For the last four months, SC House Calls and Main Street Physicians have been actively fighting COVID-19 in our workplace and senior living facilities. Of all the things we have done, the most successful strategy for keeping people safe is testing, re-testing, and tracking those who test positive to assure individuals exposed, get tested.
With over 1200 employees, we have had less than 25 cases of COVID, and we never closed our doors. Our success story involved these key points:
- When testing became available, we immediately required all employees to be tested.
- We required the use of masks and hand washing (with soap and water whenever possible).
- We did not rely solely on temperature checks since only some COVID-19 patients have a fever.
- Anytime an employee was around someone with COVID-19 without protective gear, they were asked to quarantine for five days and then get tested (the time from exposure to showing a positive test is generally less than five days). Then we re-tested in another seven days.
A Healthcare viewpoint on how to safely start going back to school or work:
- Everyone should test SEVEN days before coming back to work or school, limit activities with others, and wear masks when in public.
- Test again TWO days before returning. At that point, you will know that there is no one coming back to work or campus that has COVID-19.
- Many restaurants in Columbia only required one test before coming back to work. Many employees tested negative because of being exposed within the last five days. Re-testing is critical to ensure individuals have not contracted COVID since the initial test.
- There should be a testing hotline where a person can call and report anyone suspected of being around someone with COVID. The exposed person would be quarantined for five days and then re-tested. The whole process will take seven days since it takes 24-36 hours to get the test results back.
A few extra thoughts:
- There should be no additional cost to the individual, with or without insurance. Testing should be covered under the Cares Act, and most physicians’ groups will accommodate. While a person’s insurance is charged (if they have any), there should be no co-pays, deductibles, or even physician charges for the visit.
- There are some physicians groups and tests that are not reliable. Insist on a nasal swab or a back of the throat swap.
- The American Pathology Association should accredit the COVID test.
- Also, schools should have a Nurse Practitioner on-site for at least 30 hours per week. Permission forms should be signed, allowing the students to be seen and billed to the individual’s insurance. The Nurse Practitioner should charge for their services, and then the school should provide for indigent care for those who are not insured. This procedure is cheaper than hiring a school nurse who has no legal authority (not working for an MD) to perform nursing services.