Please clarify who gets tested and why not others do not, it's very confusing.




Answered by Dr. Erin O'Connor, Deputy Medical Director, Emergency Medicine, UHN and Nicole Harada, Registered Nurse and Patient Care Coordinator, Toronto Western Hospital.
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Question:
Please clarify who gets tested and why not others do not, it's very confusing.

Answer:
Sure yeah so you know with COVID 19 it's been really interesting times because things do change very quickly and I know that the testing you know even the symptoms that's changed over time, you know patients who are exhibiting those symptoms who come into our emerge...

[Transcript copy is verbatim per the video]
Original air date: April 23, 2020. Information shared in this video was current at time of original broadcast.

Nicole Harada:
Sure yeah so you know with COVID 19 it's been really interesting times because things do change very quickly and I know that the testing you know even the symptoms that's changed over time, you know patients who are exhibiting those symptoms who come into our emerge they're getting tested if at times if you know an individual is high-risk we might be swabbing to tests also but we're following the guidelines that are developed in the larger level at the organization so that's kind of what we're following hopefully that kind of answers the question. I know it is confusing and there's been a lot about are we testing enough people and all that sort of stuff in the media but yes so we're following our protocol that's been developed.

Dr. Erin O'Connor:
Really we ask that people come to the emerge if they're having symptoms if the symptoms are severe or you have another major medical comorbidity so you are one of the transplant patients, you are someone who's receiving active chemotherapy, you're older so aged over 60 we know that this group is at higher risk. Anyone who has anything that would compromise their immune system those patients should come to the emerge. If you are fairly well and fairly healthy and your symptoms are mild we encourage you to go to the assessment centers for testing. Even though you are hearing that our volumes are down as Nicole was saying it is helpful for us in many ways for our volumes to be a bit reduced in order because all of these extra precautions we’re taking do take time and having everybody in a single room means that we do have less space than we did before so it is actually helping us to get on with the work that we're doing to have our volumes down slightly. We are not testing everyone who wishes the test or has a desire for the test and that is actually based on Ministry of Health guidelines. The testing criteria has expanded but for an otherwise well person with stables idle signs with mild symptoms COVID test is not being recommended at this point. We have to be mindful of the fact that we only have so many swabs, that supply chains are very different now in you know in a COVID world we about a month ago had a difficulty with our swabs because all of our swabs came from Italy and as you can appreciate when Italy was shut down we were in a very much in shortage situation. We were able to obtain a different supply but we're being mindful of supply chains. There's also the other end of the test which is actually running the test in the lab, this is not an automated process this actually requires a skilled lab technicians to do and to do properly so it takes time. And the more lab tests that were running the slower our tests get and that can be problematic when the patients need the tests in order to know whether they can go to the operating room whether they need the tests to know whether they can go back to a shelter or go to one of the protected sites. The slower the testing is the slower the whole system gets and so we have to be careful with who we test.

So bottom line severe symptoms, medical comorbidities you can come you come to the emergency department. Mild symptoms you go to an assessment center, but there are very specific criteria for who we test and how we test and why and we are all following that the Ministry of Health's guidelines. They do change frequently but we are able to keep up with that and I know it can be confusing to the public. Honestly I'll be honest it's confusing to many of us as clinicians I think most of us are checking the guidelines every day before we start our shift to make sure that we're actually testing appropriately.


[Transcript copy is verbatim per the video]
Original air date: April 23, 2020. Information shared in this video was current at time of original broadcast.




Answered by Dr. Erin O'Connor, Deputy Medical Director, Emergency Medicine, UHN and Nicole Harada, Registered Nurse and Patient Care Coordinator, Toronto Western Hospital.
Click to learn more about UHN or to DONATE NOW


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