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Staff at South Peninsula Hospital have so far tested 25 people for the novel coronavirus, COVID-19, as the number of cases in Alaska grows and the state’s public health sector attempts to keep up with testing amid a national shortage of supplies.
The samples collected from 25 people have all been sent out for testing, said hospital Public Information Officer Derotha Ferraro in an update to the Homer City Council on Monday. Ten tests have come back negative — the rest are still pending. South Peninsula Hospital is experiencing a turnaround time of up to four days for the samples to be processed, according to a press release from the hospital. The hospital is utilizing both the state laboratory and and a commercial lab for testing samples, Ferraro said.
Homer Public Health Nurse Lorne Carroll also updated the city council in Monday. He told council members that public health nurses in Homer are not currently following any active COVID-19 cases, COVID-19 contacts or “persons under investigation.” They are, however, currently following two “persons under monitoring” on the Southern Kenai Peninsula, he clarified in an email.
“(Persons under monitoring) are very low risk folks that we are personally case managing to assure that as a team we’re doing everything possible to contain disease and prevent transmission,” Carroll wrote. “That being said, we’re also working with the other 15 Public Health Centers across the state on helping them manage new cases of COVID and contacts.”
The hospital is only offering COVID-19 testing if it’s recommended by a person’s regular medical provider. If a person notices symptoms of coronavirus — including fever, coughing and shortness of breath — they need to contact their regular care provider for an over-the-phone or modified screening appointment. If that provider pre-qualifies that person for a test based on the recommendations that have been put out by the Alaska Department of Health and Social Services, the person will be sent to SPH.
Patients arriving for a COVID-19 test are not to enter the hospital, according to the release. Instead, they must drive to the main entrance parking lot and call a designated phone number. An emergency room triage nurse will meet the patient at their vehicle for sample collection, according to the release.
“The new outdoor testing is going smoothly, and is the recommended method to limit exposure to others and conserve hospital resources,” said Dawn Johnson, the hospital’s chief nursing officer and head of COVID-19 operations, in the press release. “Our team is really pulling together with creative workflow, scheduling and problem solving to provide the care needed for the community while keeping everyone safe.”
Entry to all South Peninsula Hospital facilities is currently restricted. The only entrances currently still open are the lower level entrance, the west end entrance and the upper level main entrance. Screening is in place at all of those entrances for people entering the hospital, according to the release.
“Only employees, persons with appointments, persons seeking critical medical care in the ER and pre-approved visitors who do not have symptoms, have not traveled out of state, and have not been exposed to a confirmed COVID-19 case are permitted,” the release states.
General visitation to the hospital’s Long Term Care department is also prohibited.
People who are not allowed into the hospital at this time are: general visitors, contractors, people making deliveries, and employee guests. The cafeteria is closed to the public and is currently providing to-go service for hospital staff, the release states.
The hospital has postponed all non-essential procedures and appointments, and the press release states that telehealth clinic visits “should begin shortly.”
With regard to treatment of potential COVID-19 patients in Homer, Ferraro told the city council on Monday that the hospital is ready. She spoke of a statewide plan that designates what will be done with patients who have varying degrees of symptoms.
Currently, the plan dictates that patients with mild symptoms be sent home or sent to a designated location where they can self-isolate. Those with moderate symptoms will be hospitalized at South Peninsula Hospital.
Patients with more “severe or critical needs” will be transferred to a special site just for COVID-19 treatment. Right now, Ferraro said the plan is to designate a hospital and surgery centers in Anchorage for that purpose, because many surgery centers are empty and they have the equipment needed to provide critical care, like ventilators.
South Peninsula Hospital does have three ventilators of its own, which Ferraro said could be used as a backup for patients with more severe treatment needs. The hospital has 22 medical beds, 28 nursing home beds, nine ER beds and three isolation rooms.
The hospital also plans to turn its inpatient floor into a place for those with COVID-19, and move other patients to a different site for care.
Who is eligible for testing?
Not everyone is automatically eligible to be tested for the novel coronavirus. One current obstacle to testing in the United States is a nationwide shortage of nasopharyngeal swabs used to collect samples from patients.
Dr. Anne Zink, Alaska’s Chief Medical Officer, referred to the shortage in a press conference on March 20 during which state officials updated reporters on the number of cases in Alaska, two new health mandates and a new health alert.
“We continue to try to expand lab testing,” Zink said. “… We have testing here in the state of Alaska, but communities can also choose to send their lab sample out to another test site. There are private companies that are able to do the testing. We don’t have any way to guarantee those turnaround times — we do see some variability with those turnaround times, and as a result we are trying to get as much capacity set up here in the state of Alaska to get the turnaround times (down) once the sample has been collected.”
But Alaska continues to struggle with a shortage of swabs, Zink said. She urged other medical offices or clinics that might have the swabs to consider donating them to their local healthcare professionals.
According to updated testing standards from DHSS, the people who “should be considered” for COVID-19 testing and are high priority to be tested are those who have a “clinically compatible illness” such as a fever and a cough, or shortness of breath, and meet at least one of the following criteria:
Had close contact to a laboratory-confirmed case of COVID-19 in the past 14 days
Have traveled in the last 14 days to a location where community transmission of COVID-19 is occurring
Live in a long-term care facility
Are a health care worker or first responder (with a negative influenza test)
According to the most recent recommendations, people who are at a medium priority to be tested are those at increased risk of illness due to being over 60 years old or having chronic medical condition such as asthma or heart disease, as well as any other patient determined by clinical discretion.
The new DHSS recommendations state that people with no symptoms are not to be tested.
Locally, the Hospital Incident Command activated its Emergency Operations Plan on March 5, and the incident command team has worked exclusively on planning and response since that time, according to the press release. Incident Command meets daily using telecommunications with the city of Homer, the Kenai Peninsula Borough and State Emergency Operations Centers.
Only essential staff for immediate patient care working on the hospital campus. More than 30 employees are currently working from home, Ferraro told the city council on Monday.
To minimize potential exposure, all patients with symptoms are asked to call 907-235-0235 when they get to the hospital, or before they come. They are not to enter the hospital before calling.
For more information related to COVID-19 response, updates on services for local patients and phone numbers you might need, visit www.sphosp.org.
Reach Megan Pacer at firstname.lastname@example.org.