SEMINAR 1:
COVID-19 Specimen
Collection, Handling, and
Transport
WHAT IS COVID-19?
• A highly contagious infectious
disease caused by severe acute
respiratory syndrome coronavirus
2 (SARS-CoV-2).
• First reported in Wuhan, Hubei
Province, China, in late
December 2019, SARS-CoV-2.
• COVID-19 is regarded as a
systemic viral illness.
TYPES OF COVID- 19 SPECIMEN:
1. UPPER RESPIRATORY
SPECIMEN
® Recommended by CDC
on collecting and testing
COVID-19.
® Most common in
Philippines is NPS.
• Nasopharyngeal Swab (NPS)
• Oropharyngeal Swab (OPS)
• Nasal Mid-turbinate (NMT)
• Anterior Nasal Specimen
• Nasopharyngeal Wash/
Aspirate
• Saliva
2. LOWER RESPIRATORY
SPECIMEN
• Bronchoalveolar Lavage
® Can aspirate pleural
fluid and lung biopsy.
® Usually collected in
severe cases COVID
patients.
• Tracheal Aspirate
® Collected in
mechanical
ventilated patient.
• Pleural Fluid
• Lung Biopsy.
• Sputum
® Not recommended.
® Patient is faster to
produce aerosol.
3. Other
• Fecal Sample
• Blood (EDTA
recommended)
® 5mL
• Serum Specimen
® Anti-anticoagulated
test tube or Red top.
® For antibody
technique.
® Collected preferably
withing 7 days after
the onset of the
illness (1st specimen).
® 2nd specimen should
be collected 3-4
weeks after the onset
of the illness.
SPECIMEN CONSIDERATION:
NASOPHARYNGEAL SWAB (NPS):
• It is recommended to collect
only the NP specimen, although
an OP specimen is acceptable.
• Can be collected from both
sides using the same swab, but
not necessary if the mini-tip is
saturated with fluid from the first
collection.
• Respiratory tract specimens
should be collected ASAP,
PRETTY JAH (✿◠‿◠)
 before the patient administer to minimize the exposure to
antibiotic therapy or within 3 biological hazards.
days of symptoms.

OROPHARYNGEAL SWAB (OPS):

• The sampled person first gargles
with normal saline to avoid
contamination.
• The sampler immerses the
swabs in sterile saline (virus
preservation solution is not DONNING PPE:
allowed to avoid antibiotic 1. Perform hand hygiene. Wash
allergies). hands thoroughly with soap and
water OR apply alcohol-based
OTHER SPECIMENS: hand rub.

2. Put on N95 mask or double layer

of surgical masks and inner
disposable gloves.

PERSONAL PROTECTIVE
EQUIPMENT FIT TEST OR SEAL CHECK
• This equipment will prevent the
1) Using both hands, mold the
spread of infection when malleable nosepiece to fit
collecting and testing specimen snugly against the nose bridge,
from confirmed and suspected and face, below the eyes.
COVID-19 patients.
• Observe proper sequence of
donning and doffing PPE to

PRETTY JAH (✿◠‿◠)

2) Using a mirror, further check
and adjust the edges to provide
good seal around the face.

3. Put on the head cap and shoe STANDARD PRECAUTION

cover. ® Treat all the body fluids
potentially infectious or
hazardous.
Droplet
® Organisms can travel within
3ft.
CONTACT PRECAUTION
4. Put on over-all (Bunny Suit) and
® All disposable or single used
outer gloves.
items, should be discarded
immediately.
® Reusable equipment should
be disinfected after use.
DOFFING PPE:
1. Disinfect outermost gloves.

5. Put on isolation gown and 2nd

outer gloves.

2. Remove isolation gown

together with the outermost
gloves.
• Turn gown inside out
and fold or roll into a
6. Put on face shield. bundle.

PRETTY JAH (✿◠‿◠)

 5. Sanitize gloved hand and
remove head cap.

6. Remove inner gloves and wash

hands thoroughly.

3. Sanitize gloved hand and

remove contaminated face
shield.
7. Change N95 or face masks.

TYPES OF SAMPLES for COVID-19

TESTING
SUPPLIES/ EQUIPMENT NEEDED:
4. Remove overall (Bunny Suit),
outer gloves and shoe cover in
a rolling outward motion.
• COVID-19 Case
Investigation Form (CIF)
Version 9
• Virus Transport Media
(VTM)/ Universal Transport
Media (UTM)/ Sample
Storage Reagent
• Nasopharyngeal Swab
(NPS), Sterile Dacron/
Rayon swab with pliable
shaft
• Oropharyngeal Swab
(OPS), Sterile Dacron/
Rayon swab with plastic
shaft
• Sterile Tongue Depressor
• Absorbent Pad/ Tissue

PRETTY JAH (✿◠‿◠)

