Causing chaos across the nation, the symptoms of COVID-19 are deceiving, masquerading as pneumonia, the common cold, and sometimes leaving patients completely asymptomatic. Regardless of what symptoms patients display, testing is imperative as it allows public health officials to examine the evolution and prevalence of the virus. In the words of Dr. Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization, “We have a simple message for all countries: test, test, test.”
However, the unfortunate reality is that while testing plays a critical key in the containment of the virus, there’s a very real shortage of testing supplies available to clinicians. In fact, because of these shortages, 39 percent of healthcare workers feel only somewhat prepared to manage patients who may present to their practice setting with COVID-19 according to a recent survey by Clinical Care Options.
According to Dr. Rod Hochman of Providence St. Joseph Health in Seattle, in many cases clinicians are lacking reagents. In other cases, it’s simpler items including the appropriate swabs needed to take the samples for testing that are unavailable. “I think we needed to rethink how we’ll deal with a pandemic. If there was an outbreak in China several months ago that should’ve started a whole sequence of events going. But that’s the history,” said Hochman. “What do we do now?”
To preserve supplies while providing tests during the shortage clinical experts, including Celine Gounder, MD, ScM, FIDSA, urge healthcare professionals to consider a tiered approach to testing symptomatic patients. “Start by testing for influenza A and B and respiratory syncytial virus. If those are negative, then perform a multiplex PCR for other common respiratory viruses as a second-line test. And if that’s negative, then test for SARS-CoV-2. This allows us to target testing to those at highest risk for COVID-19,” explained Gounder for Clinical Care Options.
Gounder also explained crucial steps post-testing. “Patients who are younger than 50 years of age and who do not have chronic medical conditions should be counseled to quarantine themselves at home while awaiting test results. However, patients older than 50 years and patients with chronic medical conditions may consider presenting to an inpatient facility, especially if they are symptomatic and/or test positive prior to presentation.” Studies show that patients diagnosed with COVID-19, especially those with preexisting conditions, fall extremely ill one week into illness. Knowing this, time is of the essence for clinicians making decisions regarding patient treatment plans.
As the demand for testing increases, while supplies and test kits decrease, the key is for clinicians to become more strategic and systematic with their testing approaches and from there determine patient treatment, whether that’s inpatient services or self-quarantine. By doing so, clinicians are able to further monitor the evolution and prevalence of the virus in the United States while keeping positive patient outcomes a priority.
For more expert advice on managing COVID-19 at your practice, click here.