As of this week, Sutter Tracy Community Hospital has yet to see any COVID-19 patients, but the hospital also has yet to determine just how many patients it could get as a growing number of people test positive for the novel coronavirus.
Thursday afternoon, San Joaquin County Public Health Services reported 83 confirmed cases in the county, up from 14 at the same time last week, including three deaths.
Sutter Tracy CEO David Thompson said that the people the local hospital has tested have all turned out not to have the virus, but the hospital isn’t testing as many people as it would like.
“The test kits are in short supply nationally, and that is the case here at Sutter Tracy as well,” Thompson said. “We are not doing mass public screening or testing at this time.”
Meanwhile, the hospital is still bracing for COVID-19 cases from Tracy.
“The Department of Public Health does not tell us, for example, where they’ve tested patients, if they’re from our community or not. But in talking with other hospitals, we know that there’s been at least one person in Tracy that has tested positive, so we know it’s here,” Thompson said.
Dr. Praveena Sarma, Sutter Tracy’s infectious disease specialist and a member of the hospital’s COVID-19 Task Force, confirmed that as of Thursday morning, all of the 53 people tested at the hospital over the past two weeks had received negative test results, meaning the virus was not detected.
Sarma said that those 53 people included high-risk patients who not only showed obvious COVID-19 symptoms, such as high fever and shortness of breath, but also have underlying cardiopulmonary diseases; are immune-compromised, including transplant patients; or are elderly.
“Eventually where we all want to get to is we test everybody, even the asymptomatic,” she said, referring to people who are not showing symptoms, “as we are aware that asymptomatic patients also have viral shedding and can spread the virus.”
Sarma added that doctors continue to be cautious even when they get negative test results.
“We currently have, in the United States, a false negative rate of about 30%, which is pretty high, so we are also retesting our high-risk patients who are already admitted to hospital, like day four or five, to be absolutely sure,” she said, adding that even those not admitted should continue to be cautious about the potential spread of the virus. “I make sure that even if their test is negative, and if in my mind I think they have a classic presentation of possible COVID, I have asked every one of those patients to self-quarantine for 14 days.”
While testing isn’t widely available at the moment, Sarma said that situation is constantly changing.
She noted that earlier tests taken at Sutter Tracy had been sent to the county health department, but as of Monday, the hospital is using Shared Laboratories in Livermore, which produces results much faster.
“We’re getting a 24-hour turnaround, which has been amazing,” she said. “With Public Health being inundated — because Public Health not only does us, they have so many other hospitals in the county — we weren’t getting results for four or five days.”
Sutter Tracy is now working with a company that expects its tests could produce results within an hour after testing, Sarma added.
Dr. Shital Hubli, one of three doctors at Patel, Pulliam and Hubli Medical on West 12th Street, said that her office had received plenty of requests for testing. Information on how many people have been tested or whether any patients have tested positive is confidential, but she said that not everyone who requested a test had been able to get one.
“We expect it to become more available soon,” she said. “It’s slowly changing. It’s changed from what it was last week, not as fast as we’d like it to change, but changing for the positive.”
Those who think they might have the coronavirus still should be in contact with their doctors. Hubli said that while the situation is ever-changing, there is still plenty that doctors know about the virus, including how to tell if someone is likely to test positive and how they should proceed if the symptoms of COVID-19 — including fever, body aches and a dry cough — are present. People who notice any of those symptoms getting progressively worse should call their doctor.
Hubli said that doctors urge people to call first and are often able to help patients through telephone calls and video conferencing. The large majority of cases are manageable without hospitalization, with the symptoms lasting for about a week.
She also warned that, in a small percentage of cases, people who test positive for COVID-19 won’t show symptoms at all but could still spread the disease to others who might develop more dangerous symptoms.
“What we’ve seen is that in 80% of cases, the disease is mild,” she said. “Most of the time it is mild, but in 20% it does become progressive, and out of that, 5% will need ICU admission.”
Once people have trouble breathing, or if they become fatigued or short of breath while engaging in normal activity in the home, such as walking from one room to another, they should go to the hospital.
She said that, on average, a person will show symptoms about five days after exposure, but it could take as long as two weeks after exposure to show symptoms.
“That’s why we say, quarantine for two weeks,” she said.
Sarma said that COVID-19 is unique among contagious diseases as the virus that causes it originated in bats but then mutated, spread to humans, and mutated again.
“So basically we don’t have any acquired or natural immunity to it,” she said. “The body doesn’t recognize it.”
In addition, the symptoms don’t show up in a predictable manner as they would with influenza.
“You could have symptoms on day five, six, seven, eight,” she said. “You could be infected and not even know it for almost a week.”
It’s that unknown factor that is causing health care experts around the country to recommend widespread self-quarantine and social distancing, at least until they have a way of knowing exactly where the virus is and where it is likely to spread to next.
“Social distancing is what’s going to work right now, until we can get testing for everybody,” Sarma said.