CUMBERLAND — While medical experts warn the COVID-19 pandemic is expected to spread in Maryland and beyond, ways to fight the disease are also evolving.
On Friday morning, Maryland had 774 confirmed cases of the virus, which marked an increase of 425 cases over the prior three days.
The Allegany County Health Department on Friday afternoon reported that of 282 local residents that had been tested for COVID-19, 202 were negative for the disease, and 80 results were pending.
“Laboratories are struggling to keep up with the nationwide demand for testing,” ACHD officials stated. “Therefore, it is taking longer for test results to come back.”
During a press conference in Pittsburgh on Friday, Graham Snyder, medical director of infection prevention and hospital epidemiology for UPMC, said the health system has expanded use of its own COVID-19 diagnostic test.
“Physicians have the ability to order this test for their patients based on the patient’s symptoms and the context of their potential exposure to the virus,” he said.
Across the UPMC system, 1,743 tests have been performed, with 141 having positive results, he said.
“The relatively low prevalence we’re seeing in our communities also tells us that we can still safely perform medically necessary procedures now that cannot be delayed for months,” Snyder said.
Social distancing should continue to be practiced, he said.
Snyder declined to say how many UPMC workers have tested positive for COVID-19 or where they’re based.
Donald Yealy, chairman of the UPMC Department of Emergency Medicine, said as of Friday morning, UPMC had 25 inpatients that tested positive for COVID-19.
“We have adequate supplies of all the equipment that’s necessary,” he said and added that every UPMC staff member and visitor will be screened for the virus and given a mask for protection.
UPMC Chief Medical Officer Rachel Sackrowitz said the 5,500-bed hospital system can benefit from its large size that’s spread out over a large area.
“If one region in our system ends up getting hit hard, we can safely transfer patients with or without COVID-19 to hospitals in our system that are under less stress,” she said.
Nancy Adams, senior vice president and chief operating officer at UPMC Western Maryland, recently outlined the COVID-19 testing procedure.
“If a patient suspects they have COVID-19 and aren’t having high fever or breathing problems, our advice from the start has been to call their primary care provider or the Allegany County Health Department to get initial advice,” she said via email. “Doing this from home is best for all and limits spread of any infection; if needed, they will be guided safely to the next care site.”
If the patient has a high fever or breathing trouble, they are directed to go to the UPMC Western Maryland Emergency Department.
“Specimen collection is only for patients with an approved referral from their physician or who meet the criteria determined by a doctor at the emergency department,” Adams said.
Specimens will be collected by trained health care providers who wear recommended personal protective equipment including gowns, gloves and appropriate masks.
“Patients will be isolated to ensure no contact with other patients,” she said.
Collection rooms have negative pressure to assure air does not exit until it flows through a high-efficiency particulate filter, which removes infectious pathogens.
The collection process involves a thin wire with a cotton-like tip that is inserted deep into a patient’s nose.
“Using the swab method collects both mucus secretions and cells from the patient’s airway, which is the best place to find the virus,” Adams said.
Once the specimen is collected, it is securely transported to a clinical laboratory for testing, she said.
“Packaging for shipping and delivery is done according to federal guidelines that are already in use for many pathogens being routinely tested,” Adams said.
“If a patient tests positive, we will notify the patient, their physician, and all the appropriate officials in government who are tracking this outbreak,” she said. “Our physicians will decide on an appropriate course of care based on the severity of the symptoms being experienced by the patient. Sometimes that will mean care at home, other times it will be at a UPMC Western Maryland.”
Adams said it’s important to remember that most people infected with the virus will not have severe or disabling symptoms.
“Those patients do not need to be in emergency departments or inpatient settings,” she said. “We are making sure that everyone gets the care they need.”
Gerald Goldstein, senior vice president and chief medical officer, said COVID-19 specimen results being processed through Quest Diagnostics are taking more than six days due to limited capacity.
“Therefore, UPMC Western Maryland will be implementing a new protocol for sending specimen collections for inpatients who are suspected of having the COVID-19 virus,” he said via email.
“Once the lab receives a specimen for COVID-19 testing, the order will be reviewed by UPMC Western Maryland’s command center team including the chief medical officer, the infectious disease physician and infection prevention nurses. The team will review the clinical data to see if the specimen collection is appropriate to be sent to the state lab. By doing this, we are hoping the results from the state lab will be returned in less than 48 hours.”
As of Thursday, UPMC Western Maryland had collected 135 specimens to be tested for the disease. None were positive for COVID-19.
In addition to Quest, laboratories being used locally are LabCorp, and the Maryland Public Health Laboratory in Baltimore, Allegany County Health Officer Jenelle Mayer said.
“Positive results must be reported to the Allegany County Health Department,” she said via email.
ACHD will notify the public when there is a COVID-19 case in the county.
Waiting time for test results varies depending on the lab used.
“We have seen cases where it takes more than a week,” Mayer said. “Labs must now prioritize tests for: hospitalized patients, symptomatic health care and emergency services personnel, symptomatic patients in congregate living facilities such as nursing homes, and high-risk unstable patients whose care would be altered by a diagnosis of COVID-19.”