Private labs see increase in wait times for Covid-19 testing results

Most Pittsburgh-region hospitals aren’t seeing an increased lag in Covid-19 test results, although an Allegheny County health official said an extended timeline for some results has occurred due to a crush of testing at the national level.

Allegheny County Health Department Director Dr. Debra Bogen brought up the lag Tuesday afternoon as the county and the rest of southwestern Pennsylvania see the highest case numbers so far in the pandemic. Another 230 cases were reported Tuesday and 1,449 cases since the beginning of July. There were 1,997 new test results overnight with an 11% positivity rate.

“For a while our tests were returning very quickly, usually within two or three days. I have heard about a lag in results recently,” Bogen said. “I think that’s because the national labs are overwhelmed with the new surge in cases.”

Two major test providers, Quest Diagnostics and LabCorp, on Wednesday acknowledged increases in testing around the country has led to a longer-than-normal wait time for results. Quest said priority patients’ wait times are still one day but the average turnaround times for all others have gone from 3-5 days to 4-6 days recently. LabCorp said it could take 1-2 days longer for test results to come in.

“In recent weeks, we have seen a steady increase in demand for Covid-19 molecular testing, and we are doing everything we can to continue delivering results in a timely manner while continually increasing testing capacity,” a LabCorp spokeswoman said.

Neither UPMC nor Allegheny Health Network, the region’s two biggest players in health care, have reported any lag in test results. UPMC, which developed its own test and has deployed it across its system by the tens of thousands, generally gets results back within 24-48 hours, said UPMC spokesman Paul Wood.

AHN also has not seen a lag in testing, and most patients receive their results within 3-5 days. It administers about 300 tests per day across its testing sites and its mobile unit but doesn’t include inpatient tests.

“That number has increased notably since the first two weeks of June where we saw roughly 130 tests on average, per day,” said AHN spokeswoman Nikki Buccina.

St. Clair Hospital in Mt. Lebanon uses a combination of rapid-result tests in its own lab where the results come within the hour and its partnership with the Mayo Clinic for the bulk of its tests, said Dr. John Sullivan, St. Clair’s chief medical officer. There’s been no lag among St. Clair Hospital patients, but Sullivan said he’s heard in the community of some delays elsewhere.

The partnership with the Mayo Clinic has helped St. Clair maintain its testing turnaround times throughout the pandemic, said Meredith Borst, executive director of strategic initiatives at St. Clair.

“We definitely have seen an increase in the number of tests that have come through, but in our turnaround times, they pretty much are constant,” Borst said.

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Region’s top doctors make plea to community

The chief medical officers of the region’s big hospitals and health systems and the head of the Allegheny County Health Department on Tuesday afternoon released a letter to the community and businesses urging southwestern Pennsylvania to come together to stop the spread of Covid-19 and protect the economy.

The letter was signed by the chief medical officers of UPMC, Allegheny Health Network, St. Clair Hospital as well as Health Director Dr. Debra Bogen. It comes as Allegheny County struggles with more than 125 new cases daily since late June, including 206 reported Tuesday along with six deaths and seven hospitalizations.

“This public health crisis is unlike anything most of us have ever experienced in our lifetimes, and it is only through a collective focus and response by health care leaders, our business community and everyone who calls western Pennsylvania home that we can manage this pandemic in a manner that minimizes its serious associated health risks while also protecting the short- and long-term economic well-being of our region,” the letter said.

It was a show of solidarity between the health care systems during the Covid-19 pandemic, which has led to regular meetings of the systems’ chief medical officers and chief nursing officers as well as other collaboration. Each of the hospitals and health systems have been impacted by the Covid-19 pandemic, and each have had patients.

“We remain ready to provide care for patients — but we also need you to take some important steps to help reduce the spread of Covid-19 in our community,” the letter read. “We believe it’s imperative to not lose our focus on the basic steps that allow each of us to help all of us — protecting ourselves, our friends and our family members, particularly those who are most vulnerable.”

Those include:

  • Wearing protective masks, and correctly
  • Washing hands regularly
  • Cleaning high-touch surfaces regularly
  • Practicing physical distancing everywhere
  • Staying home and calling a doctor if you get symptoms of Covid-19
  • Staying home if you think you have been exposed to Covid-19 and calling a doctor for advice

The letter ends with a version of Bogen’s continual advice to be kind, prescribed throughout the pandemic.

“A little more thoughtfulness, understanding and tolerance for the inconveniences we are experiencing may be the best medicine of all,” the letter said.

