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Coronavirus Testing Goes Mobile in Seattle Coronavirus Testing Goes Mobile in Seattle
(3 days later)
SEATTLE — On an overcast day in Seattle, a few dozen medical staff members, students and emergency workers with symptoms of the fast-spreading coronavirus spent their lunch break driving to a parking garage.SEATTLE — On an overcast day in Seattle, a few dozen medical staff members, students and emergency workers with symptoms of the fast-spreading coronavirus spent their lunch break driving to a parking garage.
The UW Medicine’s Medical Center Northwest has turned part of the first floor of their four-story parking garage into a mobile testing clinic. Think fast-food drive-through, but instead of getting served a juicy burger, nurses come to take a nasal swab.The UW Medicine’s Medical Center Northwest has turned part of the first floor of their four-story parking garage into a mobile testing clinic. Think fast-food drive-through, but instead of getting served a juicy burger, nurses come to take a nasal swab.
In about a day, patients find out whether they have the coronavirus.In about a day, patients find out whether they have the coronavirus.
Delays in testing have set back the United States’ response to containing the coronavirus, and the mobile clinic that has operated since March 6 is one attempt to identify cases earlier in Seattle, the center of the nation’s outbreak.Delays in testing have set back the United States’ response to containing the coronavirus, and the mobile clinic that has operated since March 6 is one attempt to identify cases earlier in Seattle, the center of the nation’s outbreak.
“It’s been a crazy couple of weeks,” says Dr. Seth Cohen, who is leading the effort and is the medical director of infection prevention at the UW Medical Center.“It’s been a crazy couple of weeks,” says Dr. Seth Cohen, who is leading the effort and is the medical director of infection prevention at the UW Medical Center.
It is difficult to screen a large volume of people for the coronavirus inside a hospital, Dr. Cohen said. The space would need proper ventilation, and patients should not be contained in a waiting area where they could infect one another.It is difficult to screen a large volume of people for the coronavirus inside a hospital, Dr. Cohen said. The space would need proper ventilation, and patients should not be contained in a waiting area where they could infect one another.
Before patients are allowed to enter the drive-through clinic, they must fill out an online survey: Have they been experiencing cough, fever, shortness of breath, muscle aches, a runny nose or a sore throat? Did they have a specific exposure or recently travel to any countries with a current travel advisory?Before patients are allowed to enter the drive-through clinic, they must fill out an online survey: Have they been experiencing cough, fever, shortness of breath, muscle aches, a runny nose or a sore throat? Did they have a specific exposure or recently travel to any countries with a current travel advisory?
Responses are screened, and those who seem to be candidates for testing are offered an appointment.Responses are screened, and those who seem to be candidates for testing are offered an appointment.
“This is a clinic for people who have symptoms,” says Dr. Cohen. At this moment, there is no way for people who are asymptomatic to be screened.“This is a clinic for people who have symptoms,” says Dr. Cohen. At this moment, there is no way for people who are asymptomatic to be screened.
Dr. Dan Doherty, a developmental behavioral pediatrician at the Seattle Children’s Hospital, felt the onset of a cold last Wednesday when he woke up with a sore throat, which then progressed to a low-grade fever and congestion. “I did not have a known exposure, other than being in Seattle,” he said. In an abundance of caution, he got an appointment at the mobile clinic on Monday morning.Dr. Dan Doherty, a developmental behavioral pediatrician at the Seattle Children’s Hospital, felt the onset of a cold last Wednesday when he woke up with a sore throat, which then progressed to a low-grade fever and congestion. “I did not have a known exposure, other than being in Seattle,” he said. In an abundance of caution, he got an appointment at the mobile clinic on Monday morning.
The samples are kept in a refrigerator until a courier comes to deliver them to the UW virology lab. Nurses then change their protective gear before examining the next patient. All told, it takes about five minutes for the nurses to test one patient, said Dr. Cohen. Within the two-hour testing block on Tuesday, the nurses were able to collect samples from 40 to 50 patients.The samples are kept in a refrigerator until a courier comes to deliver them to the UW virology lab. Nurses then change their protective gear before examining the next patient. All told, it takes about five minutes for the nurses to test one patient, said Dr. Cohen. Within the two-hour testing block on Tuesday, the nurses were able to collect samples from 40 to 50 patients.
One man, as he pulled away from the nurses and tents, said to his child in the back seat, “Now we’re going to go home,” as if they had just picked up lunch.One man, as he pulled away from the nurses and tents, said to his child in the back seat, “Now we’re going to go home,” as if they had just picked up lunch.
The virology laboratory — a stone’s throw away from Amazon headquarters — has been operating 24 hours a day starting this week, turning what was once a research lab into an round-the-clock center for screening samples for coronavirus.The virology laboratory — a stone’s throw away from Amazon headquarters — has been operating 24 hours a day starting this week, turning what was once a research lab into an round-the-clock center for screening samples for coronavirus.
