Friday, December 11, 2020

Health officials encourage Kentuckians without symptoms to get coronavirus tests at testing sites, not hospital emergency rooms

By Melissa Patrick
Kentucky Health News

Lexington health officials are imploring Kentuckians without Covid-19 symptoms who want or need to get tested for the coronavirus to go to a testing site, and not the busy emergency departments of local hospitals. 

“If your question is, ‘Do I have Covid?’ there are many, many options better than our emergency departments to get that question answered,” Dr. Roger Humphries, chair of emergency medicine at UK HealthCare, said at a virtual press conference Friday. 
 
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Physician leaders and administrators from CHI Saint Joseph Hospital and Baptist Health Lexington, who made the plea along with UK, said they are seeing similar difficulties in their organizations' hospitals across the state.

Colleen Swartz, UK HealthCare's vice president for hospital operations, said there are "hotspots" all across Kentucky, and many hospitals are experiencing a surge of Covid-19 patients that need inpatient care, including those in Pikeville, Danville and Bowling Green, Somerset and the rest of the Lake Cumberland area. She said many hospitals "are fairly overrun right now."   

The officials said many people often come to emergency departments to get tested because they think they've been exposed. Humphries called them the "worried well." 

Dr. Mark Sloan, medical director at Saint Joseph's emergency department, said such patients have been 10 to 15 percent of his patient volume this month. 

He said any strain on the Lexington hospitals "propagates out" to other hospitals, limiting the number of patients that can be transferred in from other CHI St. Joseph sites if they need a higher level of care. 

Swartz said when an emergency department is used as a testing site it consumes "precious resources" such as personal protective equipment, and uses space often needed by those who are critically ill. 

The officials said laws that don't let them question the motives of people who come to an emergency department, so they can't ask them why they are getting tested there instead of one of the many free testing sites in Lexington. 

All that said, the officials stressed that patients with covid-19 symptoms need to be seen by a health-care provider, and those with severe symptoms need to come to the emergency room. 

'We want to be clear: If you're symptomatic and you're short of breath or you're having any of the other symptoms that we can talk about, you should be seen by a provider," Swartz said. "And if your symptoms are severe, then certainly the emergency department is the appropriate venue. But if you're just wondering if you're Covid-positive because you may or may not have had an exposure, we have good alternatives for testing in the community and that would be the preference, that you get tested at one of those venues." 

Humphries added, "If you're having severe shortness of breath or you can't get up and walk a few steps without getting severely short of breath or if it's so difficult you're having trouble talking . . . we want you to come to the hospital with those symptoms as soon as possible." 

The Centers for Disease Control and Prevention offers a "Coronavirus Self-Checker" tool to help you make decisions on when to seek testing and medical care. Humphries suggested people managing Covid-19 symptoms at home should buy a pulse oximeter to measure oxygen levels, noting that an oxygen level in the low 90 percent range is concerning. 

With spread of the virus so heavy, the officials said their greatest concern is their ability to keep staffed. Swartz said UK has 100 staff members out due to because they have been infected or exposed to the virus. 

"It makes the work difficult to get done when we're challenged not only with an increase in demand and volume, but reduced resources to deploy," she said. 

Dr. David Dougherty, infectious disease specialist at Baptist Heath Lexington, said hospital and ICU capacity "doesn't just have to do with beds, it has to do with staff. And if our staff is getting infected out in the community and people aren't masking, because our staff still has to go to the grocery stores and get food, then we're going to run into bigger problems."

While waiting on vaccines to become widely available, Swartz called on Kentuckians to "double-down" on masking, social distancing, hand washing and not gathering with anyone outside of your immediate household. 

"Those very basic practices literally can save lives," she said, adding later, "Part of our call to action today is to really think about your own practices and then to choose venues of care wisely, so that we can have the highest level and intensity of care available for those who are the most ill." 

For a list of testing sites near you go to Govstatus.egov.com/ky-covid-testing. The site includes a link to sites that offer free testing throughout the state. 

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