Here is the letter in full:

A letter from local health care leaders:

Over the past three months, our organizations have proudly come together in an unprecedented fashion to address the enormous challenges we have faced as a community due to the novel coronavirus (COVID-19) pandemic. This public health crisis is unlike anything most of us have ever experienced in our lifetimes, and it is only through a collective focus and response by health care leaders, our business community, and everyone who calls western Pennsylvania home that we can manage this pandemic in a manner that minimizes its serious associated health risks while also protecting the short- and long-term economic well-being of our region.

Despite success, the virus remains a threat. In recent days, the number of COVID-19-infected patients has risen locally and across the country. We remain ready to provide care for patients — but we also need you to take some important steps to help reduce the spread of COVID-19 in our community.

We believe it imperative to not lose our focus on the basic steps that allow each of us to help all of us — protecting ourselves, our friends, and our family members, particularly those who are most vulnerable. The latter includes the elderly, but also people with other compromising medical conditions — and it isn’t always easy to know who those individuals are at a glance. So we all must do the simple things that matter the most in helping to prevent illness and death during this pandemic — for the young, our seniors, and everyone.
As health care leaders, we ask the people of this region to:

  • Wear protective masks whenever you’re around others and wear them correctly (cover your nose and mouth) … do it for yourself, and do it for others.
  • Wash your hands and clean high-touch surfaces often … make it a habit.
  • Practice physical distancing everywhere, staying 6 feet apart.
  • If you have symptoms that you think could be COVID-19 or a respiratory illness, stay home and call your doctor.
  • If you feel you may have been exposed to COVID-19, but have no symptoms, stay at home and call your doctor. That allows the best planning for possible testing and care.
  • Finally, be kind to each other. A little more thoughtfulness, understanding, and tolerance for the inconveniences we are experiencing may be the best medicine of all.

Thank you. Be safe and well.

Donald Whiting, MD
Chief Medical Officer
Allegheny Health Network

Donald M. Yealy, MD
Senior Medical Director
UPMC

Carol Fox, MD
Chief Medical Officer
Excela Health System

John Six, MD
Chief Medical Officer
Washington Health System

David Rottinghaus, MD
Chief Medical Officer
Butler Health System

John Sullivan, MD
Chief Medical Officer
St. Clair Hospital

Michael Cratty, MD
Chief Medical Officer
Heritage Valley Health System

Debra Bogen, MD
Director
Allegheny County Health Department

Ali Sonel, MD
Chief of Staff
VA Pittsburgh Health Care

By Paul J. Gough  – Reporter, Pittsburgh Business Times

Link:  https://www.bizjournals.com/pittsburgh/news/2020/07/07/regions-top-doctors-make-plea-to-community.html

2 local hospitals named in IBM Watson top 100

PITTSBURGH — St. Clair Hospital and West Penn Hospital have been named among a prestigious ranking of top-performing hospitals by IBM Watson Health.

They were the only two hospitals named in the Pittsburgh region and two of four hospitals in the entire commonwealth. Fortune/IBM Watson Health’s 100 Top Hospitals list takes into account clinical outcomes, financial health and patient satisfaction across 3,134 hospitals in the United States.

St. Clair was named among large community hospitals in the country and West Penn Hospital as teaching hospitals in the nation.

IBM Watson praised the hospitals operations and efficiency and said that if all the health care facilities in the country followed their lead it would save 106,000 lives and reduce health care by $8.3 billion. Results of the study are published in Fortune Magazine.

Link:  https://www.wpxi.com/news/business/2-local-hospitals-named-ibm-watson-top-100/BBNGWX3KJJGSDAWMAYPPGMPQRM/

 

2 local hospitals named in IBM Watson top 100

St. Clair Hospital and West Penn Hospital have been named among a prestigious ranking of top-performing hospitals by IBM Watson Health.

They were the only two hospitals named in the Pittsburgh region and two of four hospitals in the entire commonwealth. Fortune/IBM Watson Health’s 100 Top Hospitals list takes into account clinical outcomes, financial health and patient satisfaction across 3,134 hospitals in the United States.

St. Clair was named among large community hospitals in the country and West Penn Hospital as teaching hospitals in the nation.

IBM Watson praised the hospitals operations and efficiency and said that if all the health care facilities in the country followed their lead it would save 106,000 lives and reduce health care by $8.3 billion. Results of the study are published in Fortune Magazine.

