MANITOULIN – Manitoulin Health Centre (MHC) implemented a major component of its COVID-19 readiness plan this past Friday, March 20 with the launch of designated external screening facilities at both the Little Current and Mindemoya hospital sites to test possible cases of the virus away from the main hospital, a move that will lower the risk of the coronavirus spreading within the hospital compared to having the tests conducted internally.
“Primary care providers, all the staff at the hospital, the managers and everyone have come together to develop this centre and work towards containing it on the Island; it’s been quite impressive,” said MHC VP of clinical services and chief nursing officer Paula Fields as she led The Expositor on a tour of the Little Current facility in the final hour before it opened for patients.
COVID-19 testing is by appointment only. Anyone wishing to be tested must have a fever above 38 degrees Celsius and a new or worsening cough. They must have, in the 14 days before experiencing symptoms, been outside of Canada, had close contact with a confirmed or probable COVID-19 case or had close contact with someone who had COVID-19 symptoms and was themselves outside of Canada.
Those who match the above criteria must call MHC at 705-368-2300 for Little Current or 705-377-5311 for Mindemoya and follow the phone prompts to reach the COVID-19 assessment line. That phone number will be monitored from 9 am to 5 pm every day.
For the people whose symptoms warrant an in-person assessment, they will be given a time slot to visit one of the two sites which are open from 1 to 5 pm from Monday to Friday.
The Little Current assessment centre is in an old house in the parking lot of the hospital next to the easternmost entrance off Meredith Street. The building was previously used for withdrawal management services and until last week was filled as a storage space for the hospital. The outside door has controlled access and patients should show up right at their appointment time, not before.
Through the front door is a small table with face masks and hand sanitizer as well as a couple of chairs. This is not a waiting room for later appointments—only one patient is allowed in the building at a time so all others will have to wait outside or in their car until they are allowed to enter.
There are designated parking spots for COVID-19 assessment patients and staff members are on standby to help people with mobility issues get into the space. The Mindemoya assessment centre is housed in an old garage located near the entrance to the emergency department, around the side and rear of the building. The garage space has plastic sheeting set up for makeshift wall dividers.
Appointments are arranged in 30-minute intervals on the top and bottom of every hour. That time window allows for patients to check in, get assessed, swabbed if necessary and released, with enough time to sanitize the space between uses.
“All our staff (in the assessment centre) will be wearing full personal protective equipment (PPE) which means gloves, N95 masks, face shields and the gowns,” said Ms. Fields.
Beyond the waiting area in an empty room sits a fan unit that provides fresh air to the building that does not otherwise have ventilation. The big green fan boxes are set up at both assessment centres.
To the right of the waiting area is an old kitchen that has been turned into the assessment area and is littered with medical supplies and diagnostic equipment. This room will be staffed by two individuals—a physician or nurse practitioner and a nurse.
“This is where patients will be assessed by the doctor and the nurse, and swabs will be taken if necessary. We have equipment to do vital signs, so heart rates, oxygen saturation and listening to their lungs. We also have lab staff ready to be deployed to come over and draw blood if required and do further testing,” said Ms. Fields.
All staff must only wear their uniforms in the centre and the hospital will take care of the laundering of those items. There is a phone line to call for supplies or assistance if needed to reduce the number of people going in and out of the building.
Due to supply shortages of the swab kits, public health agencies across Canada are exploring alternative tests and have authorized some swabs made for other purposes that can be used for COVID-19 testing.
Not everyone who has an appointment will be swabbed. However, the screening process is designed to eliminate as many unnecessary visits as possible so a majority of those who get to the stage of in-person screening will indeed receive a swab test.
As for MHC’s capacity to test patients, Ms. Fields said the Island was in decent shape compared to other locations.
“We’re actually not doing bad because our primary care providers have given their swabs to us because they know now that the centres are open. This is where the test should be performed,” she said.
Having other doctors send their swabs to the hospital will hopefully create a more efficient single point of testing.
Even though the assessment centre is only open for four hours per day during the week, as virus activity increases those hours may be lengthened. However, the people working in the assessment centres also staff the hospital’s clinics and emergency department so staffing needs to be carefully balanced.
There is less urgency to get a test done because the care pathways are the same—self isolate, rest up and allow the body to heal. If a patient has difficulty breathing they will have to be given more intensive care, test results notwithstanding.
Every patient that gets tested will have the appointment logged into Meditech, the electronic health record system that is used across Northeastern Ontario. Their results will later be added to that record.
The electronic health record system will enable faster information sharing and ensure patients get their test results as soon as they arrive without them having to follow up.
“Even though our nurses are going to provide information on self care and self isolation, public health is going to call them with information. Whether their swab is negative or positive, they will get a call as soon as that result’s in, so there’s no sense in calling the hospital or their doctor’s office.”
Ms. Fields said she noticed some early signs that people were following the public health directives to stay home as much as possible. Patient volumes at the emergency department were down and visitors have been respectful of the hospital’s recent no-visitor policy, the latter of which has made the hospital executive especially grateful.
The first day of the centre’s operation did not see a full slate of appointments but did have some patients through for testing.