New trailers up for COVID-19 screening, what is the status of testing in Cincinnati area?March 25, 2020Source
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This story has been updated.
The latest screening locations for people who might have the novel coronavirus illness COVID-19 are trailers parked outside four of St. Elizabeth Healthcare's emergency departments.
They are not for everyone, hospital officials say. And that is the rule across the Cincinnati area.
In the new pandemic world, tents and trailers of various sizes and shapes are set up near emergency-room doors at hospitals throughout the Cincinnati area as a drive-up way to handle testing for COVID-19, the respiratory illness caused by the novel coronavirus.
But only the patients with symptoms (and only some of them) may get tested. Although the FDA has relaxed rules about diagnostic-test development for the illness, there are too few tests for everyone to get one, health officials and medical providers say.
And for now, only those directed by medical caregivers to go to these sites are permitted to get tested.
Dr. Barry Wendt, an internal medicine provider for St. Elizabeth Physicians in Northern Kentucky said, "Right now, you don't need to go out and get a test" if you're asymptomatic or have mild symptoms of the infection. In part, that's because medical professionals don't have a treatment for the illness, he said. If you experience mild symptoms, you will be asked to stay home.
Testing capabilities improve in Ohio
The ability to diagnose COVID-19 has improved here significantly since it was first suspected in Ohio, with two Miami University students late in January, health leaders say.
Back then, Ohio did not have the laboratory capability to diagnose the illness and had to have a U.S. Centers for Disease Control and Prevention lab do the work. The tests were given Jan. 28 and the results – negative – came on Feb. 2.
Ohio got its first two CDC test kits (which contain hundreds of individual tests) late in February, which meant the state was able to take and analyze tests beginning March 1 in Columbus, said Melanie Amato, spokeswoman for the Ohio Department of Health. Two private labs then opened, and a week later, Ohio received two more test kits, which increased capabilities to test people, Amato said.
That still did not mean everyone could get a test. Testing anybody who wants a test isn't necessary, medical professionals say.
Ohio releases an updated guide for testing
The Ohio Department of Health updated its guidance for COVID-19 testing and isolation, and the Health Collaborative, the trade group for the Cincinnati region's hospitals, released that information regionally on Monday. The basic idea is, medical providers are to give "targeted" testing.
Here's what you can expect if you think you or a loved one has symptoms of the illness:
- Physicians are to pre-screen patients who have symptoms, which include cough, fever, and shortness of breath, to decide whether that person should be tested for COVID-19. TriHealth hospitals, for example, are having phone appointments with these patients before any are tested. St. Elizabeth Hospitals are asking patients to call their primary-care doctors. They may be linked to a virtual nurse triage team that will decide what happens next. Check with your provider to learn your caregivers' protocol.
- Patients who are hospitalized with symptoms with COVID-19 are among those prioritized to get tested.
- People at higher risk, such as older adults and those with chronic medical conditions or an immunocompromised state are prioritized to get tested.
Here's Ohio's tier-based testing strategy, which St. Elizabeth hospitals in Northern Kentucky are also following:
- Tier 1: Patients hospitalized or at other healthcare facilities, including long-term care, with symptoms suggestive of COVID-19.
- Tier 2: Healthcare workers at Tier 1 institutions with symptoms and all individuals in public safety work. "We wouldn't want those folks infecting people," Wendt said.
- Tier 3: People with mild to moderate symptoms who are at high risk for COVID-19.
Christa Hyson, the spokeswoman for the Health Collaborative, said, "Until our region receives more test swabs (and) testing kit materials, for the most part, we will continue testing Tiers 1 and 2."
The Christ Hospital had a testing site in Mason that was closed on Friday. The hospital put out a statement saying that test-kit availability across the state was diminishing, and so the test site was closing.
Like the others, this hospital system encourages people to check with their physicians if they are ill. In addition, the Christ Hospital had hoped to open a test site on its Mount Auburn campus, but spokesman Bo McMillan said that the site has not yet been opened. The idea was to allow people to go to the drive-up site, where a clinician would evaluate prospective patients and decide whether to send them on testing.
On Monday, McMillan said that he did not have new, specific information about how testing will be done in the future.
He did say that The Christ Hospital has testing available for people who are in the hospital and need to be tested.
St. Elizabeth hospitals' trailers had not been used as of Monday for testing, Wendt said. The triage nurses are directing patients who need tests to the emergency departments. The trailers are for the future, he said, "to handle overflow from ERs if that becomes necessary."
St. E also is not currently offering up drive-thru testing. Gov. Andy Beshear said on March 20 that his administration was pushing to expand it and drive-thru tests are available in Dansville and Lexington.
How many are getting tested is unknown
The number of COVID-19 tests in the region remains unclear, with hospitals reporting that have a supply but not saying how many they have available. Also, the state can no longer say exactly how many negative tests there are because while positive test results for COVID-19 must be reported to the health department, private testing locations are not required to provide negative test results, Amato said.
Dr. William Miller, senior assistant dean of research and professor of epidemiology at Ohio State University said it is understandable that some people are frustrated "by not being able to get a test if they feel like they need it."
“Testing is not as widely available in the United States as we would like from a public health perspective," Miller said.
But that lack of generalized testing is a major reason people are required to stay at home, Miller said, noting, "The upside to that is, that you're sort of protecting the tests, so healthcare workers can be tested, sick people can be tested to see, is it COVID-19 or something else."
Whitehouse said the TriHealth system "is in good shape."
“Our supply chain got out in front of this in January, so we currently have an adequate number of tests for individuals who, via screening, are determined appropriate for testing."
He did indicate that might change “when we see a greater influx" of people who have symptoms of COVID-19 but added, “Our team is working on getting more tests, including some new tests that have shorter turnaround times than the current ones.”
Amato said the state lab can get test results in about 24 hours.
TriHealth’s six emergency rooms have testing capabilities, Whitehouse said. “We’ve set up separate entrances and exam areas or these patients.” The emergency departments remain open for other needs.
Every hospital group in the region has systems in place to address COVID-19.
Bon Secours Mercy Health, for example, has "flu clinics" set up to evaluate and treat symptoms, which can include fever, cough, and shortness of breath. People are encouraged to check with their physician if they have symptoms, or they can call a COVID-19 hotline, 888-700-9011, with questions.
Nanette Bentley, the spokeswoman for Mercy, said that the health system is monitoring supplies and began planning early. "We have plans in place to support our needs and remain committed to the appropriate and responsible use of supplies and equipment, at this time and always," she said in a statement. She would not provide more detail and didn't respond to a question about tents being erected outside at least one Mercy Health emergency room.