A shortage of COVID-19 testing kits is hampering hospitals statewide, officials said, but Decatur Morgan Hospital CEO Nat Richardson on Monday said he hopes a delay in any coronavirus-related surge of patients will give the hospital time to find more supplies.

Richardson said the hospital needs more N95 respirators and more protective gowns. It has five ventilators in use, but has access to more due to its affiliation with Huntsville Hospital, which has several in a warehouse. More testing kits for collecting specimens are needed, he said, but he hopes that shortage will ease soon.

“That hopefully will come midweek,” Richardson said. “As you know, there was one big shipment that was diverted to Washington State and New York, which makes sense, but we hope to get a shipment in so we can do more testing in our state sometime midweek.”

State Health Officer Scott Harris on Monday said there’s a statewide shortage of testing kits, which includes the swab, transport tube and other supplies necessary to obtain a specimen from a patient and send it to the lab. Complicating this shortage is the fact the federal government is providing no assistance.

“As you know the states have been told that we are on our own in terms of finding this equipment, so everyone is competing with each other trying to find sources that can provide those materials,” Harris said. “So far, the lack of these screening materials, like swabs, has been the limiting step in terms of setting up the screening sites we have around the state.”

He said there are at least 17 screening sites across the state, and he expects that number to increase to 25 by the end of this week.

Richardson said the fact that the peak of COVID-19 cases could be many weeks away “is concerning, but it also gives us time to plan. Because we haven’t surged, right now we’re doing everything we can to plan for a potential surge.”


Confirmed cases

As of Monday afternoon, the Alabama Department of Public Health had reported no COVID-19 cases in Morgan or Lawrence counties and one in Limestone County. Madison County had 21 and Lauderdale had three. Statewide, there were 196 cases reported Monday afternoon, up from 157 on Sunday afternoon. Eighty-six of the confirmed cases are in Jefferson County.

Harris, however, warned that the number of confirmed COVID-19 cases in any given county may have less to do with the spread of the virus than the lack of testing capacity.

“There’s no question that the sites with the most testing capability are the more populated counties, but also the counties that have the most screening that’s going on,” Harris said. “… Jefferson County has the highest number of cases, as you know. It’s not clear if that’s because there’s just more testing available there, or if there’s actually more disease there.”

Richardson said Decatur Morgan Hospital has collected samples from 51 people for COVID-19 testing, 16 have come back negative, and no positive results have been reported. The remaining 35 tests are either pending at the state lab — turnaround time at the ADPH lab has been in 24-48 hours, he said — or were reported directly to the patient’s physician, without notification to the hospital.

Even when the swab samples are taken at the hospital, Richardson said, the Alabama Department of Public Health lab “may be communicating those results directly. These are patients of course that may have been sent home. Once they get sent home for quarantine, then those results will be called to them directly. We wouldn’t know unless the patient told us. … If the physician sends you for a test, and your test results come back, they can’t just send it to the hospital. That’s between you and your personal physician.”

To avoid the spread of the virus within the hospital, Richardson said a screening tent has been set up outside Decatur Morgan’s main campus, and a fever and flu clinic is being set up today at 1211 U.S. 31 in Hartselle, at Hartselle Family Practice. COVID-19 samples will not be taken there, but if screening suggests a patient may have COVID-19, he or she will be sent to another testing site. Those visiting the clinic should bring a photo ID, insurance card and cellphone, and should wear a mask in the clinic if they have one. Its hours are 9 a.m. to noon on weekdays.

As of Monday afternoon, a drive-thru screening clinic set up by Athens-Limestone Hospital at 902 W. Washington St. had seen 203 patients in its first three days of operation and collected 103 specimens for testing at the state lab in Montgomery, according to hospital spokeswoman Felicia Lambert.

All who enter Decatur Morgan Hospital must first have their temperature taken, and they are sent for screening if they have a temperature of 100.4 degrees or higher.

“We’ve had a couple of team members who have been tested. Those have come back negative,” Richardson said.

Harris said protecting hospital workers from COVID-19 is critical.

“We’ve seen in other countries, Italy in particular, how infections among your health care staff can really devastate your ability to take care of people,” he said.


Testing criteria

Because of the shortage of testing kits, Harris said it’s important that people without symptoms — even if they have reason to think they were exposed to the coronavirus — not seek screening.

If physicians want to order tests for patients who do not meet ADPH criteria for testing, they should use a commercial lab.

“We know the commercial labs are now reporting more than a week turnaround time for them,” Harris said, while the state lab is turning tests around in 72 hours or less.

Some of the testing kits have been wasted. Tuscaloosa Mayor Walt Maddox on Friday announced that 528 specimens were rejected by the ADPH lab because they were insufficient or spoiled. Harris said the Tuscaloosa samples were not refrigerated during transport, despite guidelines that they needed to be.

“The results wouldn’t have been valid had we run those samples. It was very unfortunate,” Harris said.

Even for those with symptoms, Harris said ADPH generally recommends physicians only order COVID-19 tests for those who have a compromised immune system, other health conditions, or who are over 65 years old. He said he expects the ADPH to issue more restrictive guidance on testing criteria today.

Harris said 53% of the confirmed COVID-19 cases in the state are male, and they range in age from 2 to 97 years old. The median age is 44.

“In Italy, a full 40% of the people who went into the hospital actually were young adults and middle-aged people, although deaths are still much more common in the elderly population,” Harris said.

About 6% or 7% of those with COVID-19 are hospitalized, he said, including several who are on ventilators.

“Some hospitals are already nearing capacity (on ventilators) and we’ve had to coordinate hospitals within the state so that they can share resources as needed,” Harris said, and the ADPH is seeking more ventilators from out of state.

Harris said it is unknown whether a person who has recovered from a case of COVID-19 is immune from another course of the disease. Infections from other types of coronavirus, such as the one that causes the common cold, do not necessarily provide immunity. 

One Morgan County employee tested for COVID-19, triggering Commission Chairman Ray Long to close the courthouse Friday. Long said results from the employee's test have not come back, but the courthouse was thoroughly cleaned over the weekend and reopened, for employees only, on Monday.

Decatur Mayor Tab Bowling, who last week closed City Hall to the public except by appointment and placed employees on a modified work schedule, said no city employees have been tested for COVID-19.

Bowling said he's been impressed by social-distancing efforts by Decatur residents.

"I’m really proud of our residents and how they’re responding to recommendations and guidelines from the CDC and the Alabama Department of Public Health," he said. "It’s producing what I believe are encouraging numbers for Decatur, especially when you look at the communities around us."

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eric@decaturdaily.com or 256-340-2435. Twitter @DD_Fleischauer.

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