By Gina Mysliwiec, MD, MS
Living during a pandemic is different in so many ways from living during ordinary times. On the news and on social media, we see terrifying images of people dying. We hear about hospitals and hospital workers stretched to their limits, and beyond, as they struggle to keep up with the disease without becoming sick themselves.
Working as a healthcare provider these days is also different—and not just because a disease has reached pandemic proportions. It is because the disease we are facing is new.
New diseases must be studied for some time before effective treatments can be found. It also takes time, not only to develop vaccines against the new disease, but even just to develop tests that can reliably identify the disease.
Some medical tests are very reliable because scientists have had years to refine and improve them. For example, the influenza test we use at Columbia Memorial Hospital (CMH) has a sensitivity of about 97-percent for Influenza A and 100-percent for Influenza B.
However, the tests that have been used to look for the novel coronavirus that causes COVID-19 are only about 70- to 80-percent sensitive. That means that for every 100 people who are infected, only about 70 to 80 of the tests will come back positive. So, even if you were tested and your test came back negative, COVID-19 could still be the cause of your symptoms.
The pandemic has felt different here than in other places, in part because we don’t have as many sick and dying people here. We’ve been protected by our distance from bigger cities, our physical distancing from each other, and the quick action of our state and local legislators to close places where people tend to congregate. Our community has been relatively lucky.
This does not mean that the novel coronavirus isn’t circulating in our area. As of April 13, there were six positive test results in Clatsop County and one in Pacific County. One reason there haven’t been more is that there are only a limited number of tests available.
Tests and other medical supplies are being sent to where they are most needed. The cities that have been hit the hardest are running low on testing kits, important protective equipment, hospital rooms, and even ventilators. Hospitals in those areas will receive more of the available resources than CMH and Clatsop County.
Fortunately, this has not affected the quality of medical care given at CMH. Everyone who needs medical evaluation and treatment still receives it. We have been preparing ourselves every day to care for sick people using the equipment we have.
Because there are not enough tests to diagnose every person who may be infected with the novel coronavirus, CMH has developed criteria to determine who should be tested. This is based on CDC guidelines and follows the recommendations of the Oregon Health Authority and Clatsop County Public Health.
The most important reason for testing is to track the movement of COVID-19. Because the current test is not very reliable, the test result does not change the fact you should follow the advice provided by the CDC.
Anyone who has been seen at CMH for concerning symptoms has been told to act as though they have COVID-19, regardless of testing. The treatment is the same for people with positive and negative test results. People who are well enough to take care of themselves at home receive the same advice for CDC-recommended supportive care.
Regardless of test results, continued physical distancing is important. To protect yourself and others:
Information about COVID-19 changes almost every day, but is available to everyone on cdc.gov. You can read about symptoms, how to prevent transmission of disease, how to treat your symptoms or care for a family member, how to disinfect your home, how long you should stay in quarantine, how long before you should go back to work, and many other topics.
The CDC provides the most reliable information and advice, but if their website doesn’t answer your questions you can call the CMH COVID-19 hotline at 503-338-4699. The hotline is staffed by CMH nurses weekdays 9 a.m.-5 p.m., and supported by providers and pharmacists.
Remember, there will be people who are infected by the novel coronavirus but who do not meet the hospital’s threshold for testing or have a negative test result. These people may unknowingly pass the novel coronavirus to others. For this reason, continued physical distancing is so important. Even when better tests become available, we should still do all we can to prevent a resurgence that might hit Clatsop County harder than it has been hit so far.
Regina Mysliwiec, MD, is board-certified in emergency medicine. She serves as the Medical Director of the CMH Emergency Department. She’s also an Assistant Professor of Medicine and Vice Chair of the Department of Emergency Medicine at Oregon Health & Science University (OHSU). Read more about Dr. Mysliwiec.
Call for information about COVID-19:
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