“From small community hospitals to major teaching hospitals, the organizations on this list demonstrate a relentless commitment to high-value, patient-centered care and innovation,” said Dr. Kyu Rhee, VP and chief health officer at IBM Watson Health in a statement. “It is clear that the COVID-19 crisis will be a catalyst for reinvention, and we believe these top performing hospitals are positioned to emerge stronger and smarter out of this crisis.”

Since the Top 100 Hospitals list was established in 1993, West Penn Hospital made the list six times.

“This honor again is reflective of the extraordinary talent and dedication of our physicians, nurses, volunteers and employees at every level,” said West Penn Hospital President Ron Andro.

St. Clair has won the award five times since 2012 and three times in a row, only one of 32 hospitals that have done that. It has also been honored by U.S. News & World Report, Leapfrog Group and Healthgrades, among others.

“At a time when great health care has never been more important, we’re proud of the health care heroes who’ve made St. Clair one of the nation’s highest quality hospitals,” said Dr. John Sullivan, chief medical officer of St. Clair Hospital.

By Paul J. Gough  – Reporter, Pittsburgh Business Times

Link:  https://www.bizjournals.com/pittsburgh/news/2020/07/01/2-local-hospitals-named-in-ibm-watson-top-100.html?ana=wpxi

St. Clair Hospital Named One Of Nation’s Top 100 Hospitals In 2020

MT. LEBANON (KDKA) — Local healthcare heroes got a little more recognition recently.

St. Clair Hospital was found to be one of the nation’s top 100 hospitals by IBM Watson Health.

“Hospitals, health systems and the dedicated clinicians and staff who work at these organizations have emerged as true heroes of the COVID-19 pandemic and we are grateful to be able to recognize these extraordinary leaders at this time,” said Kyu Rhee, M.D., M.P.P., Vice President and Chief Health Officer, IBM Watson Health. “Organizations on this list demonstrate a relentless commitment to high value, patient-centered care and innovation.”

The hospital has received this distinction five times in total since 2012 and has consistently been included in this list for the last three years. According to a spokesperson from St. Clair Hospital, only 32 hospitals have been included on the list for three consecutive years.

“At a time when great health care has never been more important, we’re proud of the health care heroes who’ve made St. Clair one of the nation’s highest quality hospitals,” John T. Sullivan, M.D., M.B.A., Chief Medical Officer at St. Clair, said.

 

Link:  https://pittsburgh.cbslocal.com/2020/06/30/st-clair-hospital-top-us-hospital/?fbclid=IwAR0jGkV7UDKo-iM5-Ymy8xGVMqdm9pv8J-Fy0VkPEf4XdM-4Rjsj7M0vddo

St. Clair Hospital Named Among 100 Top Hospitals

IBM Watson Health today named St. Clair Hospital one of the nation’s 100 Top Hospitals for 2020. This marks the third consecutive year and fifth time since 2012 that St. Clair has won this prestigious honor.

The 100 Top Hospitals are selected annually based solely on an objective analysis of multiple measures of patient safety, quality, patient satisfaction, and operational efficiency. All acute care hospitals in the United States are evaluated for potential inclusion on the list.

Joining St. Clair are such notable institutions as Stanford, UCLA, the University of Florida, and NorthShore University Health System (Evanston, Ill.). St. Clair is one of just 32 hospitals to make the list in three consecutive years.

“Hospitals, health systems and the dedicated clinicians and staff who work at these organizations have emerged as true heroes of the COVID-19 pandemic and we are grateful to be able to recognize these extraordinary leaders at this time,” said Kyu Rhee, M.D., M.P.P., Vice President and Chief Health Officer, IBM Watson Health. “Organizations on this list demonstrate a relentless commitment to high value, patient-centered care and innovation.”

John T. Sullivan, M.D., M.B.A., Chief Medical Officer at St. Clair, said, “At a time when great health care has never been more important, we’re proud of the health care heroes who’ve made St. Clair one of the nation’s highest quality hospitals.”

In an accompanying study, IBM Watson Health notes that, if all hospitals in the nation performed at the level of the 100 Top Hospitals, more than 106,000 lives could be saved, 49,000 patients could be complication free, and the cost of health care could be reduced by $8.3 billion.

Today’s announcement continues a tradition of excellence that is unsurpassed in western Pennsylvania. In recent years, St. Clair has received accolades from U.S. News & World Report, the Leapfrog Group, the Centers for Medicare & Medicaid Services (CMS), CareChex, Healthgrades, and others. St. Clair is western Pennsylvania’s exclusive member of the Mayo Clinic Care Network.

