Since the first cases of the novel coronavirus (COVID-19) were confirmed in Michigan last week, doctors and hospital officials at Michigan Medicine have begun preparing for a steep increase in cases as the virus spreads.
There are 65 confirmed cases of COVID-19 in Michigan as of Tuesday, including seven in Washtenaw County.
Shortly after the first two cases of the virus in the state were announced on March 10, Michigan Medicine confirmed it was treating one of the patients.
According to the Detroit Free Press, on Tuesday morning, Michigan Medicine CEO Marschall Runge said the hospital is currently caring for two confirmed coronavirus patients and “treating several patients” who are awaiting testing results. However, the Michigan Medicine website notes it will not be disclosing the current number of COVID-19 patients as the situation is rapidly evolving.
Michigan Medicine announced on Monday the opening of a new 32-bed isolation unit in order to handle a possible influx of coronavirus cases. The new unit, known as the Regional Infectious Containment Unit, will be used to care solely for patients diagnosed with COVID-19.
Michael Mulholland, senior associate dean for clinical affairs at Michigan Medicine and executive director of the University of Michigan Medical Group, spoke Tuesday afternoon in a media call about limited curbside screening for Michigan Medicine patients who have been referred to the hospital by their doctors. Mulholland said there are now three screening centers available to Michigan Medicine employees and patients if they are showing symptoms.
At these curbside screening centers, patients drive up to the curb of the hospital, where hospital employees will swab the patient’s nose. These samples are then sent to other labs which test for the virus. Currently, Michigan Medicine cannot test for COVID-19 in its own labs.
Michigan Medicine is relying on the Michigan state laboratory to conduct tests and has also contracted a private vendor to process tests. In two to three weeks, Michigan Medicine should be able to test for COVID-19 in its own on-site laboratories.
Until then, if using the state laboratories, the University must first send samples from patients who may have the virus to a local health department. The local health department screens the sample for other common illnesses such as the flu through an interview process and several forms. Once at the state laboratory, the turnaround for testing the sample is about four to five hours.
Mulholland said the curbside screening will make this process quicker and more effective.
“The screening process is designed to try to figure out who might be infected and the symptoms are similar to a couple of other illnesses,” Mulholland said. “The COVID-19 infection is much more serious than the other two (common cold and influenza) even though the symptoms, at least at the beginning, are very similar.”
Michigan Medicine’s screening process design has multiple stages. First, patients who suspect they may be infected will call a hotline dedicated to concerns about COVID-19. If they are very sick, they will be referred to a video call, where their symptoms will be reassessed by doctors. Patients with severe symptoms, especially those indicative of COVID-19, will be sent to an ambulatory care site to get tested or referred immediately to the emergency room depending on severity.
Those using the drive-through testing site, which opens at 8 a.m., must be either “existing patients” or employees of Michigan Medicine.
Mulholland said this curbside sampling system will lower Michigan Medicine employees’ risk of exposure to the virus. The sample is taken by swabbing the back of someone’s nose without the patient having to leave their car.
“We’re asking patients that are sicker and need to have that testing to drive to one of our ambulatory care sites,” Mulholland said. “We’re also trying to arrange it so that they don’t have to come inside. The reason for that is we don’t want to expose the other people in the clinic, as far as we can, to potentially sick people.”
The Michigan state lab is currently able to conduct 115 COVID-19 tests per day, according to Dr. Joneigh S. Khaldun, the chief medical executive for the Michigan Department of Health and Human Services, in a press conference on Sunday. However, she said the facility receives “far more than that” every day, highlighting what she called a “capacity challenge.”
Processing the tests at commercial vendors such as LabCorp and QuestDiagnostics currently takes about three to four days.
Michigan Medicine also said it would give doctors, nurses, therapists and other workers who care for COVID-19 patients paid time off if they become sick with the virus or if they are quarantined because of possible exposure. This additional 120 hours of paid time off is on top of the existing 80 hours of paid time off available for all University employees.
According to the Michigan Medicine website, the risk of infection remains low for employees of and visitors to the hospital. However, visitor policies have been revised, limiting most visits to one adult per patient and prohibiting visitors under the age of 16.
Michigan Medicine is looking to reschedule some non-emergency medical procedures to a later date, as these procedures could expend resources that might be needed if an influx of COVID-19 patients were to be admitted into the hospital. However, Michigan Medicine’s website says they are expanding their ability to conduct video visits for individuals who would like medical advice and treatment for non-urgent medical conditions.
University Health Services also remains open for students who are unable to leave campus. On its website, there is a brief paragraph to summarize what UHS is doing regarding COVID-19, which includes working with the county’s public health officials to screen those who have traveled internationally.
“UHS is coordinating with Washtenaw County Public Health, Michigan Medicine, the Provost Office, Global Michigan, the International Center, and other university stakeholders regarding response,” the website reads. “UHS and Michigan Medicine have implemented additional screening for recent international travelers.”
The University canceled all in-person classes on March 11, the day after Gov. Gretchen Whitmer announced two confirmed cases of coronavirus in Michigan. Since then, two cases of coronavirus have been confirmed in student apartment buildings Vic Village and ArborBLU.
On Tuesday morning, an email was sent out to all students still living in on-campus housing stating they must move out unless they are unable to do so. Students who want to stay must give valid reasons and are not guaranteed to remain in their current room, and those who do not fill out the petition by Wednesday 8 a.m. will be assumed to have moved out and will lose their building access.
Preeti Malani, the chief health officer of the University, said these social distancing measures put in place by universities across the country are becoming increasingly crucial to slowing the spread of the virus.
“Social distancing has become part of our collective lexicon in the past week,” Malani said. “And last week, I think it’s a term that none of us understood or used, and now we’re talking about it all day. Just like the phrase implies, it’s having space between you and others. And it is essential to prevent transmission of coronavirus.”
The Centers for Disease Control and Prevention recommends people wash their hands often and avoid touching their eyes, nose and mouth. Individuals are also encouraged to maintain a six-foot distance between one another and avoid social gatherings.
Symptoms of coronavirus include fever, cough and shortness of breath. Anyone who believes they have been exposed to COVID-19 should call their primary care physician to speak to a health care provider. Individuals can also contact their local health department, which in Washtenaw County can be reached at 734-544-6700.
Daily News Editors Liat Weinstein and Claire Hao can be reached weinsl@umich.edu and cmhao@umich.edu.