Operating in a newly refurbished building that for years was Dr. Bill Owings’s office across the parking lot from the Bibb Medical Center main entrance, BMC at Home combines the “old-school” practice of doctors making house-calls with a modern approach to primary medical care. In a simplified sense, it’s like taking the doctor’s office and staff to the patient’s home.
Caregivers include a physician, a nurse practitioner, two RN’s, and two social workers. The basic process functions just like going to your doctor for an office visit, except the visit takes place in the patient’s home. All the layers of modern medical practice are in place, such as the nurse evaluating and drawing lab work, for example. House calls are no longer an old country doctor showing up with a stethoscope and a leather bag full of tongue depressors.
Not just anyone can be an “at Home” patient. There are criteria that must be met, such as being on Medicare. This means most of their patients are elderly who cannot leave the home easily. As for the newly added service of being tested for COVID-19 without leaving your home? That requires the same qualifications to be tested as elsewhere.
I spoke with Karlee Johnson, CRNP, and Dawn Jones, RN, about the new services available to Bibb County residents since October. Johnson heads the team, and sees the bulk of the patients, which now total 88 regular patients. The COVID testing “is not for our regular patients,” Johnson said. To be tested at home, someone who thinks they need a test would call the BMC COVID Hotline (205-926-3302) and speak to a nurse to see if they qualify for a test.
So far, they’ve tested four individuals, according to Jones.
“If we do think they have COVID-19, we want to keep them at home. We don’t want to bring them in to contaminate anyone else,” Johnson added, “We’ve had a flood of people call, but they just don’t meet the criteria.” The criteria put in place by CDC and Alabama Department of Public Health (ADPH) say you must be displaying symptoms as well as having come in contact with someone known to have the virus or who has recently traveled somewhere known to be a hot-spot for cases. These restrictions are in place in order to conserve the use of test kits, as there are not enough to go around. It’s not for screening to see if someone has it, just because they’re curious or scared.
“The majority of people who will have it will have mild symptoms, in contrast to what people have been instructed will happen, which is the absolute worst case scenario. What we are trying to do is conserve the tests for the people who are more likely to have negative outcomes if they contract it – such as elderly and people who have multiple chronic conditions,” Johnson said.
When asked about the occurrences now being seen of children and younger adults contracting serious cases, Johnson explained that as viruses spread we see more and different trending effects. While China did not see many cases in children, other regions have seen more. “Which is why we need to decrease the potential spread of the virus,” she added. Everyone needs to stay home if possible, she said.
“The best analogy I’ve seen is to think of the virus like glitter. Like, after Christmas you keep finding glitter all over the place for weeks. Imagine you’re covered in glitter, and you’re trying to keep from getting the glitter on other people or things,” Johnson explained, “Everyone should assume they have it. It’s not about protecting yourself, it’s about protecting your grandmaw and your kids. We have to start thinking more about other people in this.
“There are some people who are so scared and taking it to the Nth degree, and there are people who don’t think it’s a thing to be worried about,” she went on, “There are people who want to be tested just because they’re scared they have it. But, just because you test negative today doesn’t mean you won’t get it tomorrow. After you’ve had your nasal swab, you could walk out of that office and contract it.”
“You could be positive before you get your results back saying you’re negative,” Jones added.
“Right,” Johnson continued, “A test is only good for the day it was given … A negative test does not mean you don’t have COVID-19. So, to overuse them, like the people who are going in droves to Birmingham to stand in line for hours, they’re actually more likely to catch it standing in line.”
The test kits should be reserved for people potentially in danger of a serious condition, who are presenting symptoms, so that medical professionals can know how to treat the patient. There are other illnesses that could be mistaken for COVID-19, which would not be treated the same way.
The test numbers we see updated daily are results of tests administered 3-7 days ago, as that is the average turn around for lab testing of samples. So while we continue to see cases rise, we have not yet seen the effect of social distancing, because it takes time for the data to process through. It could take weeks or more to “flatten the curve.” Medical professionals such as Jones and Johnson urge everyone to practice social distancing – even if you aren’t afraid of getting it yourself. Think about the other people you come in contact with, they said. Stay away from each other, wash hands, disinfect. If you present symptoms, call the BMC hotline to be evaluated. And don’t panic.
“We need people to be smart, not scared,” Johnson concluded.
[…] in patient load,” Karlee Johnson said. Johnson is a CRNP with BMC at Home in Centreville. I spoke with her recently about the novel corona virus crisis and how it has effected daily interact…. How the crisis is affecting her profession is an entirely different set of questions, […]