| from Brendan Cowan | Director, San Juan County Department of Emergency Management
Testing and Rumor Control COVID-19 updates from San Juan County around subjects on the minds of islanders.
TESTING
A lot of people have questions about testing. We want to highlight a few key things:
- First off, if you’re on Orcas or Lopez, read this excellent article from Anne Presson of the Lopez and Orcas Hospital Districts (and the County Response Team) with info specific to those islands. Similar general information will be summarized below with the whole County in mind.
- It’s important to understand that not everyone who feels ill needs to be tested, particularly those with mild illness. A health care provider will determine if you should be tested, and it’s likely their advice on managing your symptoms will be the same whether you test positive or negative. Tests are being given by healthcare providers in San Juan County, and islanders with significant symptoms are being tested.
- That’s not to say that we wouldn’t love to see the surge of testing availability that we keep hearing about at the national level, or that our response wouldn’t benefit from wide availability of testing. The better our testing is the better our understanding. We’re confident that testing availability will continue to improve, and we’re as eager as anyone for that to happen. But it’s important to know that islanders are being tested now, and have been for some time.
- According to the World Health Organization and many others, the vast majority of those who get COVID-19 have mild to moderate symptoms and feel better within a couple of weeks. Those with underlying health issues are at greater risk for more severe symptoms, and it’s important that our medical providers have the time and resources to closely monitor those patients. If you experience symptoms of illness and you can manage your illness at home, please stay there and avoid contact with others.
- The idea of the “test kit” has been poorly explained in the media. Test kits are the supplies that individual large off-island laboratories use to test samples for COVID-19. The process for testing starts with nasal and/or throat sample taken by your health care provider. The healthcare provider sends the sample to one of the large laboratories for testing. It is likely that the laboratory is the same one that they use to provide other types of test results in normal times.
- We are hopeful that in the weeks to come, new technologies, approaches and delivery models for testing become available that will expand testing to a broader swath of the community. This will be a very good thing, and the San Juan County response team is making plans for when this might become available.
- At this time there are no positive test results in San Juan County. The Health Department recommends self-quarantine for patients with pending test results and their close household contacts while waiting for results. If a positive result is received, Public Health staff will trace wider contacts and provide guidance on limiting disease spread – including isolation and quarantine requirements.
RUMOR CONTROL
The County COVID-19 response team has received many questions about information being shared in the community regarding islanders who have symptoms that might be COVID-19, who were transported, or are friends or family members of someone who has been tested. A few key points about this type of speculation:
- A number of islanders have contacted their healthcare providers and been treated for COVID-19 like symptoms. Some of them have tested positive for other illnesses (influenza for example), some have tested negative for COVID-19, and some have been tested for COVID-19 and are still waiting on results. Just because someone has symptoms that could be COVID-19 does not mean they have it. At this time, San Juan County is not aware of any positive test results. Obviously that can (and likely will) change at any moment.
- The County will be updating the case count page daily. The community may have information that we don’t because we’re a small community and word travels fast. We’ll keep the page updated daily, and know that as soon as there is a positive case, public health responders will be conducting rapid case tracking and communication with those impacted.
- We’re a small community and everyone knows someone who is a healthcare provider or who is a school employee or who works in a medical office or is otherwise informed. Those people should be thoughtful about avoiding speculation and keeping confidential information to themselves, and we in the community should recognize the hard work they’re doing and the stress they’re likely under.
- And just some words about rumors in general: we’re living in a time of unprecedented anxiety and high emotion. If ever there were a moment to breathe deep and think twice before sharing unverified information, this is it. We want to be smart, efficient, and coordinated in our response, but that doesn’t necessarily mean that we need to jump every time we catch the slightest hint of trouble.
Stay calm, islanders; our spirit will see us through. Thanks to all.
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I think it needs to be emphasised that the protocol for determining who gets tested is driven by the availability of test kits.
“Given this reality we are doing all we can do.”
But to say this is what is Best Practice or Most Desirable from a *Patient *Advocacy *point *of *view* is simply wrong, and everyone that says so is saying what they need to say because they do not know how else to say what needs to be said in a way that does not feel like inciting panic.
