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Ramped-up testing in Maryland likely to reveal far more coronavirus cases as Hogan focuses on slowing outbreak

The drive-up testing area at Carroll Hospital is located on the third floor of its parking garage in a section without any other cars.
The drive-up testing area at Carroll Hospital is located on the third floor of its parking garage in a section without any other cars.(LifeBridge Health)

Johns Hopkins Hospital has begun testing for coronavirus in its labs, which could significantly increase the number of people tested in Maryland, the institution said Friday as officials around the state announced seven new cases bringing the total infected to 19.

The addition of Hopkins, which developed its own test, and other private labs, will bolster the testing done at the state lab in East Baltimore, which had conducted about 100 tests as of Wednesday but no longer reports how many tests it conducts.

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The news of additional testing capability comes on a day when Gov. Larry Hogan said on MSNBC that the state had “moved on from testing, quite frankly, to other things right now."

Hogan, who has declared a state of emergency in Maryland, said the state was focusing on measures such as closing schools and limiting public gatherings to mitigate the outbreak, as well as treating the sick.

"Rather than talk about what they didn’t do and why the hospitals aren’t ready, why the tests aren’t ready, I just want to say what can we do right now,” said the Republican governor, who has sought millions of dollars for the state’s response.

Nonetheless, a spokesman for the Maryland Department of Health said the state is working to increase testing availability and will expand testing as supplies become available.

“At this time, testing is appropriate for those who are at highest risk for developing severe COVID-19 disease,” said Charles Gischlar, a department spokesman. “Not everyone needs a test, but everyone can adapt recommended practices such as good hand washing and social distancing to reduce their risk of exposure to COVID-19.”

Hopkins officials said they expect to increase testing capacity from about 30 a day now to about 1,000 in coming weeks, which will enable public health officials to control the spread of the virus by quarantining those affected and help them understand where it’s headed. It’s only testing samples collected on those with symptoms at its hospitals.

“We want to tell people they are infected because we want them to stay home and provide information on people they may have exposed and put those patients in quarantine," said Dr. Karen C. Carroll, Johns Hopkins’ director of the division medical microbiology and professor of pathology. "If we can do this more quickly, we can interrupt the spread. This worked well in China and Korea.”

Since widespread testing has been delayed, and largely limited to people who have traveled or come in contact with someone infected, there are surely more cases in the community that have gone undetected.

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Symptoms include fever, cough and shortness of breath and about 80 percent of cases are mild. The easily-transmittable illness, which has spread rapidly into every continent, has sickened at least 136,000 and killed more than 5,000 people worldwide as of Friday.

“Without widespread testing, we have no idea the extent of community spread of COVID-19,” said Dr. Leana Wen, a former Baltimore health commissioner and a professor at George Washington University.

“There may be dozens or hundreds of people in the Baltimore region who have the novel coronavirus and don’t know it,” she said. “Testing is key to understanding the degree of the outbreak and guiding the public health strategy for reducing the spread of the disease.”

President Donald Trump declared a national emergency Friday and said a million more tests might be made available within a week and millions more within a month. His administration has been criticized for the slow rollout of testing, as the number of cases climbs and the response alters everyday life for every American.

The U.S. Food and Drug Administration announced this week that it has approved three other private labs to conduct tests across the United States: LabCorp, Quest Diagnostics and Roche.

Quest said in a statement that it expects to be able to perform tens of thousands of tests a week within the next six weeks across the country. LabCorp said in a statement that it could perform several thousand tests per day and is rapidly adding new equipment and staff to create additional capacity.

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None of the private labs allow people to walk in and have a test because of the infectious nature of the coronavirus. They all require a doctor to order a test at a hospital or clinic capable of safely swabbing patients.

Public health officials say the tests will help control the virus.

“A lot more diagnostic testing will help us understand where we are,” said Dr. Tom Inglesby, director of the Johns Hopkins Center for Health Security. “There has been limited diagnostic testing capability, but that’s going to change in the next week or two or three.”

He emphasized that the process of collecting the sample was important to keep health care workers and other patients from becoming infected. Health departments are outlining a process where they direct a patient to a specific place where they are met by workers who are prepared with protective gear and an isolated space to swab someone’s nose and throat.

Hospitals also are asking people who believe they may have been infected not to come to the emergency room, but call their local doctor or health department for instructions and screening per guidelines approved by the U.S. Centers for Disease Control and Prevention.

To ease the threat of cross-contamination in emergency room triage centers, some Maryland hospitals have set up drive-up collection sites for patients suspected of having the contagious upper respiratory disease. Others have set up triage tents outside.

LifeBridge Health, a hospital network that owns Sinai Hospital of Baltimore, Northwest Hospital, Carroll Hospital, Levindale and Grace Medical Center, said it plans two drive-up specimen collection centers. Carroll Hospital launched its testing site on the third floor of its parking garage Wednesday and Sinai Hospital expects to have its drive-up site operational by Monday, said Leslie Simmons, executive vice president at LifeBridge Health.

The drive-up testing sites allow patients to remain inside their vehicles. They’re handed a swab and swipe their nose and throats with the windows closed before handing the sample back to hospital personnel.

With coronavirus believed to spread via direct contact with people and surfaces exposed to the virus, drive-through testing centers can perhaps slow the person-to-person passage of the disease.

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University of Maryland Upper Chesapeake Health, a University of Maryland Medical System affiliate, also began drive-up specimen collection Friday in its emergency room parking lot. No other UMMS affiliates had rolled out similar testing sites.

Tests, however, remain limited, and many people who suspect they are showing symptoms have been turned away if they do not meet specific criteria set by the CDC and state health department.

Simmons did not say how many tests have been run at Carroll Hospital so far, or if any had come back as COVID-19 positive. Carroll County announced its first case Friday.

But she did say that if a person did drive up to the mobile site and asked to get tested in the car without a referral, they would be turned away.

“We have to be concerned we’re following CDC’s algorithm so we use supplies judiciously so we are not randomly testing but focusing on those most at risk,” she said.

LifeBridge said it was using the CDC’s test for now but was considering the possibility of using another type of kit, such as one developed by Hopkins. Mercy Medical Center and Greater Baltimore Medical Center also said they are working on plans to swab patients outside of their facilities.

Even as hospitals gear up for a surge in patients seeking care for the coronavirus and dealing with other medical issues, many healthcare professionals, researchers and staffers said they could fall far short of handling the outbreak, especially since medical systems have a finite number of intensive care beds, ventilators, protective gear, doctors and nurses on hand.

Baltimore Sun Media Group reporter James Whitlow contributed to this article.

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