On January 19, 2020, Puget Sound became ground zero for the new coronavirus disease (COVID-19) in the United States, when an Everett man was confirmed as the first case. In response, medical experts throughout the region leapt into action.
Among them is John Lynch, MD, MPH, medical director of Harborview Medical Center’s infection prevention and control program, who — like many other local public health officials — has been on call nonstop since the outbreak first made landfall. Although the risk to the general public is low, Lynch and other medical experts are instituting health and safety protocols just in case.
“When someone comes in with one of these new pathogens, it requires a lot of resources,” he explains in a KOMO News interview. “It displaces a lot of resources and space in our emergency departments. It requires one-on-one nursing and physicians dedicated to that work.”
Why home assessments work for outbreaks
To minimize disruptions like these at UW Medicine facilities and to prevent infection to people in the waiting room, Harborview and Public Health — Seattle & King County have taken a different approach to evaluating potential patients for the virus, a new form of the SARS virus. Instead of setting aside space for a quarantine zone in hospitals, Harborview deploys a five-person Home Assessment Team to visit patients at their own homes.
Usually these patients have been to mainland China within the past 14 days, where the virus originated, or have been in contact with someone who has. They also may exhibit some of the COVID-19 symptoms, such as a fever, cough, sore throat or difficulty breathing, but not to the extent that they require hospitalization.
Members of the Home Assessment Team prepare for a house call in a stairwell to avoid alarming neighbors.
How the team makes house calls
So far, Lynch and Home Assessment Team lead Vanessa Makarewicz, RN, MN, who is Harborview’s infection and prevention control manager, have made five house calls with other members of the team. Because the virus is spread when droplets from coughing or sneezing come into contact with another person’s mouth, eyes or nose, the team wears special equipment including masks, gloves and gowns during these home visits.
The team arrives at the home in scrubs and then don their equipment in a private area such as a stairwell or garage to avoid alarming neighbors or other building residents. Inside the home, they’ll evaluate the patient and swab their nose and throat for samples. It takes more time to put on and take off the gear than it does to evaluate the patient, Lynch notes, so the process for the patient is relatively quick.
Once the evaluation is complete, team members then decontaminate themselves and send the samples to the Centers for Disease Control and Prevention for testing. Right now, tests take between three and five days to get results, but that turnaround will be shorter when the test becomes available in the state. Patients are instructed to continue reporting their symptoms to public health officials and remain within their homes.
Being able to make these special house calls not only frees up UW Medicine hospitals to perform other life-saving care, it’s also an efficient way to help contain further spread of the virus in Puget Sound.
What to know about COVID-19
Although the Home Assessment Team has checked several potential patients, none of the cases were positive. The chances of becoming infected with the virus in the United States remain low. Frequent handwashing, especially before touching your face or eating, is the best preventive measure to take. To learn more, read UW Medicine’s COVID-19 FAQ.
If you have a fever or respiratory symptoms like a cough or shortness of breath and have either traveled to mainland China in the past 14 days or have come into close contact with someone who’s suspected to have COVID-19, read UW Medicine’s employee safety guidelines. If a family member or friend is exhibiting symptoms and meets other criteria, encourage them to call their provider or schedule a Virtual Clinic appointment before visiting a clinic in person.
