You’ve been tested, now what?
As positive COVID-19 cases begin to be confirmed in the communities in western Maryland and the surrounding region, more COVID-19 tests are being administered, and as a result, questions about the testing process and the results of the test are naturally arising.
At UPMC Western Maryland, the process for testing begins with a specimen collection. If a patient suspects they have COVID-19 and aren’t having high fever or breathing problems, UPMC Western Maryland’s advice from the start has been to call their primary care provider or the Allegany County Health Department to get initial advice.
Doing this from home is best for all and limits spread of any infection; if needed, they will be guided safely to the next care site. If the patient has a high fever or breathing trouble, we are directing them to go to the UPMC Western Maryland Emergency Department.
Specimen collection is only for patients with an approved referral from their physician or who meet the criteria determined by a doctor at the Emergency Department.
These specimens will be collected by trained health care providers who will wear the recommended personal protective equipment – that means gowns, gloves and appropriate masks or respirators.
Patients will be isolated to ensure no contact with other patients.
The collection rooms are negative pressure rooms, which assure that air in the room does not exit until it flows through a high-efficiency particulate air (HEPA) filter, which removes infectious pathogens. The collection process involves a swab – a thin wire with a cotton-like tip – that is inserted deep into a patient’s nose. Using the swab method collects both mucus secretions and cells from the patient’s airway, which is the best place to find the virus.
Once the specimen is collected, it will be safely and securely transported for testing to a clinical laboratory. Packaging for shipping and delivery is done according to federal guidelines that are already in use for many pathogens being routinely tested.
Currently, UPMC Western Maryland outpatient specimens are tested by Quest Laboratory in Chantilly, Virginia, which is currently working to reduce the backlog of tests.
UPMC Western Maryland recently implemented a new protocol for sending specimen collections for inpatients who are suspected of having the COVID-19 virus. Once the lab receives a specimen for COVID-19 testing, the order will be reviewed by UPMC Western Maryland’s command center team including the Chief Medical Officer, the infectious disease physician and infection prevention nurses. The UPMC Western Maryland team will review the clinical data to see if the specimen collection is appropriate to be sent to the Maryland state lab. By doing this, results are anticipated in less than 48 hours.
If a patient tests positive, they will receive notification, along with their physician, and all the appropriate officials in government who are tracking this outbreak. Physicians will decide on an appropriate course of care based on the severity of the symptoms being experienced by the patient. Sometimes that will mean care at home, other times it will be at a UPMC Western Maryland.
It is important to remember that most people who are infected will not have severe or disabling symptoms. Those patients do not need to be in emergency departments or inpatient settings. We are making sure that everyone gets the care they need.
According to the Centers for Disease Control, while a positive test result means it is very likely that a patient has COVID-19, a negative test does not completely rule out the infection. A negative test result means that the virus that causes COVID-19 was not found in the patient’s sample. A negative test in a patient who has an infection is called a false negative test. The patient’s healthcare provider will work with them to determine how best to care for you based on the symptoms, possible exposure, and test results.
“False negative results are always a concern with any diagnostic test,” said Dr. Rameet Thapa, infectious disease specialist at UPMC Western Maryland. “We don’t know the exact false negative rate with the tests being used now, but based on some studies in China the sensitivity of the test was about 70 to 80 percent. That means if we test 100 people with the disease, 20 to 30 people could have the potential of a negative test result. Most skilled clinicians know that if they suspect a COVID-19 infection, even if the test comes back negative, to continue precautions, watch the disease progression and consider retesting.”
As specimen collection and testing increase through the duration of the pandemic, UPMC Western Maryland recommends strict social distancing and proper hygiene, including frequent hand washing. For more information and for the latest updates, go to www.UPMCwesternmaryland.com and click the Coronavirus banner on the top of the page.