Update March 19, 2020

How Lancaster-area COVID-19 swab tents work: Testing still limited, call for screening first

The above story includes area health systems' latest instructions to patients who think they should be tested for COVID-19.

Posted March 15, 2020

The Pennsylvania Department of Health has updated its instructions on getting tested for COVID-19.

Its revised graphic outlines which cases the state laboratory is prioritizing, advising people with mild symptoms to stay home and contact a health care provider if they feel worse.

It is prioritizing people who are severely sick for unknown reasons, who are in congregate care settings, who were in contact with known cases of COVID-19 and health care providers.

People with severe symptoms — a fever over 100 degrees F, shortness of breath and cough — should call their health care provider, the department says. Those who do not have a health care provider should call their local department of health (Lancaster County does not have one) or the state one at 1-877-PA-HEALTH. "If you still need help," it says, "CALL your emergency department."

A more detailed fact sheet the tweet links to is at the bottom of this story.

It also has instructions for doctors.

For those who feel a patient should be tested, it says: "Order a test without consulting with the Department of Health through a commercial lab."

For those who want to consult with the department if a test is needed, it says they can call 1-877-PA-HEALTH. 

If they consulted and the department doesn't recommend a test but the doctor feels the patient should be tested, order through a commercial lab, it says.

The department has also provided guidance on when to seek care if experiencing symptoms similar to COVID-19. 

when to seek care for COVID-19

The Pennsylvania Department of Health provided this guidance on when to seek care for COVID-19. 

Spokesman Nate Wardle said in an email Friday that commercial testing has yielded "a few positive test results in Pa., and a number of negatives." Positive tests from commercial labs are added to the state's list as soon as it becomes aware of them, he said.

What Lancaster-area hospitals are doing

If a WellSpan Health doctor approves testing but the state Department of Health declines because the case does not fit its guidelines, the system uses a commercial lab, according to spokeswoman Cindy Stauffer. 

WellSpan Health's coronavirus page offers an automated online feature called "Coronavirus Assessment Tool." If you are having concerns about COVID-19, it says, "use this tool to get suggested next steps based on the most recent guidance from the CDC."

WellSpan has a tent at its Ephrata hospital to serve as temporary outdoor patient screening and testing area.  

"These tents are not to be utilized for walk-in screening at this time," WellSpan's COVID-19 page says. "Patients should call their primary care provider before arriving. Patients can take advantage of an online screening tool at the bottom of this page to determine if they may be at risk for COVID-19. Also, patients are encouraged to use WellSpan Online Urgent Care to be seen quickly and safely, without the need to travel to a care location. Patients should visit WellSpan.org/OUC to get started."

Penn Medicine Lancaster General Health spokesman John Lines said in an email that COVID-19 "testing is not indicated for every patient with respiratory or cold symptoms," and that "Physicians are guided in their testing decisions by each patient's unique situation and recommendations from the CDC's screening guidance."

But, he wrote, for now, if the system's doctors determine that COVID-19 testing is warranted, testing will happen either through state Department of Health or a commercial testing facility. 

He also mentioned an earlier statement that Lancaster General is "examining how to effectively conduct additional testing on an outpatient basis as resources and capacity permits."

UPMC, the Pittsburgh-based parent organization of UPMC Pinnacle, announced Saturday that it has developed a COVID-19 test and will start using it Tuesday in Pittsburgh, with plans to open specimen collection sites at an unspecified later date in Harrisburg, Erie, Williamsport and Altoona.

It says it plans to rapidly increase capacity to be able to test "hundreds of patients per week in the near future," returning most results in 24 hours, and that the system will "work with commercial laboratories to send specimens to them as soon as they have capacity, which will maximize the health system’s ability to test all who need it."

UPMC Pinnacle spokeswoman Kelly McCall said in an email that UPMC is developing its own COVID-19 test, "but currently the specimens we obtain are sent to the Pennsylvania Department of Health for testing.

"When specimen collection for a patient is needed, we properly arrange for that, with full infection prevention precautions to ensure the safety of our staff, patients and visitors," she wrote. "Clinicians systemwide have been instructed on what to do if they believe a patient needs testing, and our infection prevention team is available to help them 24/7 through an internal hotline."

A midafternoon Friday message from UPMC that UPMC Pinnacle's account retweeted said UPMC outpatient and urgent care locations "will not collect specimen and request testing independently."

"Commercial laboratories have limited testing capabilities and long turn-around time, and do not do specimen collection," it continued. Most physician offices are not equipped to collect specimen using proper infection control procedures."

Many Lancaster-area health systems and insurers have phone lines or virtual visit options that they're encouraging patients to use. Information on some of those is available here.