The coronavirus scare has overwhelmed many South Florida residents over the past few weeks.
Laid-off workers are struggling to stay afloat, parents can't find childcare in the wake of school closures, financial markets are floundering, and folks are worried they might hurt someone they love just by breathing on them.
We've swiftly entered an age when every sniffle feels like cause for alarm and public sneezes are seen as biohazards.
As the saga plays out, the Florida Department of Health and Miami's Jackson Memorial Hospital have been updating advice for people who feel ill and suspect they might have COVID-19, the disease caused by the novel coronavirus.
Among health officials' new recommendations: Younger patients with mild symptoms should not rush out to get tested for COVID-19 at hospitals and doctors' offices. That advice might not be music to the ears of the anxious, but officials say it's warranted in light of medical supply shortages and the need to curb the spread of the virus in healthcare settings.
"For minor symptoms with no underlying diseases, we recommend you stay at home, hydrate yourself, get rest, and quarantine yourself for 14 days," Jackson Memorial's head of infection control, Lilian Abbo, said in a public statement March 18.
"There is no need to always test if you have a mild cough or a mild, low-grade temperature... You are actually exposing more people by going to an emergency department to just check if you [test] positive," Abbo said. "Some people are going to be critically ill, and we want to use our resources for people who really need [them]."
The Centers for Disease Control and Prevention (CDC) says people with severe symptoms, such as difficulty breathing or a high fever, should seek care immediately.
Older residents, particularly people over the age of 60, should get treatment even if their symptoms are mild, the CDC says. Before going to a doctor's office, urgent care center, or hospital, patients with respiratory illness should let their healthcare provider know about their symptoms so infection-control measures can be put in place.
For those seeking help via telemedicine, Baptist Health South Florida has announced a program that aims to make doctors available at any time for online medical appointments. The nonprofit hospital operator is directing interested patients to visit its website.
Meanwhile, Jackson Health System, Miami's public health network, tells New Times that its three emergency rooms have set up outdoor triage areas to handle incoming cases of COVID-19. Hospital visitors might be subjected to a temperature screening to ensure they are not sick before they enter Jackson Health campuses.
To meet the ballooning demand for COVID-19 testing, drive-thru centers were rolled out in South Florida this week. Gov. Ron DeSantis said he's working with the National Guard to increase drive-thru testing capacity throughout the state. The following are already operating:
- Community Health of South Florida opened a drive-thru screening site at its Doris Ison Health Center in Cutler Bay on March 18 and plans to operate from 9 a.m. to noon weekdays.
- Cleveland Clinic's Krupa Center in Weston began performing drive-thru coronavirus testing March 19. The site's planned hours are 9 a.m. to 5 p.m. weekdays.
- Run by the National Guard in conjunction with Memorial Healthcare System, a large-scale testing site at C.B. Smith Park in Pembroke Pines opened March 20. Long lines of cars snaked around the park as soldiers donning masks and gloves directed traffic.
- Broward Health has set up a testing site behind the Festival Flea Market in Pompano Beach. Only patients who've registered in advance will be allowed to enter.
- A testing center at Hard Rock Stadium at 347 Don Shula Drive opened March 23. Only symptomatic patients over age 65, healthcare workers, and first responders are eligible as of now.
As of March 20, the state health department was advising that testing is generally reserved for people with severe symptoms, sick individuals over the age of 60, people who have had contact with a suspected or confirmed COVID-19 patient, and folks who have traveled abroad or been in areas of substantial active transmission in the U.S.
Upon opening, a pilot testing center in West Palm Beach operated by the nonprofit Found Care received 6,000 calls for appointments in one day. The patient volume was well beyond the testing capacity, and Found Care announced it would no longer take new appointments.
"For those patients who have an appointment to see us, we will proceed with testing as long as our supplies remain," Found Care CEO Yolette Bonnet said. “We hope to receive additional supplies soon and will communicate that information at foundcare.org. In the meantime, we encourage patients to contact the Florida Department of Health for other options for testing."
As far as finding COVID-19 testing in a local doctor's office, a Department of Health agent tells New Times patients should temper their expectations. Nasal swabs and other testing materials have been in short supply. Moreover, many doctors' offices and urgent care centers lack the necessary personal protective equipment and patient isolation measures to handle suspected COVID-19 cases.
Still, some local doctors' offices are trying to step up to the challenge and help folks who fear they've contracted the virus.
Former Miami Beach City Commissioner Kristen Rosen Gonzalez is one local figure who has spoken out about her COVID-19 testing experience. She said her primary care doctor proactively set up a screening area for potential COVID-19 cases. After developing flu-like symptoms, Rosen Gonzalez was able to get a coronavirus test during a swift appointment at her Bay Harbor Islands doctor's office.
"My doctor was so organized... She had it set up where the front office was for healthy patients. I went up a back stairwell, and she had a small room there [for COVID-19 screening]," Rosen Gonzalez tells New Times.
The physician took nasal swabs from Rosen Gonzalez and sent them out to a third-party lab, which is the typical process for local healthcare providers conducting COVID-19 testing. Generally, local doctors and even hospitals don't yet have the ability to analyze samples onsite, so patient specimens are delivered to a state-run laboratory or a diagnostics company such as Quest. (Quest asks that patients not show up at its locations because they are not collecting specimens themselves.)
Rosen Gonzalez expects the results of her COVID-19 test to come back next week.
"We don't have sufficient testing. Hopefully, other primary care physicians will be able to do what mine did," she says. "If the local health system doesn't have the ability, maybe municipalities need to hire nurses and just start testing people."
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For those who are sick at home, state and federal health officials have released some basic but detailed guidelines to help avoid the spread of infection. Keeping yourself confined to a designated "sick room," washing your hands frequently with soap, and minding where you cough and sneeze are among the recommendations. The CDC also advises that roommates and family members should avoid touching the dirty dishes and laundry of a sick household member.
The CDC stresses that the new guidance about what younger patients should do if they have mild symptoms does not mean COVID-19 sickens only seniors. A study released March 18 shows that 20 percent of surveyed patients hospitalized in the United States for COVID-19 were between the ages of 20 and 44. However, the virus tends to afflict older people more severely — a large majority of critically ill patients surveyed in the study were over the of age 45. Less than 1 percent of the hospitalizations in the study involved juvenile patients.
Though death-rate estimates from the U.S. National Institutes of Health indicate the novel coronavirus is much more virulent than the seasonal flu, the statistics are tentative given that many cases of the virus might be going undiagnosed.
A study published in February by China's disease control agency — which reviewed tens of thousands of mild to severe cases of the novel coronavirus — showed that more than 2 percent of the surveyed patients died. Over 80 percent of COVID-19 infections analyzed in the study were categorized as mild.