COVID-19: A local hospital’s perspective on the virus

By Michelle Price
Special to the UCBJ

COOKEVILLE – At a time when our nation faces massive uncertainty and endless questions about this virus, Cookeville Regional Medical Center (CRMC) tries to make some sense of it all.

Although CRMC began testing patients for COVID-19 in early to mid-January, there is still much to learn. The initial tests were sent to the Centers for Disease Control and Prevention in Atlanta. Later tests were sent to the Tennessee Department of Health.

Fortunately, of all those tests taken in the past two months, there haven’t been any positive test results reported so far.

Tennessee has 154 confirmed positive cases, and just yesterday, Cumberland County had the first positive test result in the U.C. 

CRMC has now partnered with LabCorp for COVID-19 testing, which is faster than the state lab, and the turnaround time for results is four to five days, even for patients ill and in the ICU.

CRMC is closely following the CDC guidelines on who they test for COVID-19. 

“The CDC has always made the recommendation that asymptomatic people not be tested,” said Dr. Mark Pierce, CRMC infectious disease specialist. “And there‘s really no medical reason to test someone who’s asymptomatic.

“People who are not desperately ill are not going to get anything more than just symptomatic treatment,” Pierce continued. “It doesn’t make sense for people to be tested unless they are ill enough that they need to make sure they don’t have something else. For instance, we would hate for a person not to be tested when they actually have an early pneumonia.”

Pierce mentioned that the flu was still active in the area, as well as colds, sinus infections and allergies. 

“As a general thing, someone who feels like they might have a cold or an upper respiratory infection, if it’s not enough for them to go to the doctor, they should isolate themselves at home,” said Pierce. “That’s clearly the best thing because then they won’t spread it. Even if you’re asymptomatic, it doesn’t mean that you have a lesser strain of the virus…you have it. And someone who is more at risk, you could pass it to them, and they could die from it.”

According to Pierce, the people most at risk are the elderly and people with other serious medical conditions. His advice for these people is to stay home. That is the best way to avoid being exposed to COVID-19. 

How do people know when to come to the hospital? CRMC Emergency Department Medical Director Dr. Ken Colaric has a simple litmus test.

“If this whole COVID-19 crisis wasn’t going on, would you spend your money out of your pocket to go see a physician, go see an emergency department to be evaluated?” Colaric asked. 

“Almost everybody (with COVID-19) has a fever, so, if there’s no fever, they probably don’t need to be seen,” added Pierce. “If they have fever, significant cough and worsening shortness of breath, that’s the person who really should be tested and who should be seen by a physician.”

There are still many questions about this virus since it is a brand new virus.

“It seems like you have a group of people who downplay the risk, you have a group that are panicked about it, and I’m sure the answer is somewhere in between,” said Pierce.

People keep comparing this illness to SARS or the flu, but it isn’t following typical patterns with either of those. All we currently have to go by is the numbers from other parts of the world, and people need to take the virus seriously.

“If you look at what happened in Italy, it is concerning,” explained Pierce. “They actually had the Board of Physicians in Italy giving their doctors direction about rationing ventilators in ICUs. That’s a scary thing, but it could actually happen if the virus goes unchecked.

“Anytime you have a brand new virus that moves into a population unchecked, everyone there is susceptible,” Pierce continued. “We’ve had coronaviruses before, but not this particular strain. Maybe if you’ve had a previous coronavirus, you may have some degree of immunity, but that is unknown at all. 

“We have to assume that everyone in the U.S. is susceptible, so if it is allowed to run through our population unchecked, 40-45% of the population will become infected, a significant number of those people will die. It will overwhelm our hospital system. That’s kind of worst-case scenario, but I think without any action, that is likely what would happen,” Pierce explained.

Pierce believes the actions that are being taken now will help slow the spread of the virus.

“What we are doing now is prudent,” Pierce stated. “Social distancing, not gathering, 

those things really can slow the curve down. It should be like most respiratory viruses 

that circulate through flu season, this summer it should go low – low numbers in the background.”

CRMC has limited both visitors and visiting hours to protect both the patients and their visitors. Visiting hours now end at 7 p.m., and visitors are screened upon entering the building.

“We are asking the public to partner with us,” said Stephanie Etter, RN, CRMC infection prevention manager. “Don’t come to the hospital to visit if it’s not necessary. We are limiting visitors. We need people to take this serious and stay at home. Social distance is important.”

Colaric wanted to remind people that there is a limited amount of resources in the U.S. to manage the COVID-19 crisis, and we must utilize them wisely.  

“I think it’s important that people that have mild disease stay at home and don’t overwhelm our healthcare system so that we are available to manage not only the elderly who are going to get this, but people are still going to be having heart attacks, people are still going to have car crashes, and we have to have our healthcare personnel available to manage those crises and not have to deal with the minor viral symptom patient who should just be at home and self-quarantined,” Colaric explained.

CRMC’s advice for surviving COVID-19:

  • Limit where you are going
  • Wash your hands thoroughly
  • Watch your temperature – fever is critical 
  • If you have other symptoms with a fever, you may want to contact your physician.

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