 • Laboratory Sealing Film
(Parafilm)
• Resealable Plastic Bag
• Masking Tape/ Sticker
Paper (Labeling)
• Permanent Tube Marker
• Sterile Scissors
• Refrigerator (for storage)
PRE-COLLECTION GUIDELINES:
• Inspect VTM and integrity of the
NPS/ OPS swabs.
• Label the tube and resealable
drugs. Information on the label
must match the CIF and ID
presented:
® Patient’s full name
(Surname, First Name, and
Middle Name)
® Birthday and Age
® Gender
® Date and Time of
Collection
NASOPHARYNGEAL SWAB (NPS)
PROCEDURE:
• Identify the patient.
• Instruct the patient to tilt the
head back 70 degrees.
• Insert the swab into the nostril
parallel to the palate and into
the nasal cavity (usually 5-6 cm
in adults) until a slight resistance
is met.
• Rotate the swab 4-5 times over
the surface of the posterior
nasopharynx.
• Slowly remove swab while
rotating it.
• Repeat in the other nostril using
the swab.
• Place NPS immediately in the
VTM tube to avoid drying of the
swab.
• Snap/ cut off the end of the shaft
that sticks outs of the tube
(break-point) and close the tube
tightly.
OROPHARYNGEAL SWAB (OPS)
PROCEDURE:
• Instruct patient to open his/ her
mouth.
o Tell the patient to say
“AHH” to elevate the
uvula.
o Hold down the tongue
with a sterile tongue
depressor.
• Make a sweeping motion to
swab the posterior pharyngeal
wall and tonsillar palate.
o Avoid swabbing the soft
palate.
o Do not touch the tongue
with the swab tip.
• Place OPS immediately in the
VTM tube to avoid drying of the
swab.
• Snap/ cut off the end of the shaft
that sticks out of the tube (break-
point) and close the tube tightly.
• Secure the cap with parafilm to
prevent leakage during transport.
PRETTY JAH (✿◠‿◠)
COVID-19 SPECIMEN PACKAGING
PRIMARY RECEPTACLE
(SPECIMEN COLLECTOR):
® Watertight and leak-proof.
® UTM/ VTM containing the
specimen should be wrap with
absorbent pad or tissue.
® Place it in an upright position
inside the receptacle with
complete label.
SECONDARY PACKAGING
(RELEASE BAG OR ZIPLOCK):
® It must be watertight and leak-
proof to secure and protect the
primary receptacle.
® Complete label: Full Name of
Patient, Age, Gender, Date and
Time of Collection, Type of
COVID-19 Swab Sample.
® It must be properly and
completely labeled.
OUTER PACKAGING
(THERMAL BOX OR BAG):
® Where the secondary packaging
is placed.
® 4-8 icepacks are recommended
to maintain the required transport
temperature and viability of the
samples.
MATERIALS NEEDED:
• Transport box (Styro/ Thermocol)
o Put the hospital or
laboratory institution, and
address.
• Frozen icepacks (minimum of 4)
PRETTY JAH (✿◠‿◠)
 • Releasable plastic bag (e.g. 5. Using a thermocol box/ styro box
ZiplockTM) as an outer container and
placing the secondary container
within it, surrounded by hard
frozen gel packs (minimum of 4)
to maintain the quality of
specimens.

• Completely filled out forms (LRRF,

CIF, Line List)

PROCEDURE FOR SPECIMEN

PACKAGING AND TRANSPORT: 6. Keep the tube with specimen in
upright position in between the
1. Use PPE while handling specimen. icepacks or tape the re-sealable
2. Seal the neck of the sample vials plastic bag in the side of the box/
using parafilm. container.
3. Wrap UTM/ VTM tubes containing
the specimens in absorbent
material or tissue paper and
place upright in a separate leak/
puncture proof container. Place
it inside in a releasable plastic
bag.
7. Separately pack the filled-out
forms in a sealed clean plastic
bag/ case and attach it firmly to
the outside portion of the 3rd
outer container to avoid soaking
the documents.
8. Label the box with complete
4. Place the releasable plastic bag details of the recipient.
inside a sturdy plastic container
and seal the neck of the
container.

The specimen is ready for shipment.

PRETTY JAH (✿◠‿◠)

GENERAL INSTRUCTIONS FOR
STORAGE OF COVID-19 SAMPLES:

• Samples which cannot

transported within 5 days from
testing should be FROZEN (-70 to -
80° C).
• Frozen samples should be
transported in DRY ICE.
• COVID-19 samples maybe
retained at refrigerator
temperature (2 to 8° C) for up to
72 hours prior testing.
• It is essential to maintain the
storage temperature of the
sample to ensure integrity of the
sample and accuracy of the test
result.

PRETTY JAH (✿◠‿◠)