Thursday, June 11, 2020

ASAP

 I was at a meeting where in the closing minutes the question was raised about EMS testing for COVID-19.  A person wanted to know if EMS services were going to be required to get their employees tested for COVID-19.  And if they did, was there a recommended manner of getting them tested?  And what should the service do if they tested positive?  And what should they do if a great number of their employees tested positive? Another speaker mentioned that the hospital where he worked was planning to test 10% of its employees each week to ensure that they wouldn’t suddenly lose too many people.

I spoke up then and suggested that all EMS employees should get tested ASAP.

There was prolonged silence and then the next voice said “Move to adjourn,” and that was it for the meeting.

I hadn’t expected the topic so I was not prepared to fully state a position, but here it is now it.

It is shameful that most health care workers and first responders in our state have not been tested.  While it is true at the beginning of the epidemic there was a shortage of tests that limited them to the sickest of people with high suspicion for COVID*, there is no shortage of tests today nor has there been a shortage for some time.  The state health department has identified first responders as among the groups most likely to cause transmission and spread and thus are a priority to be tested.

Where do I go to get tested for COVID-19? How do I know if I should be tested?

The fact is one EMT who is positive could interact with ten patients on one shift, not to mention entering multiple nursing homes. They also interact in a closed confined cab with their partner, who could then go on and spread COVID to additional patients and nursing homes, as well as their families.

COVID-19 testing is free.  If you have insurance there is no copay.  If you don’t have insurance, the state will pick up the cost.  It is in the public interest to get tested.

If you test positive, you should quarantine until you test negative or until you go a specified number of days (10) without symptoms.  The state health department should issue directions or point to the CDC guidance .

Criteria for Return to Work for Healthcare Personnel with Suspected or Confirmed COVID-19 (Interim Guidance)

I suspect that services and hospitals may not want their asymptomatic employees to get tested because it may cost them money and lead to holes in their scheduling.  That is my belief.

The worry that massive numbers of employees will test positive isn’t much concern right now in Connecticut where only about 2% of everyone tested is testing positive where many weeks ago the number was in the 30% range.

The idea that you test only 10% at a time to start is amoral.  It is basically following the what we don’t know won’t hurt us school of thought.  No one who has COVID should be actively treating patients or interacting with their co-workers.  We have to stop the epidemic.  Testing is quick and easy today and results are usually available within 24 hours.

This all reminds me of the same early argument where people were told not to wear masks because it would deny them to health care workers and where health care workers were told to wear surgical masks instead of a proper N95 mask unless doing high risk procedures because otherwise we would run out of PPE.  It is the same line that said you can be in an ambulance with someone with COVID for 15 minutes without any mask at all and it won’t be considered an exposure, so you wouldn’t have to miss work.

We know that asymptomatic and presymptomatic people are capable of spreading the disease.

Asymptomatic? Get tested.

Expediency should never come before truth.

Testing, identification and quarantine of positive patients is the only way to stop this epidemic.  Health care organizations should step up, do their part, and get all their workers tested ASAP.

 

*Emergency departments had to call the state health department to get permission to test specific patients for COVID.  In order to get approval to be tested the patient had to be admitted to the hospital.  Sick patients who were not being admitted were referred to out-patient clinics for testing.