The task of screening patients who believe they have symptoms of novel coronavirus often falls to the network of primary care doctors, and Sansum Clinic started car-based COVID-19 testing for patients last week.
Santa Barbara County healthcare providers collaborated on criteria that prioritize testing for high-risk patients (such as seniors living in group housing), healthcare workers and first responders.
“If someone thinks they have COVID-19, they should talk to their doctor first,” Sansum Clinic CEO and Chief Medical Officer Dr. Kurt Ransohoff told Noozhawk.
“Everybody thinks they have this right now,” he said. “Most, thank God, I don’t think most people have this disease yet, but it’s a scary disease because it’s so mysterious you know – it can be nothing or it can be really severe.”
Public Health officials have urged everyone feeling sick to stay home, even with mild illness (like a fever, cough, sore throat, runny nose), since COVID-19 can present with a wide range of symptoms.
Even though people with mild symptoms could spread the disease, testing criteria make it very unlikely they would be tested.
“If someone woke up with their throat scratchy and a runny nose – we just do not have the capacity to test those people,” Ransohoff said.
More information about COVID-19, including guidance on what to do if you are feeling sick, is available on the county’s COVID-19 Public Health Department website here.
Sansum Clinic, which operates primary care and specialist clinics in southern Santa Barbara County, is being flooded with calls from patients.
If people seem like they may be a candidate for testing, they are referred to a nurse keeping track, who then asks questions to see whether they meet the testing criteria, Ransohoff said.
If they do, an appointment is set for car-based testing.
“They pull up with the window closed, then somebody holds up a sign and says dial this number (if they have a cell phone) and get registered with the window closed. The point of doing it in the car is just to expose as few people as possible,” Ransohoff said.
Someone walking into a medical facility could potentially expose people in the waiting room, the front desk employees, the medical staff, and contaminate the room itself, he added.
In the car, the patient is given a mask and the Sansum Clinic employee – wearing full personal protective equipment – takes their temperature, checks their oxygen level, tests them with the swab, and talks to them to make sure they are OK, Ransohoff said.
“Our people are gowned up and do the test, then the patient rolls the window up and drives away so one person in fully protective equipment is the only one potentially exposed,” he said.
“We’re doing about 25 tests a day in the cars, so by the end of Friday should have done 100. It should start to give us some sort of prevalence data,” he said.
When someone is tested, Sansum Health notifies Public Health and tells the person to stay home while waiting for the test results.
Healthcare officials all over the county have talked for weeks about the limited capacity for testing, which is expanding but is nowhere near testing everyone with potential symptoms, or everyone who would like to be tested.
“Although we have people saying that everybody who wants one can get one, there’s probably right now in the United States maybe the capacity to test one out of every tens of thousands of people, so there’s really limited capacity,” Ransohoff said.
“At every step along the way, there’s trouble,” he said: a looming shortage of personal protective equipment for healthcare workers giving the test, a shortage of viral transport media for swabs, and lack of testing capacity at laboratories, in terms of equipment and staffing, leading to long turnaround times.
“In a commercial lab currently, in our experience, we get results maybe as soon as three days, it can take as long as six or seven days to get a result. That’s far from perfect, it’s far from good even,” Ransohoff said.
As of Sunday night, the Public Health Department reported 493 tests in Santa Barbara County, with 18 positive cases, 229 negative results, one inconclusive result, and 245 pending results.
Sansum Clinic, Cottage Health, Marian Regional Medical Center and other healthcare facilities have put out calls for donations of medical supplies – including N-95 masks, which this community is familiar with using during the 2017 Thomas Fire.
They have reserves of supplies for now, but worry about future needs, representatives said.
Ransohoff said Sansum Clinic is accepting any unopened boxes of N-95 masks and regular protective masks, sometimes called surgical masks.
Cottage Health President and CEO Ron Werft said hospitals have gone from using 25 masks a day to more than 500 masks a day, as community cases of COVID-19 increase.
Cottage Health has a drop-off center opening Tuesday at a parking lot adjacent to Goleta Valley Cottage Hospital, 351 S. Patterson Ave.
For people without health insurance or a primary care doctor, safety net services in Santa Barbara County include Public Health Department healthcare centers, with locations spread around the county and a sliding scale payment system.
On the South Coast, the Santa Barbara Neighborhood Clinics asks people to call ahead before coming in, and schedule appointments through the call center at 844.594.0343.