Hospitals only testing those with symptoms or who work in essential services

Photo courtesy of Metro Creative Connections

Due to limited testing capacity, only those individuals with COVID-19 symptoms such as respiratory problems or those who work in essential services can receive a COVID-19 test at local hospitals.
Photo courtesy of Metro Creative Connections Due to limited testing capacity, only those individuals with COVID-19 symptoms such as respiratory problems or those who work in essential services can receive a COVID-19 test at local hospitals.

The novel coronavirus COVID-19 that is now circling the globe has reached southeast Iowa.

Exactly how many people have been infected by the virus is difficult to know for certain because testing in the United States remains limited to those with symptoms and select occupations. That is in contrast to countries like South Korea that have offered drive-through testing to anyone who wants it.

Officially, Washington County has 13 confirmed cases, Henry County three and Jefferson County still reporting zero. However, the Jefferson County Public Health Department issued a news release on Friday stating that, though there are no positive cases of COVID-19 in the county, “There are currently symptomatic individuals that are in home isolation at this time.”

How many tests are available?

Washington County Health Center announced that it had tested 116 individuals for COVID-19 as of Friday, March 27, adding that it was not treating any patients confirmed to have the new virus, a respiratory illness that causes coughing, fever and shortness of breath.

“Due to patient privacy, we will not share any additional information regarding testing,” stated Amy Vetter, director of foundation and marketing at Washington County Hospital and Clinics.

Neither WCHC nor Henry County Health Center stated exactly how many COVID-19 tests they have on hand. Representatives from Jefferson County Health Center had not responded to a request for comment by publication time.

Though they wouldn’t give a number, both WCHC and HCHC indicated that they had enough tests to meet the needs. WCHC stated it does not “have an imminent shortage of tests,” but added that at the same time, it does not have the capability to do widespread testing. Shelley Doak, public information director at HCHC, stated that “We have an adequate number of test kits from the State Hygienic Lab to keep up with current demand. We are working closely with our regional partners in monitoring testing supplies.”

Why does COVID-19 testing matter?

Knowing who is infected with COVID-19 and who is not can change how health professionals treat the subject. There is no vaccine to cure COVID-19, and drugs are still being developed to treat its symptoms. Nevertheless, the countries that have employed widespread testing and tracking of COVID-19 patients have been able to isolate just those individuals and the people they’ve contacted without shutting down their entire economy. For instance, the head of the World Health Organization’s Health and Emergencies Programme Mike Ryan praised South Korea and Singapore as two countries who have been able to slow the growth in new coronavirus cases by following this method.

Who can get a COVID-19 test?

Due to the limited number of tests in the United States, the Iowa Department of Public Health has issued guidelines stating who should receive the tests. HCHC said it is following those guidelines, which means it will test:

• All hospitalized patients, of any age, with fever and respiratory illness.

• Older adults (Over 60 years of age) with fever and respiratory symptoms and chronic medical conditions.

• Persons of any age with fever or respiratory illness who live in congregate settings (long term care facilities, dormitories, residential facilities, correctional facilities, treatment facilities)

• Healthcare workers, essential services personnel, first responders and critical infrastructure workers with fever or respiratory illness (i.e. Healthcare workers, fire and EMS, law enforcement, residential facility staff). However, health care providers can test patients, as they deem appropriate, for COVID-19 infection at national reference laboratories.

Triage process

Washington County Health Center recently announced it was implanting a triage process to assess all patients over the phone before they came to one of its clinics. Patients are asked a number of questions, and those who report respiratory discomfort and other symptoms of COVID-19 will be seen at the Respiratory Triage Clinic at the Medical Clinic location, 444 E. Polk St. All patients in need of an appointment will call the Family Medicine Clinic at 319-653-7291. A triage nurse and in some cases a provider will determine the best location for the patient to be seen, whether it be in the Family Medicine Clinic or Respiratory Triage Clinic.

Those who will be seen in the Respiratory Triage Clinic will be required to take a number of steps to reduce their exposure to hospital staff and other patients. For instance, they will be required to stay in their car until a WCHC staff member approaches them with additional instructions. Some evaluation and testing may be done at the patient’s car. Unless absolutely necessary, support people and family members will be instructed to remain in the car when the patient enters the facility for further evaluation by a provider.

Providers will assess patients for an illness, first testing them for flu, bronchitis, pneumonia, RSV. If they cannot be diagnosed, patients may be tested for COVID-19. Though WCHC is also following the Iowa Department of Public Health’s testing guidelines, its providers have the discretion to test patients who present viral symptoms with no specific diagnosis.

Demographics of those with positive COVID-19 test

As of March 29, 2020, Iowa is reporting 336 positive cases of COVID-19, with a further 5,013 individuals testing negative for the virus. Of the positive cases, slightly more than half are female (179 to 157). Only one case has been confirmed in those ages 17 years and younger. The age bracket with the most positive tests are the 41-60 year olds with 120 confirmed cases, followed by 61-80 age group with 106 and 18-40 with 92. Those over 80 years old account for 16 positive tests.

More than half of those with a positive test (185) have not been hospitalized, while 51 are currently hospitalized and another 17 were hospitalized but have since been discharged and are recovering. The virus has claimed the life of four Iowans thus far.