Changes and daily updates in the wake of COVID-19 have become a way of life in the world. As a trusted resource for healthcare information, Marshall Medical Center’s goal is to pass along updates as they become available.

In addition to regular updates to media outlets, MMC also encourages the residents of Marshall County and the surrounding area to stay tuned to the Marshall Medical Centers social media outlets.

Additionally, up-to-the-minute information is made available at MMC’s website’s “COVID-19 Resource Page.”

In particular, there is a link on the resource page that will direct visitors to the Alabama Department of Public Health website for information about the most recent number of confirmed cases, by county, in the State of Alabama.

Just exactly what is the Coronavirus?

According to the Stanford Medicine website, coronaviruses are a family of viruses named for the crown-like spikes found on their surface. They carry their genetic material in single strands of RNA, rather than DNA.

In a number of clinically important viruses, RNA, rather than DNA, carries the viral genetic information.

These viruses infect a variety of human and animal hosts, causing mostly upper-respiratory symptoms like those of the common cold. Until recently, two coronaviruses have been known to have caused severe disease in humans: Middle East Respiratory Syndrome – or MERS, and Severe Acute Respiratory Syndrome – or SARS.

The third example is SARS-CoV-2 – the virus currently circulating

Change in testing for COVID-19

On March 23, the Alabama Department of Public Health announced a major change in testing for COVID-19 criteria based on federal guidelines to ensure those most at risk receive testing.

Previously, testing was based on the clinical judgment of the ordering provider, however, the new guidance states the only tests to be run by the state lab (Bureau of Clinical Laboratories, BCL) are ones in which the patient:

• Is symptomatic with at minimum measured or subjective fever or cough or shortness of breath, and;

• Is hospitalized;

• Is immunocompromised or has co-morbidities, or;

• Is age 65 years or older, or;

• Is a healthcare worker, or;

• Is associated with a long-term healthcare facility.

Individuals with no symptoms should not be tested. Testing also is not recommended for persons with mild symptoms. Everyone is encouraged to stay home, practice home care and call if symptoms worsen.

As of the morning of March 25, Marshall Medical Centers had administered 131 tests.

What does the COVID-19 test entail?

A long Q-tip inserted through the nose of the person being tested in order to reach the “nasopharyngeal region.”

This is where the cells are collected. This is the area, if you open your mouth to say ‘Ahhh’ and look straight back, that’s the region where the respiratory tract meets the back of your mouth.

This is the area where the virus attaches itself, latches on and starts replicating. The test is not painful and should take 10 seconds or less.

“Right now, specimens are being sent to one of three outside testing labs, depending on what day of the week the test is collected, current turnaround times and how quickly results are needed (for more urgent patients),” said MMC pulmonologist Dr. Christopher Manganaris. “The labs all use a reverse-transcriptase polymerase chain reaction (RT-PCR) in testing the specimen.”

RT-PCR explained

The RT-PCR technique rapidly identifies the presence of viral RNA in the swabs from the noses of potentially infected people. RT-PCR uses short stretches of DNA, called primers, which bind tightly and specially only to matching sequences in SAR-CoV-2 RNA.

An enzyme, called reverse transcriptase then converts the viral RNA into complementary DNA, and, as the reaction continues, an enzyme, called polymerase is used to generate billions of DNA copes that can be detected by fluorescently tagged molecules called probes.

If the patient tests positive for COVID-19 and is clinically stable, not oxygen-deficient or significantly short of breath, the patient will be sent home to self-quarantine for 14 days and symptom free for at least 72 hours.

If the patient tests positive for COVID-19 and is oxygen-deficient or significantly short of breath, the patient will be admitted to the hospital and treated appropriately. If the patient improves clinically during the hospitalization then they will be discharged home to finish out their quarantine.

Current recommendations advise quarantine for 14 days and be symptom free for 72 hours without the need of fever-reducing medication.

MMC updates

Patients at Marshall Cancer Care Center and/or the Marshall Professional Center should be aware of the following changes:

• The Marshall Imaging Center is open only to PET/CT scans. Screening protocols are in place. No visitors are permitted.

• The Marshall Wound Healing Center is open. Screening protocols are in place. No visitors are permitted.

• Marshall Rheumatology – Patients are asked to please call before appointments – 256-894-6700.

• Marshall Sleep Disorders Center is closed through April 4 with plans to re-open on April 5.

• Northeast Alabama Vein and Vascular Specialist – business as usual. Screening protocols are in place. No visitors are permitted.

• Marshall Cancer Care Center is open. Screening protocols are in place. No visitors are permitted. Exceptions will be made for extraordinary circumstances.

Employees

Marshall Medical Centers’ employees are being screened for fever as they report to work in an effort to protect the wellbeing of our patients and staff.

Even though MMC is caring for patients who are sick and may have been exposed to the virus, Marshall Medical is still safe for individuals who need care. MMC is taking the outbreak very seriously and taking every possible precaution to protect patients and staff.

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