Philadelphia Medicine Fall 2020 - 19

p h i l a m e d s o c .o rg

'Why not protect everybody? Why not assume everybody is positive
and treat them that way as opposed to having perhaps a false sense of
security that this patient is OK, we can relax our protocols.'
- Dr. George A. Poporad, Infectious Disease Associates PC, Southampton, Pa.

Because there is no COVID-19 vaccine released as of press time, the inexpensiveness, the fast turnaround time is just as important
Johnson said the general public is hesitant to seek out routine elective as the sensitivity of the test."
care "because maybe they could be exposed to COVID-19 at that
Poporad said that COVID-19 testing is not 100% accurate and
site. Some of this is going to be public education in how seeking many people are not doing the social distancing. As a result, he said,
health care is actually safe."
"you have to assume that anybody who walks through the door is a
Staying safe, as usual, will involve masking, social distancing, calling potential case which can be contagious. How do you mitigate the risk?"
ahead, making appointments, "those types of things," Johnson said.
To mitigate risk, Poporad's clinic allows only one person in the
waiting room.

Organizational protocols
It is up to each organization's protocols to determine whether a
COVID-19 test would be required before elective surgery, according
to Poporad.
"It depends on the protocols of the institution, whether they
require a negative COVID test before they have the surgery," he said.
"Now there are protocols within the hospitals, meaning that when
someone gets admitted to the hospital, everybody gets a COVID
test. When they go from institution to institution, from say the
hospital to rehab, they get a COVID test. So that is operational.
Within the surgery centers, from what I understand, it appears it is
up to the individual institution and individual physicians whether
they do the COVID testing or not, with the caveat that a negative
COVID test doesn't mean you are negative."
It is safe to operate on the assumption that almost anybody can
test positive, so why take chances?
"Why not protect everybody?" Poporad said. "Why not assume
everybody is positive and treat them that way, as opposed to having
perhaps a false sense of security that this patient is OK, we can relax
our protocols.
"We have to have it that way," Poporad said.
"That's the goal," he said. "What is maybe a higher goal is to
make the test sensitive enough so that you get everybody tested, it's
cheap and with fast turnaround time. If you can do that, I think

"Everybody else has to wait outside," he said. "Temperatures are
taken. Masks are worn. And a history is taken about any possible
exposure."
For some physician offices, the protocols are up to the discretion
of the surgeon.
"Some are requiring COVID testing before the procedure," Poporad
said. "That is up to individual physicians unless the surgery center
itself has that protocol. Some do and some don't."

No transmission
Johnson said the health department does not see transmission
of this infection within hospitals.
"When the pandemic first started, we saw lots of transmission
within the health-care community," she said. "It was from provider
to provider, from provider to patient, from patient to provider.
That was clearly a high level of transmission. And we had so many
health care staff that were out. Not only was there a safety issue from
COVID-19 in the hospitals, there were so many professionals either
out isolated or under quarantine.
"That's pretty much reversed now. We monitor all COVID-19
cases in the city, to do the investigation and contact tracing, and
we are not seeing any suggestion that this infection is being spread
within hospitals or health-care settings, with one exception we see
occasional cases popping up in nursing homes. We are not seeing
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Fall 2020 : Philadelphia Medicine 19

Philadelphia Medicine Fall 2020

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