Scant returns of positive tests coupled with supply shortages spurred Geisinger to scale back COVID-19 testing of patients before surgery or other procedures.
Dr. Al Casale, chief medical officer for surgical services, said just 0.1 percent, or about 12, of approximately 12,000 pre-procedural tests returned positive for COVID-19 over a six-week period. These are patients who were asymptomatic and were tested as a matter of a policy directive and not because they were experiencing any associated illness.
“We consistently saw the rate of positive tests was only in the range of 1 in 1000,” Casale said, noting the tests and results spanned the entire Geisinger system. “We didn’t see any pattern to the small number that were positive.”
As a result, Geisinger shifted beginning Aug. 5 away from testing all such patients to testing specific patient sets: Patients living in congregate settings, patients to be admitted to critical care units post-procedure, high-risk patients and high-risk procedures such as transplants, lung operations and intrathoracic procedures.
The Geisinger system performs about 6,000 total tests for COVID-19 monthly with the capacity to exceed 30,000 tests, Casale said. Geisinger’s rate of positive tests hovers at about 14 percent, according to information previously provided by health system administrators.
Supplies needed to operate the equipment are suddenly difficult to obtain, Casale said. According to Casale, the government diverted supplies destined for places like Geisinger to “hotspots” where case numbers were surging like Florida and Arizona.
“All of a sudden our relatively reliable supply of reagents were starting to vaporize,” Casale said.
Pre-procedural patients outside these specific patient sets will continue to be screened for symptoms and exposure, with testing ordered if they meet established criteria, Casale said.
The hospital setting alone in the COVID-era adds a layer of protection as the medical staff has grown accustomed to using and wearing protective gear under the more rigid standards enacted due to the virus.
“They’ve all recognized we’re taking care of most of these patients that we’re seeing as if they were positive,” Casale said.
Just one day after Geisinger adapted the new pre-procedure testing protocol, Gov. Tom Wolf and Health Secretary Dr. Rachel Levine warned on Aug. 6 that a supply shortage hampered the state’s efforts to increase testing. According to the Philadelphia Inquirer, Levine said Pennsylvania was testing more than 4 percent of the state’s population, or 22,000 tests averaged monthly but fell short of the minimum goal of 5 percent.
“We need to do better,” Gov. Tom Wolf told reporters at a press conference, according to the Inquirer, characterizing the state’s testing as “below average.”
Last week, top administrators at Evangelical Community Hospital warned Congressman Fred Keller that COVID-19 testing supplies are dwindling.
William Anderson, the hospital’s chief operating officer, estimated at the time that Evangelical had COVID-19 testing supplies to last about three to four weeks. The lack of supplies can delay returns for both and jeopardize Evangelical’s off-campus test site just a short walk from the hospital.
“The supplies to keep it operational,” said Angela Lahr, vice president, clinical operations, “it’s becoming more and more difficult to acquire the supplies needed.”