But there IS a way to tell the truth here.
And you people who present yourselves as our advocates need to learn how to say what you need to say so that WE do not have to parse your words to figure out that truth.
THAT is what leads to panic and desperate rumors.
Period.
Your/Our responsibility as Advocates is FIRST respect our clients!
We as recipients of care are very very very good at sussing out if you are bamboozling us.
And I want to add VERY CLEARLY that because of some very bad behavior on the part of trusted individuals, that EVERYONE that provides care has lost credibility. And now…
This. Is. A. Test!
get it?
We DO NOT! have enough test kits.
Period.
So what we are ABLE to do IS, IN FACT sub-optimal.
Period.
Given that truth, we are protecting our community AS BEST WE CAN.
And here is how:…..
Please fill in the blank.
This. Is. A. Test.
If only people who present with bilateral pneumonia qualify for testing you have already failed. EVERYONE needs to be tested. Asymptomatic individuals will be shedding virus and can infect many, so to say not every one with possible symptoms needs to be tested deeply challenges your credibility.
Good feedback from Leif and Luther. If we had all the testing capability we wanted/needed the testing capabilities would be drastically broader. We are resource constrained.
Right.
The point is that we are constrained to a very conservative strategy that forces us to flying blind during the crucial early days of a pandemic. It prohibits us from taking intelligent measures to protect the most vulnerable and it is virtually guaranteed to raise the number of eventual cases/deaths.
The most successful countries in this global test of national health services has been Korea. Because of their proximity to China they had been the most affected during the SARS epidemic, so they were on the ball and this time around they started early, even using at first nonstandard testing when nothing else was available .. so they would have proactive data. They have an overall test rate of 3%. San Juan County has a test rate of 0.3%, WA overall is 0.17%. [btw the USA overall is 0.0005%]*
..Korea has a COVID-19 susceptible pop. of 15%, and kept its deaths lowest per capita in the world. WA is approx. 25% and SJCo. is 50%.
..So we are doing well, in some respects.. and we have a long long way to go. I do not know statistically how to estimate at what level of testing our results become significant or in other words what the estimated true number of COVID-19 cases we have in SJCo [or WA].
*docs.google.com/document/d/1mhJWWOXCTrnEU6e4IPDUxyeATOJCBoOvvI9DdAVOc64/edit?usp=sharing
It’s about data.
See, on a case-by-case basis, it is ok to have a conservative Public Health Policy.. BUT THAT DEFEATS THE PURPOSE OF HAVING A HEALTHCARE SYSTEM.
+1. It is one thing to say: if you have a temp or cough stay home, if you have trouble breathing go to the hospital.
+2. It’s another thing to say: if you have any suspicion because of symptoms or possible exposure or you just need to know because of a perception of risk, get a test.
+❉ The first one is ADMINISTRATOR-CENTRIC, it conserves their time and resources .. [in the short term]
.. The second one is PATIENT-CENTRIC because it tells you what YOU NEED TO KNOW to manage your own health, Aaaand
❉ it HOLDS THE SYSTEM ACCOUNTABLE to managing Public Health by collecting data to best manage individual health, system-wide..
❉ otherwise WHY THE HECK ELSE HAVE A HEALTHCARE SYSTEM! HUH?
[IMHO for Orcas voters, there is NO QUESTION that managing our health as a population is MUCH MUCH less costly on a system-level than on a case-by-case basis. This coronavirus thing is a perfect illustration!
..And the tragically obvious follow-on to this, is that what we have been doing with our own infighting and inviting off-island institutional healthcare to impose their own version of what our system should look like has cost us immeasurably:
financial costs and health costs are linked by time and community, as this pandemic illustrates.
..The little local clinic has high costs because of a lack of system-level integration, the corporate clinic has high costs because their system is inappropriate to local conditions.
Let us painfully reiterate, at a system level, over time, the cost in dollars and “dolores” for a community are synonymous.]
[em, South Korea of course.]