Cameron hospital works around COVID-19 testing bottleneck

Until recently, public health agencies have recommended that samples be sent in a "viral transport medium" a substance that is in short supply. Now, health care workers can use a simpler, more common, CDC-backed substitute: medical saline solution.

Posted: Apr 2, 2020 12:49 PM

(CAMERON, Mo.) A shortage of vital COVID-19 test supplies has slowed COVID-19 testing in Missouri and nationwide. One rural Missouri hospital is working around supplies bottlenecks by quickly adapting to CDC guidelines.

Cameron Regional Medical Center is sending patients' samples to laboratories accepting a simple medical swab in a saline solution, staff said.

“I’ve had people coming from all over, really, to be tested because they are finding that they are having a really hard time being tested," said Jake Barton, a CRMC nurse practitioner testing patients for COVID-19.

CRMC had tested 218 patients total as of Tuesday night. The rural hospital is in Cameron, a city with a population of about 10,000 people.

For context, it's managed to keep pace with Mosaic Life Care in St. Joseph in testing. According to Mosaic Life Care Wednesday morning, the hospital system had tested 231 patients.

Tammy Easton, the director of nursing at CRMC, credits the hospital's COVID-19 task force with surpassing expectations for a smaller, rural hospital.

“We’ve been really fortunate that we have pretty much an unlimited supply of testing materials,” Easton said.

To limit exposure, all 18 clinics refer potential COVID-19 patients to Cameron. The task force set up a small tent for testing outside CRMC in mid-March.

“We had two main goals. Patient and staff safety and access to care and what we were finding is that we did not want a potential COVID-19 patient in one of our 18 clinics,” said Cassi Deskins, another nurse practitioner at CRMC and part of the COVID-19 task force. 

Deskins credits CRMC's testing success to the team's ability to quickly adapt as federal guidelines change.

“At first when we did this the swab had to be set in viral medium and that’s where there was a great shortage," Deskins said.

Until recently, public health agencies have recommended that samples be sent in a "viral transport medium" a substance that is in short supply. Now, health care workers can use a simpler, more common, CDC-backed substitute: medical saline solution.

Less than two weeks ago, state officials pointed to the shortage of viral transport media as the log jam stopping the state lab from processing tests. The director of Missouri state lab, Bill Whitmer said Friday, March 20, that his facility was facing shortages of swabs, materials to store patient samples, and chemicals to process the tests.

Viral transport media is more complex to make than a saline-based medium. Saline solutions, needed for transport of samples, is more common for hospitals to have on hand and more widely available.

As of April 1, the State Lab website only processes samples with viral transport mediums.

But private labs began accepting saline solution for transporting samples after the Centers for Disease Control approved the method on March 24. The World Health Organization backed the simpler collection materials on March 19.

"That has made the biggest difference in allowing us to really be liberal with our testing," Deskins said.

Barton agrees and said it has helped them provide another option for a patient who has been refused for testing by another provider.

“The health departments are recommending that these people be tested but local hospitals are refusing to test them still," Barton said. "I feel like we’ve really been able to accomplish a lot here by testing everybody."

All three, Deskins, Barton and Easton, said people who come to the hospital for COVID-19 testing will still be screened with CDC criteria.

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