Drive-thru testing

The Queen Anne’s County Health Department established a COVID-19 drive-thru test site at Chesapeake College Friday, March 20. The site is only for people with physician referrals for testing.

EASTON — As COVID-19 cases top 400,000 worldwide, federal, state and local officials are working to ensure the health and safety of their constituents.

Members of Talbot County government and health care organizations at the Emergency Operations Center are continuously working to get items needed for testing — and planning for potential surges in the number of patients.

Talbot County Health Officer Dr. Fredia Wadley, Director of Emergency Services and Assistant County Manager Clay Stamp, Council President Corey Pack, Emergency Management Coordinator Geneva Schaffle and Economic Development and Tourism Director Cassandra Vanhooser hosted a conference call for local businesses on Tuesday, March 24. The biweekly calls are designed both to update the businesses about plans being put into action and to allow businesses the chance to communicate their needs during this time.

During the call, Wadley stressed the need for social distancing, warning that people are not unnecessarily putting themselves at risk just because there’s only one confirmed case in Talbot County. She said the numbers being reported don’t necessarily reflect the whole picture.

“We try to emphasize that what you’re hearing lags behind what’s happening,” she said. “For example if we had a positive case, that case might have been tested five or six days prior because it can take that long to get the results back. They could have been exposed to the virus two to 14 days before they had symptoms and before they had a test.”

She added that people shouldn’t get too complacent just because there’s only a few confirmed cases in their counties.

“The numbers you’re getting now are people that might have been exposed two to three weeks ago for this stage,” she said. “We don’t want people to get a false sense of security that there’s only one case.”

To date, there isn’t a specific number of tests that have been done on Talbot County residents because UM Shore Medical Center, Choptank Community Health and other clinics don’t provide breakout numbers by county to county health departments. The CDC has reported the results of 22 tests of Talbot County residents to Wadley. Of those, only one has been positive.

Wadley said the number tested has increased with the alternative test site at Chesapeake College. However, she cautioned that there is still a bottleneck with obtaining the materials needed to test patients for COVID-19.

“We only have a few tubes of viral media left to do about 20-plus tests on Wednesday. If we don’t get more viral media before Friday, we will have to close the test collection site there,” she said.

The five Mid-Shore counties had joined together with the few tubes of viral media they had on hand, as well as staffing, in order to run that site.

Wadley added that certain possible cases do not qualify for testing.

“When we think there is a strong possibility that a person has COVID-19 we get approval and order the test through the state lab, but tests have to be approved as being a significant risk,” she said. “I sent the priorities for testing sent out by the state to the Talbot COVID-19 website.”

“I believe anyone in public health or clinical care would say that we did not have the testing capability early enough, and we would like to do more testing now of people with fever and symptoms,” Wadley said. “Part of the problem is the late testing capability and another part is the lack of viral media to put the swab in for transport to the lab.”

Shortages of personal protective equipment for those administering the tests is also an issue facing health care professionals at this time, which is a critical point in determining the course of the pandemic. On a conference call with reporters on Tuesday, March 24, World Health Organization spokesperson Margaret Harris was asked if the United States would overtake Europe as the epicenter of the outbreak.

“We are now seeing a very large acceleration in the numbers of cases from the United States, so it does have that potential.” Harris said. “We cannot say that that is the case yet, but it does have that potential.”

In the last 24 hours, 85% of reported cases have come from the European region and the United States, and about 40% of those cases came from the United States.

Wadley said health care professionals and government officials are gearing up for what they foresee as a potential surge in cases. She explained the reasoning behind the estimates being given by the Maryland Department of Health.

“The state is projecting that we are two to three weeks behind Italy and UK. When I looked at their timetable for spread, I could see how that estimate was made,” Wadley said. “Countries are different and they warn us to not be surprised if the spread is slower or faster depending upon the variables.”

Wadley cautioned that the numbers could continue to increase rapidly in the next few weeks.

“Within one to two weeks we could be 10 times the number now,” she said. We might be slowing the spread with our cancellations and closings and have a lower, flatter, longer spread, but we are not really sure how the spread will be over the next two to three weeks.”

As experts watch how the situation unfolds in other areas of the world, they’re getting a good idea of how to prepare as best they can. Talbot County officials are also focused on these efforts, working to develop plans that will be most effective in dealing with COVID-19.

“The Talbot County Health Department has brought a person to the EOC to help us plan for surge capacity,” Wadley said. “Plus Dr. Lisa Stone, a public health physician with international pandemic preparedness and surge capacity experience, has volunteered her time to work with Shore Regional Health on internal surge capacity and the EOC on external surge capacity. We are giving this a great deal of attention starting last week in order to be prepared if the USA is behind the UK or Italy by two to three weeks.”

“Hospitals are also working as a state group with the MDH in planning,” Wadley continued. “Most are hoping they can double the number of critical beds or increase even more.”

Talbot County officials are also looking at other options for care if the numbers of cases rise significantly.

“We also have to consider what type of facility might be able to handle any overflow of patients with COVOD-19 that need nursing care, but can be managed outside a hospital where the critical patients have to be treated,” Wadley said.

She said Talbot County EOC and health care professionals are putting together definitions for four levels of care. They are:

  • Level 1 — People have symptoms, but are not severe and can be managed at home by their family and need no assistance.
  • Level 2 — People with symptoms but can remain at home but do not have a support system at home and need either some clinical follow-up or some social needs met. Health departments and home health agencies might handle this level.
  • Level 3 — People are moderately to severely ill and may need nursing care but not intense care like critical patients in the hospital during a pandemic.
  • Level 4 — Critical patients and those on ventilators who require care in hospital setting.

Wadley explained that level 3 patients would still need a lot of hospital resources, and that health officials are working diligently to ensure they can meet those needs.

“We have already asked the state for those resources or a mobile hospital in order to have an overflow facility for the Mid-Shore region,” she said. “We do not have a site at this time, but if we could get the resources, we could find the site.”

She added that Shore Regional Health is already taking steps to be prepared for a surge in patients for the three sites in the Mid-Shore region.

Any person experiencing fever and flu-like symptoms should avoid going to the emergency room and instead seek guidance from their health care provider, who can give them the best course of action for their symptoms.

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