 

About St. Clair Hospital

St. Clair Hospital is a nationally recognized integrated health system with more than 2,500 employees and 600 physicians serving 500,000 residents of southwestern Pennsylvania. In 2016, it became a member of the Mayo Clinic Care Network. As the region’s largest independent hospital, St. Clair participates with all major insurers.

Researchers Say Drug Reduces Deaths In Severely Ill Coronavirus Patients

PITTSBURGH (KDKA) — Researchers are hopeful about a new drug to treat coronavirus patients.

“Up until now, nothing has been shown to be beneficial,” says Dr. Amit Kaura, AHN pulmonary critical care and medical director of medical ICU West Penn Hospital. “This is our first real breakthrough in terms of battling COVID.”

It’s an inexpensive, common medicine called dexamethasone.

“An IV or an oral steroid medication that we give for its anti-inflammatory properties,” said. Dr. Kaura.

In a British study, researchers randomly assign patients to get dexamethasone or the usual care. They compared the 2,000 patients who got the drug to the 4,000 patients who did not.

In patients on a ventilator, the drug group had a 35 percent lower death rate.

In patients who needed oxygen but not a breathing machine, the drug group had a 20 percent lower death rate.

For patients who did not need oxygen, there was no difference.

“….which is pretty statistically significant, as well as clinically significant,” Dr. Kaura says. “A third reduction means that there will be a lot of lives that will be saved as a result of using dexamethasone. The hospitals will make this part of their standard of care.”

While the study has not yet been peer-reviewed and published, the researchers stopped enrolling patients because the results are so clear.

“The manuscript for the study has not been released as of yet and it does make some people uneasy,” Dr. Kaura says but points out, “It’s not every day you have studies that are stopped because of overwhelmingly positive results.”

Local doctors have already been using steroids to treat coronavirus patients.

“The major factor that really turned him around was we started steroids,” says Dr. Gregory Fino, an intensive care doctor at St. Clair Hospital, in an April 24 report about a severely ill patient who survived.

There are other drugs in this class that could be used, as well.

“As of right now, dexamethasone was the one that’s been studied. But I think there will be some cross-play between other steroids. The dosages will vary, as well as the frequency,” says Dr. Kaura.

Dexamethasone also has potential side effects that can be serious, including an increased risk for infections.

“Initially, when the COVID pandemic started, there was a scare in using steroids,” Dr. Kaura says.

In the trial, these superimposed infections did not occur.

This type of drug can make your blood pressure and blood sugar go up; it can affect your bones, your eyes, your mood and your body chemistries. So it should be used only for appropriate patients and with caution.

Link:  https://pittsburgh.cbslocal.com/2020/06/17/dexamethasone-and-coronavirus/

CDC Recommends Newborns Be Tested For Coronavirus Twice And Separated From Mothers With Confirmed Or Suspected COVID-19

PITTSBURGH (KDKA) — The CDC has new guidelines for newborns of mothers with or suspected of having coronavirus.

“The recommendation is the baby be tested sometime around 24 hours after birth. And if the test is negative, they’re recommending a second test at 48 hours,” says Dr. Paul Weinbaum, an obstetrician at the Allegheny Health Network.

And these babies must be kept apart.

“The baby should not only be separated from other babies but perhaps separated from the mother if that’s feasible,” he said.

In a busy delivery ward, this could pose some issues.

But if the mother wears a mask and washes her hands thoroughly and frequently, there can be allowances.

“There is leeway in the recommendations for keeping the baby in the same room, provided it’s a large enough room that you can put the 6-foot distance,” Dr. Weinbaum said.

Dr. Weinbaum says most of the transmission of coronavirus to babies happens after birth.

“After the babies are born, they may be exposed to respiratory droplets,” Dr. Weinbaum said.

Luckily, test results that used to take days now come back in less than 12 hours.

If the baby’s tests are negative, the separation is over.

But what happens if a baby tests positive?

“They don’t recommend keeping these babies in the hospital,” says Dr. Weinbaum.

Parents are told what to watch for.

“At the first sign of symptoms, perhaps respiratory or otherwise, they are to, of course, bring the children back to be evaluated,” says Dr. Weinbaum.

Premature babies are at the highest risk for severe illness, so even full-term babies who test positive are likely to do well.

Dr. Weinbaum says at the Allegheny Health Network, they are not screening all mothers, and he has not had any positive cases at the time of delivery.

