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COVID-19 testing site set up at Butler Memorial Hospital

Butler Memorial Hospital has opened a drive-in testing tent for the coronavirus.
Patients must be refered by physician

Butler is taking a page out of South Korea's playbook in response to testing novel coronavirus 2019 by setting up an outdoor test site designed like a drive through. The Asian country has the lowest death rates to date from COVID-19, according to the World Heath Organization.

Butler Memorial Hospital staff pitched a tent in a parking lot on Brady Street to begin testing physician-referred patients for COVID-19. As of Monday, there were 167,515 confirmed cases and 6,606 deaths, according to the WHO, confirmed cases worldwide although some news outlets place that number more than 190,000. As of Tuesday afternoon there were no confirmed cases in Butler County

The tests are being processed by a private company, Quest Diagnostics, and will take four to five days for the results. Previously, hospital staff were limited in the number of tests they could run by the state Department of Health's strict requirements. For example, a patient had to be in a hard-hit country to be tested.

Now, medical personnel — and the county officials that rely on their testing — are hoping to get a better picture of the county's viral landscape.

“I have no idea what's going on in the population because we haven't been able to test,” said John Love, a medical doctor who heads the hospital's infectious disease department.

Love said the drive-through style testing is being used in South Korea, which he said has been very successful in reducing contamination.

According to the Washington Post, COVID-19 infections in South Korea surged over a 10-day span in late February when a cluster of cases grew exponentially to more than 5,000, pushing the nation into action. Out of more than 8,000 confirmed cases of the virus, less than 100 people have died so far.

“This is coming. It may already be here,” Love said. “We just haven't put our hands on it. This is no longer on the other side of state. This is here in a population that our communities have a fair chance of mixing with.”

Based on that information, Love believes the county might see its first case in about 10 days from Tuesday.

“We think it will be a significant wave of infections,” Love said. “It wouldn't be surprising if we see our ICU get filled in with these patients. I would love to be wrong.”

The drive through site is composed of a tent, a tailer and a number of medical technicians who test patients by inserting a swab deep into a patient's nasal cavity for 30 seconds. Love said that they will only test patients who are referred to them by their physicians and patients must be exhibiting symptoms related to the coronavirus.As of Tuesday morning, the facility had tested about 30 people. Love said that when the site opened at 8 a.m. there was already a long line of people waiting to be tested.“My response has been slowly moving from hopeful — basically hoping it won't be as bad as it has been elsewhere — to being proactive and moving into acceptance and trying to get everything in place before we start really having problems,” Love said.Part of the challenge of testing patients is that the process of sticking a foreign object up a nose causes people to sneeze and cough, potentially spreading germs to the medical technicians if proper medical gear isn't worn.

The news is being welcomed by Butler County Prison's warden, Joe DeMore, who agreed Tuesday to revise an earlier policy related to the virus. Previously, any inmates being brought to the jail with a fever would have to be tested at an outside location like the hospital's drive through test site.“The jail system is a big black box to me,” Love said. “No prison wants to be responsible for getting their inmates sick for not doing their due diligence. I don't know if our site is the end all answer for them.”But Tuesday, DeMore said a new agreement was made with the county where medical staff at the jail would test inmates with a fever and send the samples to the hospital for the four to five day lab testing, according to Leslie Osche, county commissioner chairwoman.While waiting for the results, inmates presenting symptoms will be isolated in jail cells that have a negative air flow, unless they are arraigned in the meantime and can afford bail.Negative room pressure is an isolation technique used in hospitals and medical centers to prevent cross-contamination from room to room. It includes ventilation that generates negative pressure to allow air to flow into the isolation room but not escape from the room. In the county jail, there are two such rooms, each can hold one inmate.The county jail has 248 inmates, another 37 federal inmates and 14 out-of-county inmates as of March 12, the most recently available data.For the month of February, there were 269 visitors in the jail's day book and an additional 285 visitors to inmates. Visitation came to an end last week as a quarantine measure by the jail's administration.In other county jails across the country, inmates are being released for low level non-violent offenses on government supervision or expediting the court process to help reduce jail numbers.However, the Butler County Prison can hold more than 500 inmates, giving the jail's administrators some “breathing” space as DeMore and others try to interpret the governor's “social distancing” advice in a penal setting.If the jail has to hold more than two inmates with fever symptoms, DeMore said, they will be placed in one of the empty open-air pods that could be separated from the general population.

Love said that the worst case scenario for everyone in the medical field is Italy. That country recorded 31,506 positive cases and 2,503 deaths by Tuesday, more than nation outside China.“Look at Italy. You don't have enough ventilators, medical equipment. They're rationing care. Who gets life support? Placing value on different people's lives. We're trying to avoid that,” Love said. “ People will get sick. Can we keep the case of severe illness down so that we can manage them and have enough supplies versus all of them coming in at once?“We're trying to draw this out and give us a chance to manage these (expected) patients.”

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