UW Medicine started gearing up in early January, after Dr. Keith Jerome, the head of virology, read about the outbreak in China and knew it was only a matter of time before the virus would show up in the United States. A team of about a dozen researchers started working to develop the capacity to screen hundreds of patient samples for coronavirus. Once they had a patient sample that tested positive for coronavirus, it was all hands on deck: While the process to validate a robust test would ordinarily take several weeks or months, they did it in just three days.UW Medicine started gearing up in early January, after Dr. Keith Jerome, the head of virology, read about the outbreak in China and knew it was only a matter of time before the virus would show up in the United States. A team of about a dozen researchers started working to develop the capacity to screen hundreds of patient samples for coronavirus. Once they had a patient sample that tested positive for coronavirus, it was all hands on deck: While the process to validate a robust test would ordinarily take several weeks or months, they did it in just three days.
“We thought this is probably going to be a wasted effort,” Dr. Jerome said. “But you don’t want to wait until the last minute to start to prepare.”“We thought this is probably going to be a wasted effort,” Dr. Jerome said. “But you don’t want to wait until the last minute to start to prepare.”
The last time Dr. Jerome got a full night’s sleep was over two weeks ago, before the Food and Drug Administration announced on Feb. 29 that academic medical labs could test for coronavirus.The last time Dr. Jerome got a full night’s sleep was over two weeks ago, before the Food and Drug Administration announced on Feb. 29 that academic medical labs could test for coronavirus.
“It’s been nonstop since then,” Dr. Jerome said.“It’s been nonstop since then,” Dr. Jerome said.
One medical laboratory scientist, Jina Chung, has pulled 15-hour days. Rohit Shankar, another technician, abandoned plans for his vacation next week to Bali, Indonesia, so he could help out.One medical laboratory scientist, Jina Chung, has pulled 15-hour days. Rohit Shankar, another technician, abandoned plans for his vacation next week to Bali, Indonesia, so he could help out.
Updated June 5, 2020 Updated June 12, 2020
Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.
So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.
A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.
The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.
Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.
Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home.Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home.
States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.
Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.
Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.
If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)
Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.
The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.
If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.
If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.
Scientists extract the genetic material from all the patient samples, and load them into 96-well plates for coronavirus screening. Any positive samples are sent to the state for further analysis, and results are also communicated to the necessary hospital or doctors, who then follow-up with patients.Scientists extract the genetic material from all the patient samples, and load them into 96-well plates for coronavirus screening. Any positive samples are sent to the state for further analysis, and results are also communicated to the necessary hospital or doctors, who then follow-up with patients.
Nearly 900 samples were being processed on Tuesday afternoon, and Dr. Alex Greninger, assistant director of the virology lab, said the facility was preparing to handle up to 5,000 daily.Nearly 900 samples were being processed on Tuesday afternoon, and Dr. Alex Greninger, assistant director of the virology lab, said the facility was preparing to handle up to 5,000 daily.
“Wow,” one laboratory technician said. “And I thought we were busy now.”“Wow,” one laboratory technician said. “And I thought we were busy now.”
As of Thursday, the mobile clinic had already screened 476 patients, with eight cases testing positive for Covid-19, according to Dr. Cohen, with many more turning out positive for influenza.As of Thursday, the mobile clinic had already screened 476 patients, with eight cases testing positive for Covid-19, according to Dr. Cohen, with many more turning out positive for influenza.
Although mobile clinics are usually seen as something ephemeral, Dr. Cohen said, “I think we’re in this for the long haul.” And by that, he means months. “Until there’s another way to get people rapidly screened.”Although mobile clinics are usually seen as something ephemeral, Dr. Cohen said, “I think we’re in this for the long haul.” And by that, he means months. “Until there’s another way to get people rapidly screened.”
UW Medicine is looking to set up a second location in the south part of the city. The priority for now is to ramp up the capacity to serve the patients and staff at UW Medicine, rather than serving the general public. A similar mobile clinic in Denver, open to anyone with a doctor’s order, had hourslong delays for testing this week.UW Medicine is looking to set up a second location in the south part of the city. The priority for now is to ramp up the capacity to serve the patients and staff at UW Medicine, rather than serving the general public. A similar mobile clinic in Denver, open to anyone with a doctor’s order, had hourslong delays for testing this week.
But like hand sanitizer, bread and toilet paper, supplies for testing are running low. “We are running low on the swabs. That’s going to be the bottleneck for this clinic,” Dr. Cohen said. “But right now we’re just trying to test as many people as we can.”But like hand sanitizer, bread and toilet paper, supplies for testing are running low. “We are running low on the swabs. That’s going to be the bottleneck for this clinic,” Dr. Cohen said. “But right now we’re just trying to test as many people as we can.”