The view from the front line of the COVID-19 fight in St. Tammany

A St. Tammany Health System colleague collects information at the Health System’s Mandeville drive-through testing site for COVID-19 coronavirus on Tuesday, March 24, 2020. (Photo by Tim San Fillippo)

By Mike Scott, mscott@stph.org

Drive-throughs: They’re not just for hamburgers and daiquiris anymore.

Every weekday for the past two weeks, St. Tammany Health System has been operating a drive-through COVID-19 testing center at its Mandeville Diagnostic Center, swabbing more than 300 patients so far who have received doctor’s orders to be tested for the novel coronavirus.

The first of its kind on the Northshore, and among the first of its kind in the state, the STHS drive-through – which is conducted entirely curbside -- is being hailed by STHS leadership as an example of the sort of innovation, nimbleness and efficiency on which employees of the Health System pride themselves.

In addition to keeping potentially infected people out of doctors' waiting rooms, the drive-through system has also proven convenient, winning praise from the dozens of patients who pass through daily, said Dionne Williams, director of the St. Tammany Physicians Network and one of the organizers of the Mandeville drive-through operation.

“They are very grateful,” Williams said. “They are very grateful for us being here.”

She was talking shortly before the drive-through clinic – which operates from 3 to 7 p.m. weekdays -- opened up on a recent Tuesday. On this day, a line of vehicles had already begun forming fully an hour before the testing center opened.

By the time 3 o’clock rolled around, a dozen were already queued up.

“From start to finish, it probably takes about 20 to 30 minutes per car that comes through,” Williams said. “As you can see, we have a long line right now, and, so, in the beginning, usually from the 3-to-4:30 timeframe, there usually is a little bit of a longer wait, just because we have so many cars coming for that time.”

One of the guiding principles of the system as designed is to eliminate the exchange of any potentially contaminated objects -- pens, papers, identification cards or anything else – between patients and healthcare workers.

So, the first stop for patients is a tent at which a masked STHS employee collects their name, date of birth and the name of the doctor referring them. Those details are written on a Post-It note and stuck to the windshield of the vehicle.

From there, the driver is asked to proceed to a second checkpoint, where additional STHS staffers relay information from the Post-It note to staffers in the building. They verify that doctor’s orders have been received, a crucial step in the process given the relative scarcity of testing kits.

“The backup starts when there’s not an order,” said Shannon Green, the department head of STHS Patient Access who on this day was one of the people staffing the second checkpoint. “If they don’t have one, we tell them to get out of line, go to the doctor and get an order and come on back.”

If all the requisite paperwork is in order, patients are sent to the final checkpoint. It’s also the busiest checkpoint. It’s there that a team of several nurses – decked out in head-to-toe protective gear – conduct the tests through vehicles’ windows.

Before a COVID test is administered, however, patients are tested for flu, which exhibits similar symptoms as COVID-19. The flu test is also both easier and quicker to process.

While patients wait for the flu test result, which usually takes around 15 to 20 minutes, they’re instructed to drive off-site and wait for a text message from the clinic.

“If it is a positive result, we tell them go home and their physician will contact them with measures to take for the flu,” Williams said. “If it’s negative, they return back here for the COVID test.”

That consists of a nasopharyngeal swab, which goes deeper into the sinuses than a flu test. The test is then sent off to be processed.

Because that can take days, patients suspected of having COVID-19 are instructed to go home, isolate themselves and treat the symptoms until test results come back. If a suspected COVID patient begins experiencing chest pains or difficulty breathing, they are told to contact their doctor’s office immediately.

On Tuesday, the drive-through process -- which was staffed by 13 STHS employees plucked from a variety of St. Tammany Health System departments – was working like a well-oiled machine.

That wasn’t always the case. The whole process was dreamed up and implemented in the course of 48 hours, so, naturally, there were wrinkles to be ironed out. But on-the-fly improvisation is nothing new to healthcare workers, Williams said.

“It takes a team,” she said. “It’s interesting that we were able to kind of come up with the idea and within 48 hours really have a team ready to go on (the first) Monday. I think the biggest piece and part is to be flexible and fluid and be able to say, ‘That didn’t work. Let’s fix it and move on.’

“There have been (changes),” she continued. “We’ve just been learning every single day: ‘This isn’t working.’ ‘This efficiency is possible.’ ‘Let’s put this process in place.’ And so while last week was a lot of change and ‘let’s try this change’ and ‘let’s try this,’ what we saw yesterday in place, and hopefully today in place, really is a smooth process.”

Aside from recent high temperatures, which are exacerbated by the layers of protective gear healthcare workers must wear when dealing with a suspected COVID patient, those staffing the drive-through were in high spirits as they worked toward their common goal. 

“The goal is to take care of everybody we can possibly take care of,” Green said.

Visit STPH.org/COVID-19 for the latest information on coronavirus in St. Tammany Parish.