Shift in testing strategy to limit spread of virus, conserve medical supplies

People who have symptoms of COVID-19, the illness associated with the virus – fever, coughing and shortness of breath – are now advised to isolate themselves at home if their symptoms are mild and they are not in a high-risk group, such as senior citizens or people with underlying health problems or weakened immune systems.

Once the COVID-19 symptoms ease and a patient is fever-free for three days, the isolation can end. If symptoms worsen, however, people are advised to call their health care providers.

"We're differentiating mild from severe because we want you to stay home and manage your symptoms on your own, if at all possible," Wake County Medical Director Dr. Kim McDonald said, "not only because we expect those sorts of cases to resolve without any negative impact, but also we don't want to send people unnecessarily to providers or the hospital, which burdens the resources and makes it difficult for the hospitals to provide care to those coming in with severe illness related to the virus."

State Health Director Dr. Elizabeth Tilson said people going out in search of a coronavirus test risk spreading the virus to others – or even exposing themselves if they aren't already infected.

"A test will not change what someone with mild symptoms will do. The vast majority will recover at home," Tilson said. "Testing is most important for people who are seriously ill, in the hospital, in a high-risk setting like a long-term care facility or a nursing home and for health care workers and other first responders."

Statistics show, while 2 percent of flu cases result in hospitalization, COVID-19 cases could result in 20 percent needing hospital care.

"It's going to stretch individuals and stretch our capability to care for folks," said Steve Lawler, president and chief executive of the North Carolina Healthcare Association, which represents hospitals across the state.

While saying that North Carolina hospitals "are ready and prepared" for a spike in COVID-19 patients, Lawler admits that it's hard to predict the future.

"The peak of all this may happen a month from now," he said.

Tracking the coronavirus curve

Hospitals are scrambling to gather needed supplies and personal protective gear for staffers, even asking for public donations and accepting homemade surgical masks.

"Obtaining those critical supplies is my top priority," state Emergency Management Director Mike Sprayberry said.

A second shipment of supplies from the federal stockpile arrived in North Carolina early Tuesday and was quickly allocated to hospitals statewide, Sprayberry said. The first shipment came last week.

State officials also have ordered nearly $50 million in medical equipment from private suppliers, but much of it is on back order.

Out of necessity, hospitals are having to get resourceful.

UNC Rex Hospital in Raleigh, for example, has upfitted eight more rooms for respiratory isolation with filtered air as a precaution and is having conversations with retired health care professionals and even second-year medical students as possible emergency backup employees. Other hospitals are looking at using ultraviolet light to sanitize masks.

"I would say it could be critical," Lawler said when asked about the supply shortage.