As cases of the COVID-19 disease are confirmed in DeKalb and adjoining counties, there’s a growing demand for testing to determine whether a person has been infected by someone they came in contact with.
Thus far, Alabama has conducted just over 4,000 tests. Figures updated daily from the Alabama Department of Public Health (ADPH) represent tests that were satisfactorily performed by ADPH’s Bureau of Clinical Laboratories (BCL), along with some data from commercial labs. The commercial labs are required, by law, to report positive tests to ADPH. Some commercial labs do not report negative specimens.
State Health Officer Dr. Scott Harris said the first step is to call your doctor and share symptoms before visiting their office. This will help the office protect themselves and other patients. This should also be done if you are planning to visit the hospital Emergency Room. Call 9-1-1 (only if you think it is an emergency). “Your local health authorities will give instructions on checking your symptoms and reporting information,” Harris said.
In Fort Payne, Encore Medical Spa & Family Medicine is offering on-site specimen collection from their parking lot. Medical Director Dr. Monique Sherrill is also available for telemedicine.
Encore Medical Spa & Family Medicine General Manager Jason Sherrill said persons wanting to be tested can call a dedicated phone hotline at (256) 273-6290 to be pre-screened for testing.
Persons most urgently needing to test include:
• Anyone who is symptomatic with at minimum (measured or subjective fever/cough/shortness of breath, and
• Anyone who is immunocompromised or suffers from conditions such as chronic lung disease, diabetes, heart disease, chronic kidney disease, immunocompromised, neurologic disorders or pregnancy
• Anyone age 65 years or older
• Healthcare workers
• Patients associated with a long-term healthcare facility
In a joint press conference on Thursday with Gov. Kay Ivey, Harris said there aren’t enough test kits for everyone, and ADPH’s Bureau of Clinical Laboratories (BCL) has refocused its testing efforts toward persons at highest risk for the disease, and potential adverse outcomes or concerns about infection control, i.e., healthcare or long-term care workers. This is consistent with federal guidelines. If patients do not meet ADPH criteria and their physician wishes for them to be tested anyway, they should be tested through a commercial laboratory.
Encore Medical Spa & Family Medicine is sending specimens to DTPM, Inc., the Fort Payne lab that recently received approval to test for COVID-19, Jason Sherrill said. Results have about a four-day turnaround.
Once pre-screened in triage for testing by Dr. Sherrill, Encore’s lab director, Sharon Williams, takes a nasopharyngeal (swab from the nose), using the same kind of swab used for flu tests while wearing Personal Protective Equipment to shield her from contamination while Dr. Sherrill supervises the process. The patient’s specimen is then put into the same viral transport media used to transport specimens being tested for flu and other viruses.
Sherrill said Encore was the first local physician’s office to offer the car-side specimen collection, as far as he knows. Other doctor’s offices have referred patients to them, and he said people have called from as far away as Chattanooga seeking testing.
“We hope other offices will jump on board and do the same,” he said.
There is no cost for the testing and Encore Medical Spa & Family Medicine is happy to take care of anybody who is concerned about symptoms.
“You do not have to be a current patient of Encore Family Medicine to get tested,” Sherrill said.
The practice is located at 1202 Gault Avenue North, near the Walgreens that is closing.
If a specimen is to be collected by a physician in a different manner, Harris recommends wearing a face mask, if possible, and keeping at least 6 feet distance from others in the waiting room.
Harris said anyone seeking testing can call the Alabama COVID-19 24/7 hotline at 1-888-264-2256 for information about approved testing sites and hours of operation near you.
A call placed to the hotline on Thursday resulted in a human agent inquiring about the caller’s primary care physician and any symptoms being experienced, followed by instructions to call DeKalb Regional Medical Center, which offers testing between 9 a.m.-3 p.m. Monday-Friday.
The closest alternate specimen collection location referred by the state hotline was Southern Immediate Care in Attalla. There is no medical advice provided at the state hotline telephone number.
In a conference call Friday afternoon, DeKalb Regional Medical Center Hospital CEO Patrick Trammell said, “We’ve seen firsthand in our facility that there’s a lot of difficulty in turning tests around in a timely manner. We are one of the ones that set up a community testing center. Employees can be encouraged to get tested if they have a real exposure, but they should contact their provider so we make sure they are not overwhelming the system. We’ve stuck within the state guidelines. They are well trained on knowing how a positive test result will change treatment. We’ve adjusted to changes in real time and are glad we are able to provide a service to the community.”
He said physicians have a phone number to call for referring patients to set up a time for specimen collection.
“If we have an acutely-ill patient, perhaps they show up at our Emergency Room or a physician urgently refers them for admission – those are sick, sick folks, somebody having difficulty breathing or a really high fever -- we are going to screen every single patient who comes to our ER or any other entry and determine whether they need to be tested. If you aren’t acutely ill but you have a concern, there’s the number you can call (256-997-2708). If you are going to seek care regardless of whether or not you think you are going to be tested, we will make sure that testing gets done as part of our care routine,” Trammell said.
Specimens collected at DeKalb Regional Medical Center are shipped overnight to the State Lab, where a test kit provided by the CDC is used to check for the virus. Results are sent to the referring healthcare provider. ADPH claims the average time frame to conduct testing at the State Lab is between 24 to 72 hours.
After anyone is tested for coronavirus, they should go home to self-isolate and remain there until their results are reported to them by their healthcare provider, Harris said. They are not to go anywhere other than home.
If a person is being tested for COVID-19 gets hospitalized, they will be put in isolation prescribed by the state’s facility Infection Control Office. The decision to discontinue home isolation precautions should be made on a case-by-case basis, in consultation with healthcare providers and ADPH.
For information on steps to help prevent the spread of the coronavirus if you are sick, visit https://www.cdc.gov/coronavirus/2019-ncov/downloads/sick-with-2019-nCoV-fact-sheet.pdf.