The Oklahoma State Department of Health has not been following updated guidelines issued by the U.S. Centers for Disease Control and Prevention directing physicians to order testing for the new coronavirus for anyone who they believe needs it.

Instead, the health department has directed doctors who have patients suspected of having COVID-19 to call a state epidemiologist for testing approval. Samples sent by physicians without prior authorization from the state are rejected.

“The OSDH is the ‘gatekeeper’ to determine whether the patient qualifies for Coronavirus testing,” stated the agency’s guidance, which was posted on a private laboratory’s website. “If the patient qualifies they will instruct the clinician on how to proceed.

“Specimens received without prior approval will be rejected.”

It’s unclear whether any physicians’ testing requests have been denied.

An Oklahoma State Department of Health spokeswoman confirmed Thursday evening that the agency is requiring physicians to obtain approval from state epidemiologists. However, asked for clarification on the process, a spokeswoman did not respond to follow-up questions by publishing time.

The health department sent out a press release late Thursday evening with testing information.

“The health care provider, in consultation with public health officials will determine if the individual meets the proper case definition that warrants testing,” it stated. “The testing is coordinated by the health care provider.”

As of the evening of March 12, the state health department reported it had tested 39 people in Oklahoma for COVID-19.

The CDC updated its guidance on COVID-19 testing on Sunday, broadening who could be tested for the virus. The federal agency previously had a narrow criteria for who could be tested — those who showed respiratory symptoms and had recently traveled to China, or had come in close contact with a positive patient.

The new guidance directs clinicians to use their “best judgment,” and is aimed to capture the extent of the outbreak in the U.S. and at “identifying cases and preventing further transmission.”

“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,” the guidance stated.

In the last week, the Oklahoma State Department of Health has identified one positive case of the virus and two presumptive positive cases. A case is considered a presumptive positive when a public health laboratory identifies a positive result but is awaiting CDC’s confirmation.

Two cases, which were not connected, were confirmed in Tulsa County residents who recently traveled from Italy, health officials said. A third case was identified in Jackson County on Thursday afternoon. The Altus Air Force Base in a statement on Thursday said the patient, who is undergoing evaluation and treatment, was an active duty U.S. Air Force airman assigned to the base.

Majority of Oklahoma’s tests were completed on Utah Jazz players, personnel

The game between the Oklahoma City Thunder and the Utah Jazz in Oklahoma City on Wednesday night was postponed just prior to tip off after it was learned Jazz player Rudy Gobert, who had fallen ill, had tested positive for the coronavirus.

Within an hour the NBA suspended its season. It was learned early Thursday that Gobert’s teammate Donovan Mitchell had also tested positive for the coronavirus.

During a news conference on Thursday updating the public on COVID-19, Health Commissioner Gary Cox said the state lab received Gobert’s specimen for testing on Wednesday afternoon and got back a presumptive positive result at 6:45 p.m.

Nurses, epidemiologists and doctors worked with game officials to test all the Jazz players, team personnel and Utah-area reporters, Cox said. In all, 58 specimens were collected and tested overnight, he said.

“I think the guidelines are that if you are either symptomatic or a physician in consultation with that patient make a joint determination that testing would be in order then that’s what happens,” Cox said of the Jazz players and personnel being tested.

The positive tests from the Jazz players and personnel will go toward Utah’s count of confirmed COVID-19 cases, Cox said. Those tested will follow up with the Utah Department of Health, he said.

As of the evening of March 12, the state health department reported it had tested 39 people in Oklahoma for COVID-19. Four tests are pending. There is no evidence of community spread, officials said.

State Epidemiologist Laurence Burnsed said at the news conference that he didn’t know the exact number of people who had been tested for the virus in Oklahoma, but the state was “nearing 100.”

It’s unclear how many tests Oklahoma’s state lab has the capacity to complete.

At a news conference on March 6 announcing the first confirmed case of COVID-19 in Oklahoma, Cox said the state had gained the capability to independently test for the virus and had the capacity to test 300 samples per day with an estimated turnaround time of six to eight hours. Before it gained the ability to test independently for the virus, the health department had been sending specimens to CDC’s headquarters in Atlanta for processing.

“Well we have the capacity to run about 100 tests a day, and we have a number of test kits,” Cox said at the news conference on Thursday. “We’re ordering additional reagents at the current time. And so we have the current capacity, I think, for about 300 tests.

“However there are two private laboratories who are in Oklahoma who either are or will be up and running very soon.”

A state health department spokeswoman did not respond to questions seeking to clarify the state’s testing capabilities by publishing time.

Further reading:

Our full coverage on coronavirus in Oklahoma