Hoping to paint the big picture of Lebanon County’s response to the COVID-19 coronavirus outbreak, WellSpan Good Samaritan Hospital (GSH) held a Thursday noontime video conference for local government and school officials.
Leading the meeting for WellSpan Health were GSH President Thomas R. Harlow, David Gasperack, D.O., Vice President & Regional Medical Director, and Mike Kuhn, GSH Director of Development.
They were joined by all three Lebanon County Commissioners (Bill Ames, Jo Ellen Litz, and Bob Phillips), City of Lebanon Mayor Sherry Capello, Lebanon County Director of Emergency Services Bob Dowd, and several other local government and school district officials.
The 40-minute session covered a range of topics that are hard to ignore in these times of social distancing and disruption, including the latest infection statistics, developments in testing, how hospitals and emergency service are adjusting, supply levels of personal protective equipment, preparations for the anticipated surge in cases, and when a peak in infections might occur.
Facts and figures at Good Sam
LebTown has reported on the changes GSH has put in place since March to battle COVID-19.
Harlow started by noting that GSH had, as of Thursday morning, “18 inpatients who are COVID positive, and about 10 of those are on ventilators, and we have about 10 patients that we are waiting for test results to come back.”
“So, if you hear people talking that this is just like the flu, this is not like the flu,” Harlow stressed.
Harlow added that WellSpan, systemwide, “has tested nearly 10,000 patients, and we have approaching 600 of those patients who have been positive.”
Public health update
Dr. Gasperack updated officials on advances in understanding the novel coronavirus.
“CDC is now estimating incubation period is anywhere from 2 to 14 days,” he reported. “So, if you’ve come in close contact with someone who tested positive, they’re recommending self-quarantine for a full 14 days.”
In addition to the now widely reported symptoms of COVID-19 – fever, headache, dry cough, and shortness of breath – Gasperack said the Pennsylvania Department of health has recently added loss of smell and diarrhea as symptoms.
“About 80% of those infected are going on to recover completely, and they recover in about seven days,” Gasperack said. “Less commonly, COVID-19 can worsen and cause complications like pneumonia.”
Gasperack left no doubt about his biggest worry. “The main uncertainty at this point is still how big will this get, and how fast? The biggest risk for any healthcare system is becoming overwhelmed by a sudden explosion of illness that requires more people to be hospitalized than [a hospital] can handle.”
Developments in COVID-19 testing
Noting that an acquaintance had waited 14 days for test results, Lebanon City Council member Amy Keller asked if WellSpan would be offering “expedited testing” anytime soon.
Harlow answered that “point of care” testing, in which results would be available in hours, would be rolled out “in the middle of next week” at WellSpan York Hospital, and at GSH soon after.
“We’ll start at York Hospital, and . . . as they can increase the quantity, eventually have the ability to do that at GSH,” Harlow said. “Until then, [GSH] will send rapid tests, especially for inpatients, to York for processing, but eventually we’ll do them right at GSH.”
Gasperack said that testing has already gotten faster. “Our turnarond time has drastically improved. Where it has been a week to 10 days for tests to come back, we’ve now partnered with Johns Hopkins . . . and we’re getting results back in 1 to 3 days. That’s already happening now, even before the point of care test.”
Lebanon County Commissioner Jo Ellen Litz asked about the false negative rate for COVID-19 tests.
Gasperack did not have an exact number, “but I can say that the reported false negative rate is about 30%, and that’s a national false negative rate with the test that we’re using right now.”
“What we know,” he said, “is that we reduce that false negative rate if we only test people with symptoms. When this all started, people were being tested if they had only been exposed, and if you did the test before they developed symptoms, we were getting back a higher number of false negatives.”
“Now that we’re primarily only testing people once they have symptoms, we’ve seen that false negative rate go down a little bit.”
“Some of the new tests have even lower false negative rates,” Gasperack said. “So, it’s starting at about 30%, but it’s improving as we develop more tests.”
Lebanon County’s response
County Director of Emergency Services Dowd and County Commissioner Phillips joined yesterday’s conference from the DES Emergency Operations Center in the basement of the Lebanon Municipal Building, which was activated in early March.
“Our focus has been the consistent flow of communication. There’s lots of guidance out there from the CDC, WHO, Department of Health in Pennsylvania,” Dowd said. But, he added bluntly, “none of it seems to be very consistent.”
In contrast, he mentioned that communication between his department and the GSH and the Lebanon Veterans Affairs Medical Center had been “excellent.”
“Our goal has been to try and get information out to the first responder community, make sure it’s in a usable form, and make sure it’s easy to follow.”
Dowd told the audience that “we’re continually supplying first responders, health care facilities, and extended care facilities with personal protective equipment, making sure they have what they need.”
Dowd was not aware of any county facility that had run out of PPE, or that was close to doing so. He added that “if you work at a facility that uses personal protective equipment and are running short, please let us know so we can help you and get an accurate idea of supplies throughout the county.”
Dowd had earlier stated that while local supplies of PPE appeared to be holding up, nationwide supply chains were being taxed, and that no one should get complacent.
Finally, Dowd noted that “911 call volume is down considerably, and has been for the last 2 weeks, and continues to stay very, very low.” Conversely, the Emergency Operations Center call volume is up a little, “mainly with questions.”
When could infections peak? Preparing for sooner rather than later
City of Lebanon Mayor Sherry Capello asked Harlow “what are WellSpan’s needs?” “None at this point,” said Harlow. “WellSpan so far has adequate space, staff, and stuff.”
“We’re pretty well handling that now.”
But, Harlow added, “the concern we have now is that some of the models that we’re seeing suggest that we’re not going to hit the peak [in Lebanon County] until the end of April to mid-May, and that’s where I think it’s going to be really critical.”
“Right now we’re OK. We’re concerned about the peak.”
Models are just educated predictions. “It depends what model you look at,” Harlow said. “We believe right now it’s the end of April to mid-May. We’re making some assumptions, and we could be wrong.”
“That’s the guessing game. So, we’re preparing for things sooner, rather than later. And if it never happens that’s great, but we’re getting ready now.”
How are statistics being handled?
Councilwoman Keller asked how statistics are being compiled and reported. Questions have been raised about where people being tested are coming from, and where results get reported.
Harlow noted that “we don’t have any data to show that there’s a large influx of people from out of the area.”
“When we register people,” he said, “we are collecting their demographic information. To the best of my knowledge, they’re Lebanon addresses,” but “we don’t have any way to independently verify that.”
Dowd added “address of record is where you get counted. If somebody from out of state were to come in and seek care in a Lebanon facility, and test positive, that would then get reported back to their home state. It would be counted there, not in Lebanon.”
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Full Disclosure: WellSpan Health is an advertiser on LebTown at present. LebTown does not make editorial decisions based on advertising relationships and advertisers do not receive special editorial treatment. Learn more about advertising with LebTown here.
An earlier version of this article misspelled Dr. Gasperack’s last name. We sincerely regret the error.