Local doctors urge caution in ‘exponentially expanding epidemic’

by Sarah Craighead Dedmon

Local health care providers are modifying their practices to prepare for an outbreak of COVID-19 in Washington County.

As of March 16, the Maine Centers for Disease Control reported 17 presumptive and positive cases in Maine, with none yet detected in Washington County.

Dr. David Rioux, of Machias, said he is “very concerned” about the outbreak, and that his practice is working on a plan to test for the virus without bringing potentially-ill patients into his medical office.

“We’re going to try to do that, the unfortunate thing is the test results are not immediate, we still have to send them away,” said Rioux, adding that COVID-19 test kits are still in short supply nationwide.

Instead of infected people entering the medical building, Rioux’s patients will be asked to answer assessing questions over the phone and, if they’re a person of interest, to drive to Machias where they could be evaluated and tested in the office parking lot. Health care workers will be wearing protective gear.

On Sunday, March 15 the Maine Centers for Disease Control and Prevention announced that the U.S. CDC has authorized Maine’s Health and Environmental Testing Laboratory (HETL) in Augusta to act as the final confirmation point for COVID-19 tests. Previously, those tests were forwarded to Atlanta, Georgia. This week, positive tests performed by a non-governmental laboratory are called “presumptive positive” and tests confirmed at HETL are simply “positive.”

“For 95 percent of the patients who get this, it’s not that bad,” said Rioux. “It’s the patients at risk who are over 60 and have another comorbid state, such as compromised lungs...that’s who we want to address the most.”

Social distancing and increased testing for the virus are two crucial interventions, according to Dr. Robert Pinsky, of Machias, an infectious disease doctor with Northern Light Health.

“This is a rapidly expanding epidemic with case numbers just like in Europe and elsewhere, doubling every several days,” said Pinksy. “We don’t know the extent of current cases in Maine because there hasn’t been adequate testing available, that’s also true nationally.”

Pinsky said the Northern Light medical system has been preparing for this outbreak since news of its existence broke in December 2019.

“If you look at the predictions, if we do nothing different now, we’re looking at a third of the population infected, hundreds of thousands of people dying, and all of that is alterable, but it means major interventions now,” said Pinsky.  

The presumed incubation period for the virus is up to 14 days, according to the CDC, with symptoms appearing as early as day two. Dr. Rioux said the biggest symptoms are fever and body aches, plus a cough. “Which is very similar to influenza, that is why we’re testing for both when someone comes in,” said Rioux. Fortunately, influenza is detected via a rapid test, and doctors can determine its presence right away.

Unfortunately, we’re still in the thick of influenza and cold season.

“We’re asking people who are not very sick [to stay home],” said Rioux. “We’ve been asked to cancel routine exams and follow-ups, which we will do.”

Rioux and Pinsky urge the public to take sensible steps to stay healthy, like social distancing, staying in self-quarantine if exposure is suspected, and using good hygiene procedures like handwashing and covering their cough.

“Because this is an exponentially expanding epidemic, days can make a difference, weeks can make a difference,” said Pinsky. “Practices of social distancing and the closing of public institutions make a difference in how many people are affected.”

From his reading, Rioux believes quick action could help curb the escalation of this disease, to flatten out the dangerous spikes in infection.

“It may broaden it out so it lasts a little longer, but [health care is] not going to be overwhelmed, which is the big concern,” said Rioux. “Here, we will be overwhelmed...if this peaks really rapidly.”

 

What to do if you suspect COVID-19

Down East Community Hospital spokeswoman Julie Hixson provided the following guidance for patients who believe they may have contracted COVID-19.

Patients should call 211, which is activated to respond to questions about COVID-19 and is manned 24 hours-per-day, seven days a week. Patients can also visit the Maine CDC for up-to-date information on the virus: www.maine.gov/dhhs/mecdc/

If someone is experiencing fever, an unproductive cough, and difficulty breathing they should call their healthcare provider. If they are going to see their healthcare provider, and they suspect they have COVID-19, they need to call them first and notify them that they are coming so they can prepare for their arrival.

If they are exhibiting symptoms, and suspect they have COVID-19, and they need emergency care, they should call the Emergency Department and talk to the Nurse Supervisor so they can prepare for their arrival. [The Down East Community Hospital Emergency Department may be reached by calling 255-3356. Call 911 in the event of an emergency.]

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