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Dr. Rai talks COVID-19 surge testing, hospital capacity and flu testing

Published: Oct. 20, 2020 at 8:16 AM CDT
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GREEN BAY, Wis. (WBAY) - A federal COVID-19 surge testing site could be coming to the Green Bay area.

“They’ve made an outreach already. That will be up to public health and local elected officials to make that decision on how they’ll be able to partner with the federal government on that,” said Dr. Ashok Rai, President and CEO, Prevea Health.

Dr. Rai joined us on Action 2 News This Morning to discuss surge testing, hospital capacity, and how they’ll test for COVID-19 and influenza.

Dr. Rai joins us Tuesdays and Thursdays. Have a question? Email news@wbay.com.

SURGE TESTING

The U.S. Surgeon General visited Neenah last week to announce a surge testing site at ThedaCare Physicians-Neenah, 333 N Green Bay Rd. The goal is to limit the spread of the COVID-19 virus and identify people who might be asymptomatic carriers.

"It’s pretty significant for the federal government to come in help us. It’s welcome help in the Valley. It’s going to likely come farther north here very soon with other projects that they’re launching. The first one was in the Valley. I think it’s important to look at it, just like we looked at the first surge that we had, that was actually much smaller, when you start to do surveillance testing. In other words, where else in the community are you not finding it, those asymptomatic patients. The more people you test, the more people you find are positive. Those people can then isolate and then you stop that chain of spreading it. That’s what the federal government is doing by bringing in this mass testing effort. It’s outside of what health systems will be involved in. We’ll maintain ours. They’ll do theirs. But that’s necessary. Theirs’s is short term, ours is long term. So think of it as an adjunct, or additive thing to it. But you’ll notice that their testing is a little different. You’ll notice in that video that it’s a self-swabbing-type situation. So there’s not a lot of staff involved. Not a lot of medical people involved. You go through line, you literally swab yourself, and then you’ll get your results back from the federal government. That’s something we’re looking at doing here. Even opening up our own testing sites within health care to people without symptoms. We want to make sure that we have the capacity to make sure we’re not missing those who have symptoms. That’s why we look to the federal government for help.

“They’ve made an outreach already. That will be up to public health and local elected officials to make that decision on how they’ll be able to partner with the federal government on that. Like I said from a health system standpoint, all of us already have all our resources dedicated. So we’d be looking for resources outside of us.”

HOSPITAL CAPACITY

"As I was just looking at our hospital updates today, most hospitals are at the capacity or just near that capacity. What that means is there may be one-or-two beds open, but they may be people waiting to fill it. Somebody in the emergency department ready to come up. It’s still an hour-by-hour situation. Remember, it’s not just an empty bed. It’s the staff necessary to take care of that. More and more staff are being exposed and falling ill and having to isolate. Some are coming back from isolation. At Prevea and HSHS, we have traveling nurses coming in. They’re arriving this week from throughout the country. We’ve asked for over two dozen to come and help right now.

“The additional help is for two reasons: number one, our own health care people are getting sick; and secondly, the sheer volume. Obviously we’re not designed to take care of an extra 140 patients in this city on top of what we normally take care of. So you do need more health care staff. It’s not just nurses. It’s respiratory therapists. People in the lab. People who clean the room. All of which need specialized training. And that doesn’t happen overnight.”

FIELD HOSPITAL

“We’re very thankful that the state government was able to put that together. At this time, at least at St. Mary’s and St. Vincent’s, we haven’t had to initiate that yet. We’re appreciative that it’s there. Understand it’s a very narrow window of who can go there. One of the most common drugs we use if you’re requiring oxygen, which is probably going to happen if you’re in the hospital, is remdesivir. We don’t have approval to give it at the acute care facility yet. So we have to wait five days before we can even make that decision. And usually at that five-day time period, either you’re getting better and ready to go home, and we’d rather do that than send you to Milwaukee, or you’re getting worse and you wouldn’t qualify to go there. It’s a pretty narrow window. So far, it hasn’t happened. It doesn’t mean we wouldn’t do that. We also want to make sure the patient and the family are comfortable with that decision, too.”