The few cases he has seen were expectant mothers earlier in pregnancy, who tested negative by the time they delivered.

St. Clair Hospital released a statement, saying:

“St. Clair Hospital is testing newborns born to moms who are either COVID-19 positive or are suspected of being positive. St. Clair is following American Academy of Pediatrics guidelines for the testing.”

UPMC released a statement, saying:

“UPMC Magee-Women’s Hospital follows the current CDC guidelines. NICU babies born to mothers with confirmed COVID-19 are tested for COVID-19.”

‘Limited Resource’: Many Factors Go Into Determining Who Gets Doses Of Remdesivir Drug Distributed To Pa. Hospitals

PITTSBURGH (KDKA) — When there isn’t enough medicine to go around, who gets it?

“It’s not easy to have to tell your patients or your patient’s family that you might not have enough drug for them,” Erin McCreary, an infectious diseases clinical pharmacist at UPMC Presbyterian Hospital, said.

The state Department of Health initially sent 1,200 doses of Remdesivir, an antiviral drug, to 51 hospitals across Pennsylvania. Today, it sent 1,548 doses to 21 hospitals, with 6,390 doses expected to be distributed to 58 hospitals on Monday. The state Department of Health says it received the doses from the federal government.

The only one in our area to get it was UPMC Presbyterian.

“The amount of drug we initially got allocated was enough drug for three patients, for each patient to have a five day treatment course,” said McCreary. “There was a study of 10 days as well, but based on our allocation, we will be giving five day treatment courses for right now.”

“Figuring out a five-day course of it is equal to a 10 day course of it, potentially, extends a limited resource,” Dr. John T. Sullivan, chief medical officer at St. Clair Hospital, said.

Which three patients will get the IV medication? A committee of ethicists, patient representatives, health system leaders and supply chain teams will identify patients similar to the ones in Remdesivir studies, and place them in the lottery.

“Patients should receive the drug within 12 days of symptom onset. Based on the mechanism of action of the drug, it seems to work better if patients get it earlier in the disease,” said McCreary.

As for which hospitals in Pittsburgh would get the drug, the state health department put together a formula taking into account the number of in-patients and the number of patients on ventilators.

The hospitals that didn’t get it are okay with that.

“It’s going to where the active cases are, so that was not surprising at all to us at St. Clair,” says Dr. Sullivan.

“Are you fortunate that you don’t have enough patients that you might need this, right?” says Dr. Nikita Bhanot, of AHN Infectious Diseases.

Other options for getting Remdesivir include clinical studies, and compassionate use for children and pregnant women.

The drug has emergency use authorization from the FDA, but it is not FDA approved yet for COVID-19.

The standard treatment is supportive – meaning that doctors keep vital systems operating with the equipment, medicines and procedures they have.

Besides Remdesivir, patients can get other study drugs, or, if available, convalescent plasma, and drugs to treat overwhelming inflammation.

No one knows when more Remdesivir will be coming.

“In order to allocate resources fairly, something that is very important to understand is your patient burden, and to know when resources are coming in,” says McCreary.

“You anticipate more production will happen and drugs will be available to other centers, too,” Dr. Bhanot added.

“It takes six months to manufacture, mostly due to acquiring raw materials,” Dr. Sullivan says.

An issue affecting the whole country.

For resources that don’t go to everyone, would hospitals share?

“If there was a spirit of sharing, we’d reach out and help each other,” Dr. Sullivan said.

Dr. Sullivan says there’s been no better environment for collaboration in healthcare than this pandemic crisis.

 

Link:  https://pittsburgh.cbslocal.com/2020/05/15/upmc-presbyterian-hospital-coronavirus-treatment-remdesivir-doses/

More Men Than Women Are Dying From COVID-19, Research Shows

PITTSBURGH (KDKA) — Across the world and in the United States, there’s a gender pattern with coronavirus.

“Men are more likely to be hospitalized, get very sick with it and die of it,” says St. Clair Hospital Chief Medical Officer Dr. John T. Sullivan.

In Wuhan, China, up to two-thirds of hospitalized patients are male.

In Italy, nearly 60 percent are male.

Among 6,000 people hospitalized in New York City, 60 percent are male, with two out of every three in intensive care are male.

And the death rate is higher for males in every age group over 20 years old.

Nobody knows why, but when it comes to gender differences, it’s usually related to one of a few things.

“Genetic, hormonal, sociologic differences can explain things,” says Dr. Sullivan.

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