By Michael Rothermich, MD
Hermann Area District Hospital and its clinics continue to offer COVID 19 testing in the parking lot at Southwest Medical Associates most days. Testing continues to be by appointment only, and if you want or need a test, call (573) 486-2118) from 8-5 M-F and Sat from 8-12 for more information or to have an appointment set up.
For most of our tests, my staff and I perform a rapid COVID-19 ANTIGEN test. However, we continue to offer PCR testing, if that test is needed or preferred by your ordering provider. Our ANTIGEN test so far appears very accurate, but uses a different technology than PCR and in selected cases we send a second sample to the State lab for confirmation.
Patients seem to appreciate having results in about 20 min (rather than 1-2 days for state PCR testing, or 2-5 days for commercial PCR lab testing).
Either test (ANTIGEN or PCR) requires a deep nasopharangeal sample for best accuracy. For this test a sterile swab has to go in your nose all the way to the back of your throat (typically 3-4 inches). While this is a routine and safe medical procedure, it can be uncomfortable.
Proper specimen collection is a key component to test accuracy, and to ensure the sample is collected correctly (all the way to the back of the throat), I personally have performed all of our off site COVID sample collection since the beginning of the pandemic. I have over 20 years of medical experience with similar procedures and now have collected several hundred of these nasopharyngeal samples. Most patients tell me that our testing is less uncomfortable than tests done at other locations and for patients being tested for the first time, most report it “wasn’t as bad as they thought it would be.” The children I’ve had to test (as young as several months old) certainly don’t like having something put up their nose, but usually we’re friends again after it’s over (although my bribes with a lollypop may help that some).
Before I collect a sample, I ask the patient to face front, tilt their head back as far as they comfortably can, and then I slowly and gently insert the swab. Everyone’s anatomy is a little different, and sometimes I have to switch to the other nostril, but I won’t force the swab if I encounter resistance. Once inserted to the proper depth, it needs to stay there for about 15 seconds, then is gently removed. Then the patient just has to wait for me to come back with their results in a few minutes.
One place we have found rapid testing to be especially useful is for patients without known exposure, who get symptoms that could be COVID related, but are more likely something else (eg cough from their summer allergies) and need a negative test as soon as possible so their employer allows them to get back to work. This has become a significant portion of the patients we test many days, and helps ensure workplaces in our county can balance keeping their workforce healthy, with having enough people at work to get stuff done.
With multiple new cases in our county, we have seen an increase in patients wanting to be tested, but so far, nearly all have tested negative (see updated results posted by Gasconade County Health Department.) When we do have a positive at our testing center, I inform the patient, give instructions regarding need for strict quarantine, and answer any questions they might have. We then immediately contact both the Gasconade County Health department and Missouri Department of Health and Senior Services, but as our testing center operates in the late afternoon, updated case counts are not reflected until the following day.
Please wear a face covering to help protect others, in case you’re infected but don’t have symptoms.
Keep the covering on your face the entire time you’re in public.
Don’t put the covering around your neck or up on your forehead.
Don’t touch the face covering, and, if you do, wash your hands.
Additionally, Hospital Administrator Dan McKinney has reported that HADH still requires a physician's order in order for testing to be done, since Hermann is not part of the areas that have sufficient testing material to allow testing for all residents.