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Health experts, officials discuss plans for fall COVID-19 testing

Staff Writer
Published: 8/14/2020 4:01:12 PM

Representatives from health networks across Franklin County met Thursday with local board of health officials and school nurses to share their respective COVID-19 testing capabilities, as well as their plans for managing the anticipated increase in demand for testing this fall.

“There’s a lot of demand for testing for people who are not symptomatic, and this is a major stressor for our system,” said Phoebe Walker, director of community services at the Franklin Regional Council of Governments (FRCOG), noting the increasing demand for testing for travelers and students returning to school. “The point of this discussion is not to solve this problem, but to understand it better and make sure we understand what is and isn’t possible.”

Baystate Franklin Medical Center’s capacity for testing asymptomatic patients has already dropped “significantly,” said Kinan Hreib, vice president and chief medical officer of Baystate Franklin, noting the facility can test about 20 asymptomatic patients a day.

“That is even a challenge considering the demand currently on the system,” Hreib added.

The facility is testing about 100 patients a day, he said, which is up from two weeks ago. That includes testing for patients coming into the hospital for procedures.

“We are going to face challenges … with the schools,” he said. “I think … the discrepancy of recommendations between the Department of Education and the Department of Public Health (DPH) is actually going to be something that really needs to be resolved.”

That discrepancy lies in the recommendations with respect to testing and quarantining, according to Glenn Alli, medical director for community primary care for Baystate Health.

“The difference was — according to my reading of Department of Education guidance … — that for children identified as a close contact in the school setting, that they would be referred for clinical assessment and testing,” Alli said. “And if that test came back negative, that they would immediately be returned to the school environment, rather than continuing with a 14-day quarantine, as what seems to be the DPH guidance.”

Alli previously explained to officials that the most reliable time for PCR testing (a molecular test using a nasal swab) is typically four to five days after exposure.

“The last thing we want to do is be giving conflicting advice to parents and to school personnel about ending a quarantine,” he said.

Alli said the health center is looking into “Point of Care” testing, using a system called Abbott ID Now, which offers more rapid test results.

“We are planning to validate the device against our internal PCR platforms as soon as we get the devices and determine what the most clinically appropriate use would be,” he said.

He said the strength of the device is that it can also be used to test for Influenza A/B and RSV, another respiratory virus, when they become prevalent again in the community. The trade-off, however, is the device has a lower sensitivity compared to the PCR tests.

“That’s part of what needs to go into the clinical decision-making … especially regarding negative results,” he said.

The prioritized use for the Abbott ID Now device would likely beemergency departments and urgent care facilities, he added.

The Community Health Center of Franklin County is also considering adopting the Abbott ID Now device in the fall, according to Stephen Segatore, assistant chief medical officer. The in-office rapid testing would be for symptomatic patients.

The community health center, which offers weekly testing at its Greenfield and Orange sites, is one of few sites without barriers to asymptomatic patients who have no urgent medical need for a test.

“Most of our testing in the last two months has been asymptomatic testing for travel and for returning from travel, and just for ‘I was in a store that had a positive employee, and I just wanted to make sure I didn’t catch coronavirus,’” Segatore said.

The Community Health Center of Franklin County has done approximately 1,000 asymptomatic swabs since May and has had zero asymptomatic positives.

Segatore also noted that with the school year coming, the center expects to lower the age for testing — which is currently set at 10 years old — and set up mobile testing to handle the high demand.

“We’re still getting DPH approval for that at this point,” Segatore clarified. “We don’t know exactly what the logistics will look like yet, but that is something we’re hoping to stand up this fall.”

Although Valley Medical Group doesn’t currently offer COVID-19 PCR testing, Gina Campbell, vice president of clinical operations, said the health center hopes to offer it in the fall.

“At the beginning of the summer, we began to actively pursue what would testing look like to be offered by Valley Medical Group,” she said. “Our current approaches are what you’ve heard from our colleagues, who are pursuing a PCR test … as well as a Point of Care test.”

She said the goal is to have testing five days a week, though she doesn’t anticipate being able to provide it to those outside of Valley Medical Group’s patient population.

“Our hope is to have testing within the next month,” she said. “But it’s really about having product in our hand.”

Mary Byrne can be reached at mbyrne@recorder.com or 413-772-0261, ext. 263. Twitter: @MaryEByrne

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