nitrogen or another similar long-term storage, as well as scheduled record updates to prevent the loss of records. Testing facilities should also assess how long their contingency plans can ensure the physical security and storage security for pathogen repositories.

Establish backup laboratories or reciprocal COVID-19 testing agreements.

Some states have the option of redirecting specimens for COVID-19 testing to another public health laboratory within the state, or they have a reciprocal agreement with a neighboring state to test their specimens, as needed.  In addition, states may have partnerships with private or university testing laboratories.  The continuity of operations plan for laboratory testing for COVID-19 during a hurricane response should include:

  • A description of the processes and triggers for redirecting specimens to a different laboratory
  • A description of the logistics and transportation assistance required for redirecting specimens
  • A plan for notifying partners and clients

Secure specimens in place.

When a storm is predicted to impair a laboratory’s operations, specimens should be secured at either the clinic or local health department where the specimens were collected or at the state/county public health laboratory conducting the testing, depending on the facility’s ability to store specimens.  The planned duration of storage could be 10 days or longer after a storm’s direct hit or subsequent flooding.  Therefore, the storage plan should describe the appropriate storage temperature and the process for maintaining temperature for at least 10 days or longer in a secured refrigerator, freezer, or storage cabinet.

Notify partners about the redirection of specimens.

Following the decision to temporarily suspend testing or redirect specimens to an alternate site, the laboratory must contact and notify the specimen-submitting entity (e.g., sentinel laboratories, county health departments, or the state preparedness office).

Assess transportation logistics.

Plan transportation assistance needed to transport specimens to alternate laboratories (e.g., dedicated couriers, FedEx, or UPS).

Have a contingency plan for mandatory non-infectious disease testing and testing for other infectious diseases.

In addition to COVID testing, public health laboratories perform other infectious disease testing that may need to be paused or require specimen redirection.  A plan to pause or redirect these specimens needs to be implemented as part of the hurricane planning.  Redirection of mandatory non-infectious disease testing (e.g., newborn screening) could utilize different partners than infectious disease testing.  The reciprocal agreement for mandatory non-infectious diseases should include the process for non-infectious specimen redirection, availability of alternate laboratories to handle specimen redirection, similarities in testing volumes, analytes tested, and use of the same Laboratory Information Management System (LIMS) for non-infectious disease specimen accessioning and report messaging.

Have a plan for extended closure of the testing facility.

If the testing facility is likely to be closed for an extended period, an alternate testing location might be needed for a longer duration.  A plan for redirecting collected specimens for testing should include fiscal, legal, logistical, and other relevant considerations that take into account this extended duration.

Have a plan for risk mitigation and facility cleanup.

Facility staff should follow the existing site-specific emergency evacuation plan. All other non-emergency responder staff should follow local guidelines for the public. State laboratories should have emergency plans for a structural breach or flood in a facility, including plans for collecting and curating breached specimen storage devices and for cleanup, risk mitigation, and communication to partners and clients.

Visit Information for Laboratories about Coronavirus (COVID-19) for additional resources and information.

Infographic: Be Ready! Hurricanes Ready: Prepare. Plan. Stay Informed. Social Media at CDC Emergency