MidMichigan Health: State tightens criteria for coronavirus testing in response to shortage State responds to shortage of supplies

A COVID-19 testing tent is set up outside of the Emergency Department at MidMichigan Medical Center-Midland Friday, March 13, 2020. "These measures have been put in place to help distance those with a concern about COVID-19 exposure from the rest of our patient population and our staff, health care providers and volunteers," said Lydia Watson, M.D., senior vice president and chief medical officer, MidMichigan Health. (Katy Kildee/kkildee@mdn.net) less A COVID-19 testing tent is set up outside of the Emergency Department at MidMichigan Medical Center-Midland Friday, March 13, 2020. "These measures have been put in place to help distance those with a concern ... more Photo: (Katy Kildee/kkildee@mdn.net) Buy photo Photo: (Katy Kildee/kkildee@mdn.net) Image 1 of / 3 Caption Close MidMichigan Health: State tightens criteria for coronavirus testing in response to shortage 1 / 3 Back to Gallery

The determination of individuals who can be tested for coronavirus in the State of Michigan has been narrowed down to five key criteria.

MidMichigan Health was notified about these changes Wednesday evening – a decision the state made by working with local public health departments and hospitals, Lydia Watson, senior vice president and chief medical officer, told the Daily News on Thursday.

“Essentially, there is recognition that there’s a shortage of our collection kits, as well as the sample media — the tubes that we put the swabs into, and the laboratory capacity,” she said.

The five criteria for someone who can be tested in Michigan are:

1. An individual presenting with the signs and symptoms of the coronavirus (COVID-19) who is a known contact of a confirmed case.

2. An individual who’s already in 14-day monitoring and quarantine, but now has become symptomatic. Watson said this might include someone who had traveled to Italy, didn’t have symptoms initially, but has since developed them.

3. An individual with symptoms who is part of an investigation by the public health department of a cluster of illnesses associated with a vulnerable population. Watson explained this could someone who lives in a long-term care facility, such as nursing home.

4. An individual with symptoms who has a higher likelihood of infecting a lot of people, such as health care providers.

5. Any individual that is ill enough to require hospitalization. So, anyone who is admitted to the hospital with a concern for coronavirus can be tested.

“So, we’re no longer using high-risk and low-risk criteria, it’s just if you have any one of these five criteria, we can test you,” Watson said.

She said if a person cannot be tested, they are sent home and given instructions about length of time to self-quarantine and to call a doctor if symptoms become more significant.

Watson said just over 300 tests have been sent in since March 11 to the state from MidMichigan Health, which has Medical Centers in Alpena, Clare, Gladwin, Gratiot, Midland, Mt. Pleasant and West Branch.

She said they took inventory of their tests Thursday morning and had just under 200 tests left. However, she said there have been additional “allowances” from the Center for Disease Control to stretch out their supply.

Watson explained when a person is tested for coronavirus, their nose is swabbed and then the end of the swab is broken off into a tube, which contains a pink liquid in the bottom, called a “transport media.” This solution helps preserve any organisms on the swab while the test is transported to the lab, and each tube normally contains 3 ml.

However, due to shortage of supplies, the CDC is telling the state that the 3ml of liquid can be divided into three different tubes to create three tests, rather than one, Watson said.

Current numbers at MidMichigan

As of noon on Thursday, MidMichigan systems had 31 patients admitted to the hospital for coronavirus symptoms, and are being monitored. Many of them are still awaiting test results, however the few that have already come back have shown negative results for coronavirus.

“If we have concerns that they might be COVID-19, they are considered PUI – person under investigation – and they are admitted into the hospital if they require admission,” Watson explained. “If they don’t need to be admitted, they’re sent home. But if they need to be admitted because of their symptoms, they’re admitted until they’re well, regardless of whether their tests come back positive or negative.”

As previously announced, MidMichigan Health has begun to roll out their telecommunication visits, and as of 11 a.m. Thursday, had cared for 22 patients via video call. Watson said there are five doctors working with iPads at an outpatient center to see patients via video calls. Watson said it has been going really well.

If someone is interested in being seen by a provider via web call, they should contact their primary care provider to see if it’s an option for them. Anyone who does not have a primary care provider can call a MidMichigan urgent care or emergency department. Each patient will be evaluated to see if they are a candidate for the video visits.