Coronavirus fear causing Utah ERs to be overrun, while testing remains limited

(Jeremy Harmon | The Salt Lake Tribune) Eddie Stenehjem, an infectious disease physician at Intermountain Healthcare in Murray, Utah, speaks about things people need to know about coronavirus on Thursday, March 12, 2020.

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Murray • Emergency rooms and urgent care clinics in Utah are facing throngs of “worried well” patients who are requesting tests and treatments for coronavirus infections they don’t have, hospital officials said Thursday.

“Our emergency rooms are getting overrun, and our InstaCares, with people who are not sick,” said Jess Gomez, spokesman for Intermountain Healthcare.

Following a spate of new cases — as well as Thursday announcements of event cancellations and restrictions on large public gatherings — patients flocked to health care facilities, Gomez said.

“They’re worried about testing, about questions. It’s mixing sick people with well people, and it’s really slowing down the system,” Gomez said.

Intermountain has seen an average of about 240 patients per day over the past few days, and about 20% of those patients had respiratory complaints, said Adam Balls, chairman of the emergency department. “We will likely see those numbers continue to increase” to about 40% to 50% of patients, he said.

The health system is urging patients to think about the best option for the care they need, helping to ensure the system is not overwhelmed.

For people who have respiratory symptoms — cough, fever or shortness of breath — but “otherwise are not feeling that ill,” though, Balls encouraged them to use Intermountain’s telemedicine service called Connect Care. This service has seen an increase in calls, so health officials asked people to be patient. Typically the service receives about 160 calls this time of year, but, it’s been closer to 200 to 300 calls each day.

For those whose symptoms get more severe, or if you’re over the age of 60 or you are in an immunosuppressed state, “by all means seek care in the appropriate venues, whether that be in urgent care or an emergency department,” said Eddie Stenehjem, an infectious disease physician.

Intermountain is changing its procedure for people who come to the emergency department, Balls said. Patients will be assessed by a nurse, and if they are in high risk travel category, they will be given a mask and be “taken back to an isolation type area to limit exposure to other patients,” he said.

The health care provider is also considering overflow areas and alternative sites, such as tents and drive-through testing. More information on those decisions will be released later, Balls said.

Getting a coronavirus test remains difficult to the frustration of many.

Tests in Utah are generally limited to patients who have developed symptoms — a cough and fever — and have either recently traveled to a place where the virus is spreading or have had contact with a confirmed patient, health officials said Thursday.

“We are concerned about testing. We’ve done some significant testing and while the testing right now is not as many people as we’d like, the good news is that ... very few have come back positive," Gov. Gary Herbert said in a news conference.

The shortage of test kits and processing capacity in Utah was one of the factors in Herbert’s recommendation to limit gatherings to 100 people, said Lt. Gov. Spencer Cox, because people may not know they are carrying the virus.

“Sometimes we don’t have the most accurate information [as to] what’s going on in the community because of the slowness of the incubation period and the lack of testing we’ve had in [recent] weeks,” Cox said. “Getting testing supplies from the federal government has been a slow process.”

As of Thursday, the state’s public health lab had completed tests for 136 patients, with results pending for another 24.

ARUP Laboratories in Salt Lake City had completed 100 tests on Wednesday, Cox said, and was “ramping up” to more capacity, said Julio Delgado, chief medical officer for ARUP. The lab had been completing tests for University of Utah Hospital and on Thursday began to offer testing to other clients nationwide.

In the coming days, Cox said, Utah providers should be able to offer at least 1,000 tests. As the testing ramp up continues, Cox said Intermountain Healthcare will launch two drive-up locations for patients. The University of Utah Health System will have four drive-up locations.

"Admittedly, we wish we were testing more and we will test more in coming days,” said Cox. Although health officials said Thursday that people without symptoms were not being tested in Utah, every Utah Jazz player was tested in Oklahoma after Rudy Gobert was diagnosed with coronavirus on Wednesday — which led the NBA to suspend the rest of the season. On Thursday morning, Donovan Mitchell confirmed he also tested positive. Every other player came up negative.

Patients without symptoms still can spread the virus, Cox acknowledged, walking back his remarks at the news conference that asymptomatic carriers cannot infect others.

Three other Utahns have been diagnosed with the coronavirus. A man in Summit County, under the age of 60, is recovering at home after a trip to Austria, where he had close contact with a person now confirmed to have COVID-19. A woman was hospitalized last week and diagnosed Monday at McKay Dee Hospital in Ogden after travels to Nevada, Florida and the Bahamas. Another patient, diagnosed on Friday in Davis County, had been a passenger in February on the Grand Princess cruise ship, before a later voyage ended under quarantine following an outbreak onboard. The cruise line last week alerted previous passengers of possible exposure to the virus.

A sixth patient has also been diagnosed in Utah, Cox said; a “nonresident who was in the state on vacation” also tested positive Wednesday in Summit County. Cox said the patient isn’t considered a “Utah” case for CDC purposes, but health officials are tracking the person’s contacts in Utah.