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Inside the pilot program to test all patients in Arizona care facilities

Elderly care
Posted at 7:54 AM, May 12, 2020
and last updated 2020-05-12 23:21:20-04

PHOENIX — After Governor Doug Ducey promised to test every person in every long-term care facility in the state, Maricopa County Public Health has started its pilot program for testing.

The non-profit testing and supply organization ProtectAZ was tapped by the state to lead a case study at an unnamed facility in the west Valley.
It was chosen because there was one known positive case among over 200 residents and staff, providing a seemingly clean slate still with potential to become a hotspot.

Within a week of being green-lighted to start testing, Dr. Tyler Southwell, who founded Protect AZ, says the facility went from one infected staff member to more than 10 sick patients -- eight in the hospital, three of them who died.

"The infection had been taking root in the facility by the time we were there," said Dr. Southwell.

RELATED: White House recommends testing in all nursing homes in next 2 weeks

A team of eight nurses, technicians and other volunteers transformed the care home's dining room into a pop-up clinic. Maricopa County Public Health provided them with gowns, gloves, masks and face shields -- enough to change out before seeing every patient. Sonora Quest Labs supplied the nasal swab tests. Working in teams, they repeated a pattern for about 200 people.

"Nurse or medical person would swab, come out, de-gown. Then go to the next room, sanitize, re-gown. We didn't want transmission to add to the problem," said Dr. Southwell.

He says paperwork was the most tedious part of the process, getting everyone to sign consent forms which sometimes meant the facility had to track down a patient's power of attorney.

The entire process lasted seven hours and testing results started to come back within 24 hours. Dr. Southwell says there were 23 new positive cases and any of the staff that had been infected showed no symptoms.

"That's kind of frightening to see the speed it can spread in a facility like that," he said, "They're helping bathe patients, their faces within inches of each other, that's how this spreads so easily and we're seeing that across the country."

The second part of the pilot is education, teaching staff how to isolate patients, create dedicated COVID-19 care teams and recovery rooms, and also educating them on what forms of PPE to use, how often to use new gear and how to properly inventory it.

Finally the team debriefed on what worked and what's next, which is returning to continue education and also retesting everyone in a week or two to see if they were successful in stopping the spread.

Dr. Southwell says it is a viable model that can be replicated other long-term care facilities but says the biggest hurdle is manpower, especially to do the paperwork and follow-up care.

"Every facility needs a dedicated care team to check in, see what they need, see how they're doing until the virus is gone," he said, "We really need an army of people in their own communities, serving their own communities' needs."

The State Health Director said in a press conference a pilot program would also launch in northern and southern Arizona. Dr. Cara Christ's office did not respond to questions asking if that has started.