FLU AND COVID TESTING

“One of the labs that we’re using, the most common one, so if you come through a Prevea drive-through site, hopefully by mid-to-late November, when we swab you, it will actually be run for both Influenza A, Influenza B and COVID, all with one swab on the same machine, so we’ll be able to know the differences. Ideally, people will mask up, get their flu shot, and we won’t have such a bad influenza season. That’s something that we are really, really hoping for. But we want to be able to test for both and we’re looking at different testing devices that can do both without negatively affecting the patient at that time.”

KIDS AND FRIEND VISITS

“The most ideal thing is, obviously, to isolate the best we can. Stick with family. But we also understand the needs that certain parents and families have. There’s no great recommendation on this, but understand that every time you create that interaction--so maybe it’s one 14-year-old with another 14-year-old--that if they have siblings that are also doing the same thing that you’re exponentially increasing that risk because of all the interactions that are possible. As tight as you can keep it. As close to the house as you can keep it. Risk benefit, that’s a personal decision. From a health care perspective, we would love to avoid the congregation. If it’s going to be in small groups, two people, not 10 people. Those two people shouldn’t be interacting with 10 others, because then it’s actually 20 people interacting. Use some common sense in that. Keep it very small if you have to do it.”

INDOOR SPORTS

“Let’s just be honest, in an indoor sport like basketball, social distancing isn’t the point of the game. You really do need to make sure that they’re masking. Right now, we’re in a really bad situation in Brown County where spread is so prevalent. So we’d rather not see that. If it has to happen, or our prevalence starts to come down, and you want to make it safe, make sure they’re wearing a mask. And by wearing a mask, and I’ve seen some sports do this, it means over your nose and your mouth, not pulling it down during practice. Because that kind of ruins the point. You’re then spreading your own respiratory particles to everybody else. So mask. Avoid it for a little bit given where Brown County is right now. And then when we start to phase in, make sure really working on the masking with our athletes.”

BROWN COUNTY OUTBREAK

Why are Brown County’s numbers so high?

“What we’ve seen in just interactions with our patients and talking to people who are positive, is that we had a lot of non-compliance with masking and group gatherings. It’s not just the large wedding--although those are things that really got us in this situation--it even got to smaller family gatherings. Really getting that physical distancing the best we can and masking, the more we can be compliant, the more we can control this. And then when we do get it under control, making sure that when we phase in, to still be compliant with some of the recommendations. That’s really what’s gotten Brown County into this situation. You gotta remember that it spreads very quickly. So all it takes is a certain percentage of the population not to be compliant for it to spread to everybody very quickly.”

ABNORMAL TEST RESULT

“Your results are really going to depend on the lab. Unfortunately, labs cannot be consistent with their language, their nomenclature. Sometimes you’ll see positive and negative. Positive means they detected COVID-19. Negative means they did not detect COVID-19. Some labs will say detected and non detected. Detected means you’re positive. Non detected means you’re negative. And at times, your test may come back as what we call inconclusive. That means there was a sample collection, they didn’t get enough of that sample. It’s not due to an operator error. It just happens to be what was in your nose at that time. Sometimes the secretions might be too thick and it literally clogs up the machine and they have to re-test you. That should be about a percent to a percent-and-a-half of all tests, so not very common. But it does happen. Detected means you’re positive. Not detected means you’re negative.”

SYMPTOMS, ALLERGIES, AND QUARANTINE

“So after you’re negative and you’ve got a good reason for it, you have normal seasonal allergies, and say you take a medication that’s controlling it, you should be fine at that point and you would not need to isolate. We would recommend you isolate if you have symptoms and you are tested. But the allergy question is going to come up a lot right now, and the cold question, the sinus congestion is coming up a lot. I have to say in the last week or two in talking to patients and testing them, that that one symptom has turned out positive more than we would have expected. So treat that symptom as real until you have another reason for it and until you test negative.”

COVID-19 RECOVERY AND FLU SHOTS

“If you’re fully recovered and feeling well, get that flu shot. That’s really important. You don’t want to have influenza right after you’ve recovered from COVID-19. Your body’s not going to take that well, that second infection. So we want to make sure you get that immunization as quickly as you can. If you’re past your 10 days, and you’re felling better, get that flu shot. Prevent yourself from getting influenza.”

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